Cross-Sectional Associations of Peripheral Hearing, Brain Imaging, and Cognitive Performance With Speech-in-Noise Performance: The Aging and Cognitive Health Evaluation in Elders Brain Magnetic Resonance Imaging Ancillary Study.
IF 1.4 4区 医学Q3 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Kening Jiang, Marilyn S Albert, Josef Coresh, David J Couper, Rebecca F Gottesman, Kathleen M Hayden, Clifford R Jack, David S Knopman, Thomas H Mosley, James S Pankow, James R Pike, Nicholas S Reed, Victoria A Sanchez, A Richey Sharrett, Frank R Lin, Jennifer A Deal
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引用次数: 0
Abstract
Purpose: Population-based evidence in the interrelationships among hearing, brain structure, and cognition is limited. This study aims to investigate the cross-sectional associations of peripheral hearing, brain imaging measures, and cognitive function with speech-in-noise performance among older adults.
Method: We studied 602 participants in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) brain magnetic resonance imaging (MRI) ancillary study, including 427 ACHIEVE baseline (2018-2020) participants with hearing loss and 175 Atherosclerosis Risk in Communities Neurocognitive Study Visit 6/7 (2016-2017/2018-2019) participants with normal hearing. Speech-in-noise performance, as outcome of interest, was assessed by the Quick Speech-in-Noise (QuickSIN) test (range: 0-30; higher = better). Predictors of interest included (a) peripheral hearing assessed by pure-tone audiometry; (b) brain imaging measures: structural MRI measures, white matter hyperintensities, and diffusion tensor imaging measures; and (c) cognitive performance assessed by a battery of 10 cognitive tests. All predictors were standardized to z scores. We estimated the differences in QuickSIN associated with every standard deviation (SD) worse in each predictor (peripheral hearing, brain imaging, and cognition) using multivariable-adjusted linear regression, adjusting for demographic variables, lifestyle, and disease factors (Model 1), and, additionally, for other predictors to assess independent associations (Model 2).
Results: Participants were aged 70-84 years, 56% female, and 17% Black. Every SD worse in better-ear 4-frequency pure-tone average was associated with worse QuickSIN (-4.89, 95% confidence interval, CI [-5.57, -4.21]) when participants had peripheral hearing loss, independent of other predictors. Smaller temporal lobe volume was associated with worse QuickSIN, but the association was not independent of other predictors (-0.30, 95% CI [-0.86, 0.26]). Every SD worse in global cognitive performance was independently associated with worse QuickSIN (-0.90, 95% CI [-1.30, -0.50]).
Conclusions: Peripheral hearing and cognitive performance are independently associated with speech-in-noise performance among dementia-free older adults. The ongoing ACHIEVE trial will elucidate the effect of a hearing intervention that includes amplification and auditory rehabilitation on speech-in-noise understanding in older adults.
外周听力、脑成像和认知能力与噪音中的语音表现的横截面关联：老年人老化与认知健康评估脑磁共振成像辅助研究》（The Aging and Cognitive Health Evaluation in Elders Brain Magnetic Resonance Imaging Ancillary Study）。
目的：基于人群的听力、大脑结构和认知之间相互关系的证据有限。本研究旨在调查老年人的外周听力、大脑成像测量和认知功能与噪声中言语表现之间的横断面关联：我们研究了602名参加老年人衰老和认知健康评估（ACHIEVE）脑磁共振成像（MRI）辅助研究的参与者，其中包括427名听力损失的ACHIEVE基线（2018-2020年）参与者和175名听力正常的社区动脉粥样硬化风险神经认知研究第6/7次访问（2016-2017/2018-2019年）参与者。噪声中的言语表现作为研究结果，通过快速噪声中言语（QuickSIN）测试进行评估（范围：0-30；越高=越好）。相关预测因素包括：(a) 通过纯音测听评估的外周听力；(b) 脑成像测量：核磁共振成像结构测量、白质高密度和弥散张量成像测量；以及 (c) 通过 10 项认知测试评估的认知能力。所有预测指标均标准化为 z 分数。我们使用多变量调整线性回归法估算了QuickSIN与每个预测指标（外周听力、脑成像和认知）每差一个标准差（SD）的相关差异，并对人口统计学变量、生活方式和疾病因素进行了调整（模型1），此外还对其他预测指标进行了调整，以评估独立关联（模型2）：参与者年龄在 70-84 岁之间，56% 为女性，17% 为黑人。当参与者有外周听力损失时，较好耳4频纯音平均值每降低一个标准差，QuickSIN值就会降低（-4.89，95%置信区间，CI [-5.57，-4.21]），这与其他预测因素无关。颞叶体积较小与QuickSIN较差有关，但与其他预测因素无关（-0.30，95% CI [-0.86，0.26]）。整体认知能力每降低一个标准差，QuickSIN 就会降低（-0.90，95% CI [-1.30，-0.50]）：结论：在无痴呆症的老年人中，外周听力和认知能力与噪声言语能力有独立关联。目前正在进行的 ACHIEVE 试验将阐明听力干预措施（包括扩音和听觉康复）对老年人噪音语言理解能力的影响。补充材料：https://doi.org/10.23641/asha.25733679。
期刊介绍：
Mission: AJA publishes peer-reviewed research and other scholarly articles pertaining to clinical audiology methods and issues, and serves as an outlet for discussion of related professional and educational issues and ideas. The journal is an international outlet for research on clinical research pertaining to screening, diagnosis, management and outcomes of hearing and balance disorders as well as the etiologies and characteristics of these disorders. The clinical orientation of the journal allows for the publication of reports on audiology as implemented nationally and internationally, including novel clinical procedures, approaches, and cases. AJA seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of clinical audiology, including audiologic/aural rehabilitation; balance and balance disorders; cultural and linguistic diversity; detection, diagnosis, prevention, habilitation, rehabilitation, and monitoring of hearing loss; hearing aids, cochlear implants, and hearing-assistive technology; hearing disorders; lifespan perspectives on auditory function; speech perception; and tinnitus.
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