PRESBYCUSIS--BIOMEDICAL RISK FACTORS

老年性耳聋是一种常见的问题，随着 我们社会中的老年人数量在增加。流行率和 老年性耳聋的严重程度在不同的人群中有很大的差异，但 这种变异性的来源尚未划定。建议数 研究将检查老年性耳聋的流行病学与 生物医学危险因素，目的是确定相对危险因素 与年龄相关的退行性疾病和年龄相关疾病对以下方面的贡献：a) 一般的老年性耳聋；b)功能障碍的主要部位，即耳蜗病， C)老年性耳聋的特殊类型，即老年性耳聋。 感官的、神经的、工业的和传导的。 建议的研究将获得外围和外部的全面测量 对一组老年人的中枢听觉功能进行了调查 40多年来一直患有心血管疾病。这将是第三次 对弗雷明翰队列的听力评估，这将允许a) 年听力损失发病率的前15年纵向分析 老年男女，b)第一次纵向评估 中枢听觉功能障碍的发生率，以及c)有机会 比较听力损失的发生率与听力损失的发生率 全身性疾病，包括心血管疾病及其前驱疾病 风险因素。使用相同的方案测试队列的后代 将为未来的纵向测试建立基准，并为 通过记录具有以下特征的基因研究为未来的基因研究奠定基础：a) 显著年龄开始前听力损失的外源性原因 影响和b)可能的遗传保护，防止老年性耳聋。 测试包括纯音阈值、导纳测听、 失真产物耳声发射，安静中的言语辨别 以及一系列中枢听觉测试。将这些测试与那些 在9年和15年之前获得的数据可能会揭示出不明显的变化模式 在横断面研究中。听力功能的多项测量应 提高我们识别各种类型老年性耳聋的能力，并更好地定义 每种疾病的流行程度。与性别相关的因素将被研究来解释 女性的低频丢失越快。通过比较以下方面的变化 生物医学状态变化的试听，包括心血管疾病 我们将检验老年性耳聋和全身性耳聋的假设 血管疾病具有共同的危险因素。知道是否 心血管疾病或其前驱疾病是 某些类型的老年性耳聋的发病机制将允许理性 预防和可能的治疗方法。

Presbycusis is a common problem that is increasing in prevalence as the number of elderly persons in our society increases. The prevalence and severity of presbycusis vary substantially in different populations but the sources of this variability have not been delineated. The proposed research will examine the epidemiology of presbycusis in relation to biomedical risk factors with the goal of determining the relative contributions of agerelated degeneration and age-related diseases to: a) presbycusis in general; b) the major sites of dysfunction, i.e. cochlear, retrocochlear, and central; and c) the specific types of presbycusis, i.e. sensory, neural, strial, and conductive. The proposed research will obtain comprehensive measures of peripheral and central auditory function in an elderly cohort that has been surveyed for cardiovascular disease for over 40 years. This will be the third audiometric assessment of the Framingham cohort, which will permit a) the first 15 year longitudinal analysis of the incidence of hearing loss in elderly men and women, b) the first longitudinal assessment of the incidence of central auditory dysfunction, and c) the opportunity to compare the incidence of hearing loss in relation to the incidence of systemic disorders, including cardiovascular disease and its antecedent risk factors. Testing the offspring of the cohort using the same protocol will establish a baseline for future longitudinal testing and lay the groundwork for future genetic studies by documenting those with: a) exogenous causes of hearing loss prior to the onset of significant age effects and b) possible genetic protection from presbycusis. Tests include pure-tone thresholds, immittance audiometry, distortion-product otoacoustic emissions, speech discrimination in quiet and a battery of central auditory tests. Comparing these tests with those obtained 9 and 15 years earlier may reveal patterns of change not evident in cross-sectional studies. Multiple measures of hearing function should improve our ability to identify each type of presbycusis and better define the prevalence of each. Gender-related factors will be studied to explain the more rapid low-frequency loss in women. By comparing changes in audition with changes in biomedical status, including cardiovascular disorders, we will test the hypothesis that presbycusis and systemic vascular disease share common risk factors. Knowing whether cardiovascular disease or its precursors are co-factors in the pathogenesis of certain types of presbycusis will allow a rational approach to prevention and possible treatment.