Abstract
Age-related hearing loss (ARHL), also called presbycusis, is a progressive disorder affecting hearing functions and among the elderly has been recognized as the third most frequent condition. Among ARHL components, the age-related central auditory processing disorder (CAPD) refers to changes in the auditory network, negatively impacting auditory perception and/or the speech communication performance. The relationship between auditory-perception and speech communication difficulties in age-related CAPD is difficult to establish, mainly because many older subjects have concomitant peripheral ARHL and age-related cognitive changes. In the last two decades, the association between cognitive impairment and ARHL has received great attention. Peripheral ARHL has recently been defined as the modifiable risk factor with the greatest impact on the development of dementia. Even if very few studies have analyzed the relationship between cognitive decline and age-related CAPD, a strong association was highlighted. Therefore, age-related CAPD could be a specific process related to neurodegeneration. Since these two disorders can be concomitant, drawing causal inferences is difficult. The assumption that ARHL, particularly age-related CAPD, may increase the risk of cognitive impairment in the elderly remains unchallenged. This review aims to summarize the evidence of associations between age-related CAPD and cognitive disorders and to define the diagnostic procedure of CAPD in the elderly. Finally, we highlight the importance of tailoring the rehabilitation strategy to this relationship. Future longitudinal studies with larger sample sizes and the use of adequate assessment tools that can disentangle cognitive dysfunction from sensory impairments are warranted.
Highlights
Age-related hearing loss (ARHL), known as presbycusis as well, is a progressive disorder that affects hearing functions
In our clinical and research experience, we have found that the use of Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM) seems to be a good standard for the diagnosis of central auditory processing disorder (CAPD) in terms of accuracy and efficiency, and for the prediction of cognitive impairment in the elderly (Quaranta et al, 2014; Sardone et al, 2018)
The second point is that age-related CAPD is often associated with a deficit of some cognitive domains, in particular executive functions
Summary
Age-related hearing loss (ARHL), known as presbycusis as well, is a progressive disorder that affects hearing functions. Two forms of CAPD are currently classified in the ICD-10 as H93.25, acquired and congenital forms (World Health Organization [WHO], 2017) This disorder may be classified as developmental, acquired (i.e., as a consequence of infections, neurological diseases, stroke, or noise exposure), or secondary CAPD (British Society of Audiology [BSA], 2017). This classification does not include presentations like age-related CAPD, called central presbycusis, which may affect older adults (Iliadou et al, 2017). It has been defined as central presbycusis (Gates, 2012)
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