Paul A Strutt, Amanda J Barnier, Greg Savage, Gabrielle Picard, Nicole A Kochan, Perminder Sachdev, Brian Draper, Henry Brodaty
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引用次数: 5
摘要
解决中年听力损失问题可以预防高达9%的新发痴呆病例,这是《柳叶刀》2017年委托撰写的报告中确定的所有潜在可改变风险因素中最高的。在澳大利亚,听力损失是老年人中第二常见的慢性健康状况,影响了74%的70岁以上老年人。估计表明,严重听力损失的人患痴呆症的可能性高达5倍,但由于方法学的限制,这些估计在不同的研究中有所不同。利用悉尼记忆与衰老研究(Sydney Memory and Aging Study)的数据,研究人员招募了1037名年龄在70岁至90岁之间的澳大利亚男性和女性,并在2005年至2017年期间完成了两年一次的评估,对听力损失与基线认知表现以及神经认知障碍的纵向风险进行了调查。报告中重度听力障碍的个体在注意力/处理速度和视觉空间能力以及整体认知指数方面的认知表现较差,并且在6年的随访中患神经认知障碍的风险高出1.5倍。听力损失独立预测轻度认知障碍的风险,但不能预测痴呆的风险。听力损失的存在是一个重要的考虑神经心理学的情况下制定老年人认知障碍。听力损失可能增加认知负荷,导致神经心理测试中可观察到的认知障碍。在非遗忘领域表现出损害的听力损失患者可能会从提供听力设备中获益;本研究为一项随机对照试验提供了支持,该试验使用助听器来改善该组患者的认知功能。
Hearing loss, cognition, and risk of neurocognitive disorder: evidence from a longitudinal cohort study of older adult Australians.
Addressing midlife hearing loss could prevent up to 9% of new cases of dementia, the highest of any potentially modifiable risk factor identified in the 2017 commissioned report in The Lancet. In Australia, hearing loss is the second-most common chronic health condition in older people, affecting 74% of people aged over 70. Estimates indicate that people with severe hearing loss are up to 5-times more likely to develop dementia, but these estimates vary between studies due to methodological limitations. Using data from the Sydney Memory and Aging Study, in which 1,037 Australian men and women aged between 70 and 90 years were enrolled and completed biennial assessments from 2005-2017, investigations between hearing loss and baseline cognitive performance as well as longitudinal risk of neurocognitive disorder were undertaken. Individuals who reported moderate-to-severe hearing difficulties had poorer cognitive performances in the domains of Attention/Processing Speed and Visuospatial Ability, and on an overall index of Global Cognition, and had a 1.5-times greater risk for the neurocognitive disorder during 6-years' follow-up. Hearing loss independently predicted risk for MCI but not dementia. The presence of hearing loss is an important consideration for neuropsychological case formulation in older adults with cognitive impairment. Hearing loss may increase cognitive load, resulting in observable cognitive impairment on neuropsychological testing. Individuals with hearing loss who demonstrate impairment in non-amnestic domains may experience benefits from the provision of hearing devices; This study provides support for a randomized control trial of hearing devices for improvement of cognitive function in this group.