Presbycusis: Biomedical Risk Factors

描述：（由申请人提供）与年龄相关的中枢神经系统变化通常会损害听力，特别是在噪音或其他听力困难情况下的言语理解。这种与年龄相关的中枢性听觉处理障碍被称为中枢性老年性耳聋。值得注意的是，早期可能患有阿尔茨海默氏痴呆症（pAD）的人表现出与中枢性老年性痴呆患者相似的中枢性听觉处理不良的迹象，只是这些迹象比对照组出现得更早、更普遍、程度更大。这表明，一些中枢性老年性痴呆病例可能是由早期阿尔茨海默氏痴呆引起的，并提出了检测中枢性听觉处理功能障碍的评估（即中枢性听觉测试）可能有助于预测pAD的可能性。本研究的目的是建立中枢听觉测试在神经心理学评估和筛查pAD的风险和存在的流行病学基础。在考虑这种可能性之前，关于中枢性听觉功能障碍与pAD之间的关系还有许多未解之谜。言语理解能力低下是由于阿尔茨海默病在听觉通路上的损害，还是在调节言语处理和注意力的额叶执行控制中心？为什么大多数pAD患者有不对称的中枢听觉表现？中枢性听觉障碍是pAD的早期表现还是衰老过程的巧合？哪种中枢听觉对早期pAD最敏感？有多少比例的中枢性老年性痴呆是由于未被发现的年龄相关性听神经病变继发于螺旋神经节变性？本研究应用程序提供了一个独特的机会来解决这些重要的问题，通过研究老年人的听力状况的成人思想的变化队列参加了在西雅图衰老和痴呆的纵向研究。在控制外周听力和神经心理状态的情况下，通过比较pAD患者和非pAD患者的行为中枢听觉测试结果，我们可以更好地了解衰老和痴呆对中枢听觉功能的影响。

DESCRIPTION: (provided by applicant) Age-related changes in the central nervous system often impair hearing, in particular, speech understanding in noise or other difficult listening situations. This type of age-related central auditory processing disorder is known as central presbycusis. Of note, people with early stage probable Alzheimer dementia (pAD) exhibit signs of poor central auditory processing that are similar to people with central presbycusis except that these signs occur earlier, more prevalently, and to a greater degree than in controls. This suggests that some cases of central presbycusis may be due to incipient Alzheimer dementia and raises the possibility that assessments to detect central auditory processing dysfunction (i.e. central auditory tests) might be useful as a predictor of pAD. The goal of this research is to establish the epidemiologic basis for central auditory testing in the neuropsychological evaluation and in screening for risk and presence of pAD. Before this possibility can be considered, there are many unanswered questions about the association of central auditory dysfunction and pAD. Is the poor speech understanding due to Alzheimer lesions in the auditory pathways, or in the frontal executive control centers that regulate speech processing and attention? Why do most cases of pAD have asymmetric central auditory findings? Is central auditory dysfunction an early manifestation of pAD or a coincident effect of the aging process? Which central auditory measures are most sensitive to early pAD? What proportion of central presbycusis is due to undetected age-related auditory neuropathy secondary to spiral ganglion degeneration? This research application provides a unique opportunity to address these important questions by studying the hearing status of the elderly members of the Adult Change of Thought cohort enrolled in a longitudinal study of aging and dementia in Seattle. By comparing the results of behavioral central auditory tests in the pAD and non-pAD subjects, while controlling for peripheral hearing and neuropsychologic status, we may better understand the effects of aging and dementing disorders upon central auditory function.