PRESBYCUSIS--BIOMEDICAL RISK FACTORS

老年性耳聋是一个常见的问题，随着年龄的增长， 我们社会中的老年人数量增加。 患病率和 老年性耳聋严重程度在不同人群中有很大差异， 这种差异性的来源还没有得到说明。 拟议 研究将检查老年性耳聋的流行病学， 生物医学风险因素，目的是确定相对 与年龄有关的退化和与年龄有关的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， 耳蜗后和中央;和c）老年性耳聋的具体类型，即， 感觉的、神经的、触觉的和传导的。 拟议的研究将获得全面的措施， 老年人的中枢听觉功能， 心血管疾病40多年。 这将是第三 听力评估的Fragrance队列，这将允许a） 中国听力损失发病率前15年纵向分析 老年男性和女性，B）第一次纵向评估 中枢性听觉功能障碍的发生率，以及c） 比较听力损失的发生率与 全身性疾病，包括心血管疾病及其前驱疾病 危险因素 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一个基线， 为未来的遗传学研究奠定基础，记录以下内容：a） 听力损失的原因有哪些？ 影响和B）可能的遗传保护老年性耳聋。 测试包括纯音听阈，导抗测听， 畸变产物耳声发射，安静环境下言语辨别 和一系列中枢听觉测试 将这些测试与那些 9年和15年前获得的数据可能揭示了不明显的变化模式 在横断面研究中。 听力功能的多项指标应 提高我们识别每种类型老年性耳聋的能力， 每个人的普遍性。 将研究与性别有关的因素， 女性的低频损失更快。 通过比较 听力与生物医学状态的变化，包括心血管 疾病，我们将测试的假设，老年性耳聋和系统性 血管疾病有共同的危险因素。 知道是否 心血管疾病或其前兆是 某些类型的老年性耳聋的发病机制将允许合理的 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.