Central auditory dysfunction, cognitive dysfunction, and dementia in older people.
Central auditory dysfunction, cognitive dysfunction, and dementia in older people.
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DOI：
10.1001/archotol.1996.01890140047010
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发表时间：
1996-02
期刊：
影响因子：
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通讯作者：
George A. Gates;J. Cobb;R. Linn;T. S. Rees;P. Wolf;R. D’Agostino
中科院分区：
文献类型：
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作者：
George A. Gates;J. Cobb;R. Linn;T. S. Rees;P. Wolf;R. D’Agostino
目的确定老年人听觉功能障碍和认知功能障碍之间的关系，以及中枢听觉测试异常是否可预测临床痴呆或认知功能下降的发生。设计前瞻性人群队列研究。研究对象心脏病研究门诊患者两年一次的检查18和21。参与者：在两年一次的检查中，认知筛查测试结果正常的心脏病研究队列成员18。测量外周听力阈值和单词识别安静;合成句子识别同侧竞争信息（SSI-ICM）;迷你精神状态检查;和详细的神经心理测试的主题与异常结果从迷你精神状态检查。痴呆的相对危险度用年龄校正的考克斯比例风险回归模型确定。结果听力损失显著降低了简易精神状态检查的言语部分的表现。在SSI-ICM中，一只耳朵评分非常差（< 50%）的受试者随后发生临床痴呆或认知下降的相对风险为6（P = 0.02）;如果双耳评分都很差，则相对风险为12.5（P = 0.001）。结论在相当多的病例中，中枢性听觉功能障碍先于老年痴呆症，并且可能是老年痴呆症的早期标志。听力测试应包括在60岁以上的人和那些怀疑有认知功能障碍的评估。
OBJECTIVES To determine in older people the relation between auditory dysfunction and cognitive dysfunction, and if central auditory test abnormalities predict the onset of clinical dementia or cognitive decline. DESIGN Prospective population-based cohort study. SETTING Framingham Heart Study outpatient biennial examinations 18 and 21. PARTICIPANTS Members of the Framingham Heart Study cohort with normal findings from cognitive screening tests at biennial examination 18. MEASUREMENTS Peripheral audiometric thresholds and word recognition in quiet; Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM); Mini-Mental State Examination; and detailed neuropsychological testing of subjects with abnormal findings from the Mini-Mental State Examination. Relative risk of dementia was determined using age-adjusted Cox proportional hazards regression models. RESULTS Hearing loss significantly lowered performance on the verbal parts of the Mini-Mental State Examination. The relative risk of subsequent clinical dementia or cognitive decline was 6 in subjects with very poor scores (< 50%) in one ear on the SSI-ICM (P = .02); the relative risk was 12.5 if the poor scores were present in both ears (P = .001). CONCLUSIONS Central auditory dysfunction precedes senile dementia in a significant number of cases and may be an early marker for senile dementia. Hearing tests should be included in the evaluation of persons older than 60 years and in those suspected of having cognitive dysfunction.