Auditory agnosia for environmental sounds in Alzheimer’s disease: Effects on daily life

IF 2 Q3 NEUROSCIENCES
J.A. Coebergh , S. McDowell , T.C.A.M. van Woerkom , J.P. Koopman , J.L. Mulder , F.R.E. Smink , J.D. Blom , S.F.T.M. de Bruijn
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引用次数: 0

Abstract

Background

Auditory agnosia for environmental sounds is a type of agnosia attributed to central auditory dysfunction. It is common in Alzheimer’s disease, and is associated with peripheral hearing loss, although independent of it, and presumed independent of language deficits. The effects of this type of agnosia on daily life in Alzheimer’s disease are unknown.

Objective

We aimed to assess the impact of auditory agnosia for environmental sounds in people with Alzheimer’s disease while also exploring the role of unrecognized hearing loss.

Methods

We tested 34 home-dwelling people with Alzheimer’s disease and a mean MMSE of 21.9 with the aid of a sound naming and recognition test, the tailor-made EESAA (Experiencing Environmental Sounds in Auditory Agnosia) questionnaire, the ADQRL (Alzheimer’s Disease-Related Quality of Life) scale, and speech and tone audiometry.

Results

Some 57 % of our 34 participants showed clinical signs of auditory agnosia for environmental sounds, and 47 % had undetected hearing loss to such an extent that it made them eligible for a hearing aid. Although the two factors appear to be independent, their joint effect can impact people’s daily functioning. Nonetheless, we found them to have only little impact on the participants’ quality of life as measured by the ADQRL, possibly because most of them lived in a sheltered environment, and some moreover showed anosognosia for their agnosia.

Conclusion

Difficulties recognizing environmental sounds in daily life are very common in people with Alzheimer’s disease. Although we found no direct relation with quality of life as measured by a questionnaire, awareness of auditory agnosia for environmental sounds is still important since it may help explain why function declines. The additional finding that 47 % of people in this group had unrecognized hearing loss shows that self-assessment of hearing is often inaccurate in Alzheimer’s disease, with implications for daily practice where clinicians might only explore hearing loss when acknowledged by their patient. On the basis of our findings we advise further longitudinal, multi-year studies of hearing screening and rehabilitation in Alzheimer’s disease, if possible starting during its prodromal stage, something supported by findings in a large trials suggesting that hearing interventions might be slowing cognitive decline in an older population at risk of this.
阿尔茨海默病对环境声音的听觉失认:对日常生活的影响。
背景:环境声音听觉失认症是一种由中枢性听觉功能障碍引起的失认症。它在阿尔茨海默病中很常见,与周围性听力丧失有关,尽管与周围性听力丧失无关,也被认为与语言缺陷无关。这种类型的失认症对阿尔茨海默病患者日常生活的影响尚不清楚。目的:我们旨在评估阿尔茨海默病患者对环境声音的听觉失认症的影响,同时探索未被识别的听力损失的作用。方法:采用声音命名和识别测试、定制的EESAA(听觉失认症中体验环境声音)问卷、ADQRL(阿尔茨海默病相关生活质量)量表和语音和音调听力学对34名平均MMSE为21.9的阿尔茨海默病居家患者进行测试。结果:我们的34名参与者中,约有57 %的人对环境声音表现出听觉失认症的临床症状,47 %的人有未被发现的听力损失,这使得他们有资格使用助听器。虽然这两个因素看起来是独立的,但它们的共同作用会影响人们的日常功能。尽管如此,我们发现他们对参与者的生活质量只有很小的影响,正如ADQRL所测量的那样,可能是因为他们中的大多数人生活在一个庇护的环境中,而且一些人还表现出失认症的病感失认。结论:阿尔茨海默病患者在日常生活中识别环境声音困难是很常见的。虽然通过问卷调查我们没有发现与生活质量的直接关系,但对环境声音的听觉失认症的认识仍然很重要,因为它可能有助于解释为什么功能下降。另外一项发现是,该组中有47% %的人有未被发现的听力损失,这表明阿尔茨海默病患者对听力的自我评估往往是不准确的,这意味着临床医生可能只在患者承认听力损失的情况下才会对听力损失进行调查。根据我们的研究结果,我们建议对阿尔茨海默病的听力筛查和康复进行进一步的纵向、多年的研究,如果可能的话,从其前驱阶段开始,一项大型试验的结果表明,听力干预可能会减缓老年人群的认知能力下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
IBRO Neuroscience Reports
IBRO Neuroscience Reports Neuroscience-Neuroscience (all)
CiteScore
2.80
自引率
0.00%
发文量
99
审稿时长
14 weeks
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