ABSTRACT

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.

摘要

解决中年听力损失可以预防多达 9% 的新痴呆病例，这是《柳叶刀》2017 年委托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 岁以上的人。估计表明，严重听力损失的人患痴呆症的可能性高达 5 倍，但这些估计由于方法学的限制，研究之间存在差异。使用悉尼记忆和衰老研究的数据，该研究招募了 1,037 名年龄在 70 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，调查了听力损失与基线认知表现以及神经认知障碍的纵向风险之间的关系进行了。报告中度至重度听力困难的个体在注意力/处理速度和视觉空间能力以及整体认知能力方面的认知表现较差，并且在 6-6 岁期间患神经认知障碍的风险高出 1.5 倍。年的随访。听力损失独立预测 MCI 风险，但不预测痴呆风险。听力损失的存在是认知障碍老年人神经心理学案例制定的重要考虑因素。听力损失可能会增加认知负荷，导致神经心理学测试中可观察到的认知障碍。在非记忆删除领域表现出损伤的听力损失个人可能会从提供听力设备中受益；