Lasica Aleksandra B, Sheppard Jack, Yu Ruan-Ching, Livingston Gill, Ridgway Nicola, Omar Rohani, Schilder Anne G M, Costafreda Sergi G
NIHR University College London Hospitals Biomedical Research Centre, London, UK; The Ear Institute, University College London, 332 Grays Inn Road, London WC1X 8EE, UK; Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
Ageing Res Rev. 2025 Feb;104:102647. doi: 10.1016/j.arr.2024.102647. Epub 2024 Dec 31.
People with adult-onset hearing loss (AoHL) are at increased dementia risk. In this study, we explore potential aetiological mechanisms by synthesising the evidence on the association between AoHL and neuropathological, cerebrospinal fluid (CSF), blood and imaging biomarkers of dementia.
We systematically searched electronic databases from inception to 30 April 2024 for cross-sectional and longitudinal studies, including quantitative data on the association between AoHL and dementia biomarkers. Study quality was assessed with the Mixed Methods Appraisal Tool (MMAT).
Sixty-six studies reporting 63 cross-sectional and 10 longitudinal analyses were included. Twenty-one studies met all MMAT quality criteria. We report a narrative synthesis due to the heterogeneity of the included studies. In CSF-based or blood-based assays or imaging, five out of six cross-sectional analyses found that AoHL was associated with elevated in vivo tau levels, whilst four out of 17 reported a link with elevated in vivo β-amyloid measures. One longitudinal analysis identified an association between AoHL and a steeper increase of CSF tau, but not Aβ, levels over time. Twenty-five out of 44 cross-sectional and six out of nine longitudinal analyses identified associations between AoHL and grey matter atrophy of the temporal regions, particularly the medial temporal lobe. Studies using other biomarkers had inconsistent findings.
AoHL was usually associated with more temporal regions grey matter atrophy both cross-sectionally and longitudinally, and elevated in vivo tau but not β-amyloid. Increasing atrophy and higher tau, leading to decreased cognitive reserve may be how hearing loss increases dementia risk.
成年后发病的听力损失（AoHL）患者患痴呆症的风险增加。在本研究中，我们通过综合有关AoHL与痴呆症的神经病理学、脑脊液（CSF）、血液和影像学生物标志物之间关联的证据，探索潜在的病因机制。
我们系统检索了从数据库建立至2024年4月30日的电子数据库，以查找横断面研究和纵向研究，包括有关AoHL与痴呆症生物标志物之间关联的定量数据。使用混合方法评估工具（MMAT）对研究质量进行评估。
纳入了66项报告63项横断面分析和10项纵向分析的研究。21项研究符合所有MMAT质量标准。由于纳入研究的异质性，我们进行了叙述性综合分析。在基于脑脊液或血液的检测或影像学研究中，六分之五的横断面分析发现AoHL与体内tau水平升高有关，而在17项报告中，有四项发现与体内β淀粉样蛋白测量值升高有关。一项纵向分析确定了AoHL与脑脊液tau水平随时间更陡峭的升高之间存在关联，但与Aβ水平无关。44项横断面分析中的25项以及9项纵向分析中的6项确定了AoHL与颞叶灰质萎缩之间存在关联，特别是内侧颞叶。使用其他生物标志物的研究结果不一致。
横断面和纵向研究通常发现，AoHL与更多颞叶区域的灰质萎缩以及体内tau升高但β淀粉样蛋白不升高有关。萎缩加剧和tau升高导致认知储备减少，可能是听力损失增加痴呆风险的方式。
