Speech understanding ability and communication intervention for persons with age-related hearing loss and mild cognitive impairment or dementia

项目摘要/摘要 这项建议的长期目标是增加听力损失的可及性和可负担性。 治疗患有听力损失和轻度认知障碍(MCI)或阿尔茨海默病的老年人 通过改善我们在这一人群中的言语感知能力的知识基础来解决相关痴呆(ADRD) 并将这些知识直接转化为一种量身定制的听力干预方法。年龄相关听证 MCI或痴呆症患者的缺失(ARHL)可能会加剧与痴呆症相关的症状，如 抑郁、冷漠、激动/攻击性。此外，参与和参与活动被认为是 痴呆症护理管理的关键方面，但那些也经历过ARHL的人处于 劣势。这项建议的目的包括基础科学调查以及改进和试点 对行为沟通干预的测试。 目标1将重点放在复杂背景噪声中语音感知能力的受控实验室测量上 以及在患有以下疾病的老年人群体中受益于常见通信修复策略的能力 MCI/早期痴呆症和老年人在年龄和听力阈值方面与这些人匹配。这 AIM将提高我们对认知障碍老年人言语感知能力的理论理解 减损。在目标2中进行的调查将侧重于评估和确定职能负担 老年群体护理环境中急性呼吸窘迫综合征和认知障碍的研究。混合方法的方法将是 在目标2中进行，以更好地了解急性呼吸道合并症和非霍奇金淋巴瘤患病率的量化方面 认知障碍与声学环境以及员工的行为/社会背景相互作用 团体护理环境中的同伴互动。最后，多组分听力护理干预将在 目标3包括声学修改、员工培训和与Target配合使用的非定制个人扩音器 团体护理环境中的个人。这项可行性研究将导致干预方案的完善 将在未来的拨款申请中使用，以测试集群干预的真实效果- 随机对照试验。 Sara Mamo博士是华盛顿大学传播障碍系终身教职助理教授 马萨诸塞大学阿默斯特分校公共卫生和健康科学学院。有了这位导师 以患者为导向的研究职业发展奖，Mamo博士打算发展方法学技能 与测试语音感知相关，并改进她在 行为干预、痴呆症临床管理的循证方法和统计学 对纵向结果的分析。这些关键的培训部分将支持听力的发展 护理干预，可纳入对认知障碍老年人的全面护理，以及 在未来的随机试验中测量与干预相关的长期下游影响。

Project Summary/Abstract The long-term objective of this proposal is to increase the accessibility and affordability of hearing loss treatment for older adults with hearing loss and mild cognitive impairment (MCI) or Alzheimer’s disease and related dementias (ADRD) by improving our knowledge base of speech perception abilities in this population and directly translating that knowledge into a tailored approach to hearing intervention. Age-related hearing loss (ARHL) in persons with MCI or dementia may exacerbate dementia-related symptoms such as depression, apathy, agitation/aggression. Moreover, engagement and activity participation are recognized as critical aspects of dementia care management, but those individuals who also experience ARHL are at a disadvantage. The aims of this proposal include basic science investigation as well as refinement and pilot testing of a behavioral communication intervention. Aim 1 will focus on controlled laboratory measures of speech perception abilities in complex background noise as well as the ability to benefit from common communication repair strategies in groups of older adults with MCI/early stage dementia and older adults matched with these individuals for age and hearing thresholds. This aim will improve our theoretical understanding of speech perception abilities for older adults with cognitive impairment. The investigations undertaken in Aim 2 will focus on assessing and defining the functional burden of ARHL and cognitive impairment in group care settings for older adults. A mixed methods approach will be undertaken in Aim 2 to better understand how the quantitative aspects of the prevalence of ARHL and cognitive impairment interact with the acoustic environment as well as the behavioral/social context of staff and peer interactions in the group care setting. Finally, the multicomponent hearing care intervention to be tested in Aim 3 includes acoustic modifications, staff training, and non-custom personal amplification use with target individuals in a group care setting. This feasibility study will lead to the refinement of the intervention protocols to be used in a future grant application that will test the real-world efficacy of the intervention in a cluster- randomized control trial. Dr. Sara Mamo is a tenure-track Assistant Professor in the Department of Communication Disorders in the School of Public Health and Health Sciences at the University of Massachusetts Amherst. With this Mentored Patient-Oriented Research Career Development Award, Dr. Mamo intends to develop methodological skills related to testing speech perception and improve her knowledge base in the theoretical underpinnings of behavioral interventions, the evidence-based approaches to clinical management of dementia, and statistical analyses of longitudinal outcomes. These key training components will support the development of a hearing care intervention that can be integrated into comprehensive care of older adults with cognitive impairment, and measure the long-term downstream effects associated with the intervention in future randomized trials.