Abstract
Strong links between hearing and cognitive function have been confirmed by a growing number of cross-sectional and longitudinal studies. Seniors with age-related hearing loss (ARHL) have a significantly higher cognitive impairment incidence than those with normal hearing. The correlation mechanism between ARHL and cognitive decline is not fully elucidated to date. However, auditory intervention for patients with ARHL may reduce the risk of cognitive decline, as early cognitive screening may improve related treatment strategies. Currently, clinical audiology examinations rarely include cognitive screening tests, partly due to the lack of objective quantitative indicators with high sensitivity and specificity. Questionnaires are currently widely used as a cognitive screening tool, but the subject’s performance may be negatively affected by hearing loss. Numerous electroencephalogram (EEG) and magnetic resonance imaging (MRI) studies analyzed brain structure and function changes in patients with ARHL. These objective electrophysiological tools can be employed to reveal the association mechanism between auditory and cognitive functions, which may also find biological markers to be more extensively applied in assessing the progression towards cognitive decline and observing the effects of rehabilitation training for patients with ARHL. In this study, we reviewed clinical manifestations, pathological changes, and causes of ARHL and discussed their cognitive function effects. Specifically, we focused on current cognitive screening tools and assessment methods and analyzed their limitations and potential integration.
Highlights
According to the statistics of the World Health Organization, almost one-third of all adults above 65 years of age are affected by hearing loss, with 226 million experiencing disabling hearing loss
A meta-analysis of 11 cohort studies found that suffering from peripheral or central hearing impairment was associated with a higher risk of cognitive impairment, and the risk increased with the degree of hearing loss: for moderate/severe hearing impairment, the risk increases by 1.57 times (95% confidence interval, CI: 1.13–2.20); for severe central hearing impairment, the risk increases by 3.21 times
The results suggested that the cortical gray matter atrophy observed in the brains of older people with hearing loss is independent of age
Summary
According to the statistics of the World Health Organization, almost one-third of all adults above 65 years of age are affected by hearing loss, with 226 million experiencing disabling hearing loss. Imaging studies of some patients with hearing loss showed that after hearing loss was aggravated, the auditory cortex atrophied, and the brain volume decreased to a certain extent, which might reduce the brain’s ability to perform other tasks besides hearing (Golub, 2017) All of these factors further accelerate the decline of cognitive function. A research report on the outcomes after cochlear implantation in the very elderly likewise showed that speech perception benefited from cochlear implants, and age was not a limitation for the implant (Wong et al, 2016) Considering this association between hearing loss and cognitive decline, researchers studied whether an assisted listening device can ameliorate the currently observed risk of accelerated cognitive decline due to hearing loss in older adults. Because the final evaluation result may be influenced by the patient’s understanding of the problem and the environment, an objective quantitative index would be more capable of reflecting the patient’s cognitive status truly
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