Presbycusis: Biomedical Risk Factors

描述：(申请人提供)与年龄相关的中枢神经系统改变通常会损害听力，特别是在噪音或其他听力困难的情况下，言语理解能力。这种与年龄相关的中枢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病(PAD)的人表现出中枢听觉处理能力差的迹象，这与中枢性老年性耳聋患者相似，只是这些迹象比对照组发生得更早、更普遍、程度更高。这表明，一些中枢性老年性耳聋可能是由于早期阿尔茨海默病，并增加了评估，以检测中枢听觉处理功能障碍(即中枢听觉测试)可能是有用的预测PAD。这项研究的目的是为中枢听觉测试在神经心理评估和筛查PAD的风险和存在方面建立流行病学基础。在考虑这一可能性之前，关于中枢听觉功能障碍与PAD之间的关系还有许多悬而未决的问题。语言理解能力差是由于听觉通路中的阿尔茨海默病，还是由于调节语音处理和注意力的额叶执行控制中心？为什么大多数PAD病例有不对称的中枢性听觉表现？中枢听觉功能障碍是PAD的早期表现，还是衰老过程的共同作用？哪些中枢听觉指标对早期PAD最敏感？有多大比例的中枢性老年性耳聋是由于继发于螺旋神经节变性而未被发现的年龄相关性听神经病？这项研究应用提供了一个独特的机会，通过研究在西雅图进行的一项关于老龄化和痴呆症的纵向研究中登记的成年人思维变化队列的老年成员的听力状况，来解决这些重要的问题。通过比较PAD受试者和非PAD受试者的行为中枢听觉测试结果，在控制外周听力和神经心理状态的同时，我们可能更好地了解衰老和痴呆障碍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.