Mediators and Moderators of Auditory Training

听觉训练的中介者和调节者

• 批准号: 10756702
• 负责人: FREDERICK J. GALLUN
• 金额: $ 74.39万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10756702
• 关键词: Mediators; Moderators; Auditory; Training

This proposal seeks to understand mechanisms of auditory training (AT) and potential of AT to mitigate hearing issues that promote risk of development of Alzheimer’s disease and related dementias (ADRD). Reports from the Lancet Commission (Livingstone and colleagues, 2020), and others, show midlife hearing loss is one of the greatest predictors of late-life dementia, and hearing aids protect against development of ADRD. While this has promoted a push for greater distribution of hearing aids, research from Gates and colleagues (2011) suggests that central hearing processes may be greater predictors of onset of ADRD than peripheral hearing (as addressed through hearing aids). Central auditory processing abilities are fundamental to understand speech, appreciate music, and separate competing environmental sound sources. Hearing challenges experienced with increasing age, especially understanding speech in noisy ambient environments, cause frustration with interpersonal verbal communication and detrimental long-term effects on functional independence, cognitive abilities, and overall quality of life, including increased risk for ADRD. Nevertheless, despite extensive research conducted across multiple fields, clinicians and researchers still disagree about the best ways to address the diversity of hearing difficulties individuals face throughout their lives. The guiding premise of the current proposal is the need for robust and reliable data sets to clarify the underlying mechanisms of AT and to identify the mediators and moderators that impact training outcomes. The overarching goal of this proposal is that better understanding of mechanisms of AT, with focus on speech in competition, can address the most prevalent hearing complaints reported by people as they age, and in turn mitigate transition to ADRD. To address this, we will recruit a large and diverse sample of older adults, including those with prodromal ADRD, and a comparison group of younger adults (1260 participants across training conditions, including separate samples of young and older adults). We will research how baseline cognitive and hearing measures predict training outcomes (moderators) and how these interact with training methods (mediators). To enhance rigor and reproducibility, we will release data sets and training/assessment tools to enable other researchers to conduct analyses, replicate our studies, and test their own training methods using common outcome measures. The proposed research will address four Specific Aims. Aim 1 – Determine the relationship of stimulus complexity and AT outcomes. Aim 2 – Determine the relationship of AT training structures and AT outcomes. Aim 3 – Determine relationships between participant characteristics (moderators) and AT approaches (mediators) on training outcomes. Aim 4 – Create an AT platform that facilitates faithful replication and modelling. Through the collection and dissemination of a large, unique, and comprehensive dataset, this proposal has potential for transformative impact by clarifying moderators and mediators of AT, and will afford translational opportunities to contribute to the mitigation of hearing and cognitive decline in individuals who may be at risk for the development of ADRD.

该提案旨在了解听觉训练 (AT) 的机制以及 AT 缓解听力问题的潜力，这些听力问题会促进阿尔茨海默病和相关痴呆症 (ADRD) 的发展风险。柳叶刀委员会的报告（Livingstone 及其同事，2020 年）和其他机构的报告表明，中年听力损失是晚年痴呆症的最大预测因素之一，而助听器可以预防 ADRD 的发展。虽然这推动了助听器的广泛普及，但 Gates 及其同事（2011）的研究表明，中枢听力过程可能比周围听力（通过助听器解决）更能预测 ADRD 的发生。中枢听觉处理能力是理解言语、欣赏音乐和区分竞争环境声源的基础。随着年龄的增长，听力会出现挑战，尤其是在嘈杂的环境中理解言语，会导致人际言语交流受挫，并对功能独立性、认知能力和整体生活质量产生有害的长期影响，包括增加 ADRD 风险。然而，尽管在多个领域进行了广泛的研究，但临床医生和研究人员对于解决个人一生中面临的各种听力困难的最佳方法仍然存在分歧。当前提案的指导前提是需要强大且可靠的数据集来阐明 AT 的基本机制并确定影响培训结果的中介者和调节者。该提案的总体目标是更好地理解 AT 机制，重点关注竞争中的言语，可以解决人们随着年龄增长而报告的最普遍的听力问题，从而缓解向 ADRD 的过渡。为了解决这个问题，我们将招募大量且多样化的老年人样本，包括患有前驱 ADRD 的老年人，以及一组年轻人（不同训练条件下的 1260 名参与者，包括年轻人和老年人的单独样本）。我们将研究基线认知和听力测量如何预测训练结果（调节因素）以及它们如何与训练方法（调节因素）相互作用。为了提高严谨性和可重复性，我们将发布数据集和培训/评估工具，使其他研究人员能够进行分析、复制我们的研究，并使用常见的结果衡量标准来测试他们自己的培训方法。拟议的研究将解决四个具体目标。目标 1 – 确定刺激复杂性和 AT 结果之间的关系。目标 2 – 确定 AT 培训结构和 AT 结果之间的关系。目标 3 – 确定参与者特征（调节者）和 AT 方法（调节者）之间对培训结果的关系。目标 4 – 创建一个有利于忠实复制和建模的 AT 平台。通过收集和传播大型、独特和全面的数据集，该提案有可能通过澄清 AT 的调节因素和调节因素而产生变革性影响，并将提供转化机会，有助于缓解可能面临 ADRD 风险的个人的听力和认知能力下降。