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

项目总结/摘要 这项建议的长远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， 相关性痴呆（ADRD），通过提高我们的知识基础的言语感知能力，在这一人口 并直接将这些知识转化为定制的听力干预方法。年龄相关的听力 MCI或痴呆患者的ARHL可能会加重痴呆相关症状， 抑郁、冷漠、激动/攻击。此外，参与和活动被认为是 痴呆症护理管理的关键方面，但那些也经历ARHL的人处于 劣势该提案的目的包括基础科学调查以及完善和试点 行为沟通干预的测试。 目标1将集中在复杂背景噪声中言语感知能力的受控实验室测量 以及从老年人群体的共同沟通修复策略中受益的能力， MCI/早期痴呆和老年人与这些人的年龄和听力阈值相匹配。这 目的将提高我们对老年人言语感知能力的理论理解， 损伤在目标2中进行的调查将侧重于评估和确定职能负担 老年人群体护理环境中的ARHL和认知障碍。混合方法将是 目标2中所开展的工作，以更好地了解ARHL患病率的定量方面， 认知障碍与声学环境以及员工的行为/社会环境相互作用， 在集体护理环境中的同伴互动。最后，将在2010年测试的多组分听力保健干预措施 目标3包括声学修改，人员培训，和非定制的个人放大器使用的目标 在集体护理环境中的个人。这一可行性研究将导致改进干预方案 将用于未来的赠款申请，以测试集群中干预措施的真实效果- 随机对照试验。 博士萨拉·马莫（Sara Mamo）是纽约大学沟通障碍系的终身助理教授。 马萨诸塞州阿默斯特大学公共卫生与健康科学学院。在此指导下， 以患者为导向的研究职业发展奖，Mamo博士打算发展方法技能 与测试言语感知有关，并提高她在理论基础方面的知识基础， 行为干预，以证据为基础的方法来临床管理痴呆症，和统计 纵向结果分析。这些关键的培训内容将支持听证会的发展 护理干预，可以整合到老年认知障碍患者的综合护理中，以及 在未来的随机试验中测量与干预相关的长期下游效应。

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.