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Usta Ozdemir H, Kitis A, Ardıc FN. Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study. J Aging Phys Act 2024; 32:496-507. [PMID: 38521052 DOI: 10.1123/japa.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 12/28/2023] [Accepted: 01/20/2024] [Indexed: 03/25/2024]
Abstract
We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.
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Affiliation(s)
- Hande Usta Ozdemir
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ali Kitis
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Fazıl Necdet Ardıc
- Department of Otorhinolaryngology, Medicine Faculty, Pamukkale University, Denizli, Turkey
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Nagaraj NK. Hearing Loss and Cognitive Decline in the Aging Population: Emerging Perspectives in Audiology. Audiol Res 2024; 14:479-492. [PMID: 38920961 PMCID: PMC11200945 DOI: 10.3390/audiolres14030040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 06/27/2024] Open
Abstract
In this perspective article, the author explores the connections between hearing loss, central auditory processing, and cognitive decline, offering insights into the complex dynamics at play. Drawing upon a range of studies, the relationship between age-related central auditory processing disorders and Alzheimer's disease is discussed, with the aim of enhancing our understanding of these interconnected conditions. Highlighting the evolving significance of audiologists in the dual management of cognitive health and hearing impairments, the author focuses on their role in identifying early signs of cognitive impairment and evaluates various cognitive screening tools used in this context. The discussion extends to adaptations of hearing assessments for older adults, especially those diagnosed with dementia, and highlights the significance of objective auditory electrophysiological tests. These tests are presented as vital in assessing the influence of aging and Alzheimer's disease on auditory processing capabilities and to signal cognitive dysfunction. The article underscores the critical role of audiologists in addressing the challenges faced by the aging population. The perspective calls for further research to improve diagnostic and therapeutic strategies in audiology, and emphasizes the need for a multidisciplinary approach in tackling the nexus of hearing loss, auditory processing, and cognitive decline.
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Affiliation(s)
- Naveen K Nagaraj
- Cognitive Hearing Science Lab, Communicative Disorders & Deaf Education, Utah State University, Logan, UT 84322, USA
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3
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Lee S, Lee SJ. Measure of Auditory Working Memory Span Using Monosyllabic Word Recognition Test in Young Adults With Normal Hearing: A Preliminary Study. Am J Audiol 2024; 33:66-78. [PMID: 37917922 DOI: 10.1044/2023_aja-23-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
PURPOSE Measuring working memory at hearing clinics is important. This study attempted to develop a test protocol that measures auditory working memory using a standardized monosyllabic word list in Korean Speech Audiometry (KSA). METHOD We included 25 young adults with normal hearing in this study. Participants conducted word recognition and word span tests concurrently using the KSA monosyllabic word lists. We designed four test conditions according to the presence or absence of background noise and word recall order: quiet-forward (QF), quiet-backward (QB), noise-forward, (NF), and noise-backward (NB). We implemented digit span tests in the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) to determine the validity of the working memory outcomes. RESULTS Word recognition scores of QF and QB were significantly higher than those of NF and NB. The percentages of correctly recalled words and word recall span scores were highest in QF and lowest in NB. Overall, the Pearson correlation and multiple regression statistics showed that our word span test outcomes for QB and NF were highly associated with digit span scores on the K-WAIS-IV. CONCLUSION Our proposed test protocol showed the possibility of measuring auditory working memory and monosyllabic word recognition simultaneously by validating the results with K-WAIS-IV outcomes.
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Affiliation(s)
- Sungmin Lee
- Department of Speech-Language Pathology and Audiology, Tongmyong University, Busan, Republic of Korea
| | - Soo Jung Lee
- Department of Speech-Language Pathology and Audiology, Tongmyong University, Busan, Republic of Korea
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Tillery KH, Rao A. An Interprofessional Approach to Aural Rehabilitation for Adults with Hearing Loss and Cognitive Concerns. Audiol Res 2024; 14:166-178. [PMID: 38391771 PMCID: PMC10886042 DOI: 10.3390/audiolres14010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Individuals with hearing loss are at risk for cognitive decline. The traditional approach to audiological care does not typically involve a team approach that addresses cognitive concerns. While cognitive screening is within the scope of practice in audiology, audiologists are not typically trained in interpreting screening results or providing rehabilitation that supports cognitive health. However, as growing evidence shows that hearing loss is tied to cognitive decline, a team approach is required to support whole-person care. Speech-language pathologists, who specialize in optimizing communication, are best situated to collaborate with audiologists to provide holistic aural rehabilitation. Audiologists and speech-language pathologists who partner to support a client's communication skills and social relationships play an important role in the life of an individual with hearing loss. In this perspective, we describe relevant background information about hearing loss and cognition and present an interprofessional approach to aural rehabilitation for adults with hearing loss who have cognitive concerns. We also discuss implications for future research.
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Affiliation(s)
- Kate Helms Tillery
- Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ 85281, USA
| | - Aparna Rao
- Speech and Hearing Science, College of Health Solutions, Arizona State University, Tempe, AZ 85281, USA
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Wang S, Wong LLN. An Exploration of the Memory Performance in Older Adult Hearing Aid Users on the Integrated Digit-in-Noise Test. Trends Hear 2024; 28:23312165241253653. [PMID: 38715401 PMCID: PMC11080745 DOI: 10.1177/23312165241253653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
This study aimed to preliminarily investigate the associations between performance on the integrated Digit-in-Noise Test (iDIN) and performance on measures of general cognition and working memory (WM). The study recruited 81 older adult hearing aid users between 60 and 95 years of age with bilateral moderate to severe hearing loss. The Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) was used to screen older adults for mild cognitive impairment. Speech reception thresholds (SRTs) were measured using 2- to 5-digit sequences of the Mandarin iDIN. The differences in SRT between five-digit and two-digit sequences (SRT5-2), and between five-digit and three-digit sequences (SRT5-3), were used as indicators of memory performance. The results were compared to those from the Digit Span Test and Corsi Blocks Tapping Test, which evaluate WM and attention capacity. SRT5-2 and SRT5-3 demonstrated significant correlations with the three cognitive function tests (rs ranging from -.705 to -.528). Furthermore, SRT5-2 and SRT5-3 were significantly higher in participants who failed the MoCA-BC screening compared to those who passed. The findings show associations between performance on the iDIN and performance on memory tests. However, further validation and exploration are needed to fully establish its effectiveness and efficacy.
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Affiliation(s)
- Shangqiguo Wang
- Unit of Human Communication, Development, and Information Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, SAR, China
| | - Lena L. N. Wong
- Unit of Human Communication, Development, and Information Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, SAR, China
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Windle R, Dillon H, Heinrich A. A review of auditory processing and cognitive change during normal ageing, and the implications for setting hearing aids for older adults. Front Neurol 2023; 14:1122420. [PMID: 37409017 PMCID: PMC10318159 DOI: 10.3389/fneur.2023.1122420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/02/2023] [Indexed: 07/07/2023] Open
Abstract
Throughout our adult lives there is a decline in peripheral hearing, auditory processing and elements of cognition that support listening ability. Audiometry provides no information about the status of auditory processing and cognition, and older adults often struggle with complex listening situations, such as speech in noise perception, even if their peripheral hearing appears normal. Hearing aids can address some aspects of peripheral hearing impairment and improve signal-to-noise ratios. However, they cannot directly enhance central processes and may introduce distortion to sound that might act to undermine listening ability. This review paper highlights the need to consider the distortion introduced by hearing aids, specifically when considering normally-ageing older adults. We focus on patients with age-related hearing loss because they represent the vast majority of the population attending audiology clinics. We believe that it is important to recognize that the combination of peripheral and central, auditory and cognitive decline make older adults some of the most complex patients seen in audiology services, so they should not be treated as "standard" despite the high prevalence of age-related hearing loss. We argue that a primary concern should be to avoid hearing aid settings that introduce distortion to speech envelope cues, which is not a new concept. The primary cause of distortion is the speed and range of change to hearing aid amplification (i.e., compression). We argue that slow-acting compression should be considered as a default for some users and that other advanced features should be reconsidered as they may also introduce distortion that some users may not be able to tolerate. We discuss how this can be incorporated into a pragmatic approach to hearing aid fitting that does not require increased loading on audiology services.
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Affiliation(s)
- Richard Windle
- Audiology Department, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
| | - Harvey Dillon
- NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
- Department of Linguistics, Macquarie University, North Ryde, NSW, Australia
| | - Antje Heinrich
- NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom
- Division of Human Communication, Development and Hearing, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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Völter C, Fricke H, Götze L, Labrenz F, Tokic M, Wirth R, Nasreddine ZS, Dawes P. Evaluation of the non-auditory neurocognitive test MoCA-HI for hearing-impaired. Front Neurol 2022; 13:1022292. [PMID: 36582608 PMCID: PMC9792785 DOI: 10.3389/fneur.2022.1022292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022] Open
Abstract
Background Since hearing loss and cognitive decline often co-occur among older adults, a cognitive screening test suitable for hearing-impaired people is of high clinical relevance. We report the first evaluation of a German language version of the Montreal Cognitive Assessment-Hearing Impaired version (MoCA-HI). Objective The aim of the present study was to compare cognitively healthy participants with and without hearing loss, to examine the impact of age, sex, educational level and degree of hearing impairment on the German MoCA-HI performance, and to develop normative data. Material and methods The German MoCA-HI was tested in 94 participants with normal or mild hearing impairment (group 1: 4PTA ≤ 40 dB on the better hearing ear) and 81 participants with moderate to profound hearing loss (group 2: 4PTA > 40 dB on the better hearing ear). Additionally, all participants performed the standard MoCA (version 8.2). Results No significant group difference between group 1 and 2 was found in the MoCA-HI total score (p = 0.05). In contrast, group 1 performed significantly better than group 2 on the standard MoCA (p < 0.001). There was no difference between the MoCA and the MoCA-HI performance in group 1 (p = 0.12), whereas individuals of group 2 performed significantly better on the MoCA-HI than on the standard MoCA (p < 0.001). Test-retest reliability of the MoCA-HI was high (p < 0.001). Higher age (p < 0.001), male sex (p = 0.009) and lower education (p < 0.001) were associated with a lower overall MoCA-HI score. Based on the demographic data normative data were developed by a regression-based approach. Conclusion The MoCA-HI is a cognitive screening test which is suitable for people with hearing impairment.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany,*Correspondence: Christiane Völter
| | - Hannah Fricke
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Franziska Labrenz
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Marianne Tokic
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University Bochum, Bochum, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Herne, Germany
| | | | - Piers Dawes
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Füllgrabe C, Öztürk OC. Immediate Effects of (Simulated) Age-Related Hearing Loss on Cognitive Processing and Performance for the Backward-Digit-Span Task. Front Aging Neurosci 2022; 14:912746. [PMID: 36420309 PMCID: PMC9677092 DOI: 10.3389/fnagi.2022.912746] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/17/2022] [Indexed: 02/23/2024] Open
Abstract
The recall of auditorily presented sequences of digits in reverse order (also known as the Backward Digit Span, BDS) is considered to reflect a person's information storage and processing abilities which have been linked to speech-in-noise intelligibility. However, especially in aging research and audiology, persons who are administered the BDS task are often affected by hearing loss (HL). If uncorrected, HL can have immediate assessment-format-related effects on cognitive-test performance and can result, in the long term, in neuroplastic changes impacting cognitive functioning. In the present study, an impairment-simulation approach, mimicking mild-to-moderate age-related HLs typical for persons aged 65, 75, and 85 years, was used in 19 young normal-hearing participants to evaluate the impact of HL on cognitive performance and the cognitive processes probed by the BDS task. Participants completed the BDS task in several listening conditions, as well as several commonly used visual tests of short-term and working memory. The results indicated that BDS performance was impaired by a simulated HL representing that of persons aged 75 years and above. In the normal-hearing condition, BDS performance correlated positively with both performance on tests of short-term memory and performance on tests of working memory. In the listening condition simulating moderate HL (as experienced by the average 85-year-old person), BDS performance only correlated with performance on working-memory tests. In conclusion, simulated (and, by extrapolation, actual) age-related HL negatively affects cognitive-test performance and may change the composition of the cognitive processes associated with the completion of a cognitive task.
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Affiliation(s)
| | - Ozan Cem Öztürk
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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9
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Parmar BJ, Rajasingam SL, Bizley JK, Vickers DA. Factors Affecting the Use of Speech Testing in Adult Audiology. Am J Audiol 2022; 31:528-540. [PMID: 35737980 PMCID: PMC7613483 DOI: 10.1044/2022_aja-21-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/04/2022] [Accepted: 04/05/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate hearing health care professionals' (HHPs) speech testing practices in routine adult audiology services and better understand the facilitators and barriers to speech testing provision. DESIGN A cross-sectional questionnaire study was conducted. STUDY SAMPLE A sample (N = 306) of HHPs from the public (64%) and private (36%) sectors in the United Kingdom completed the survey. RESULTS In the United Kingdom, speech testing practice varied significantly between health sectors. Speech testing was carried out during the audiology assessment by 73.4% of private sector HHPs and 20.4% of those from the public sector. During the hearing aid intervention stage, speech testing was carried out by 56.5% and 26.5% of HHPs from the private and public sectors, respectively. Recognized benefits of speech testing included (a) providing patients with relatable assessment information, (b) guiding hearing aid fitting, and (c) supporting a diagnostic test battery. A lack of clinical time was a key barrier to uptake. CONCLUSIONS Use of speech testing varies in adult audiology. Results from this study found that the percentage of U.K. HHPs making use of speech tests was low compared to that of other countries. HHPs recognized different benefits of speech testing in audiology practice, but the barriers limiting uptake were often driven by factors derived from decision makers rather than clinical rationale. Privately funded HHPs used speech tests more frequently than those working in the public sector where time and resources are under greater pressure and governed by guidance that does not include a recommendation for speech testing. Therefore, the inclusion of speech testing in national clinical guidelines could increase the consistency of use and facilitate the comparison of practice trends across centers. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20044457.
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Affiliation(s)
- Bhavisha J. Parmar
- UCL Ear Institute, University College London, United Kingdom
- Sound Lab, Cambridge Hearing Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
| | | | | | - Deborah A. Vickers
- Sound Lab, Cambridge Hearing Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom
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Rallapalli V, Souza P. Feasibility of Tablet-Based Remote Data Collection Method for Measuring Hearing Aid Preference. Am J Audiol 2022; 31:746-756. [PMID: 35914021 DOI: 10.1044/2022_aja-21-00273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the feasibility of a tablet-based remote data collection method for measuring preference for hearing aid signal processing features. METHOD Participants were nine individuals with bilateral mild to moderately severe sensorineural hearing loss. Stimuli were spatialized low-context sentences mixed with six-talker babble at two realistic signal-to-noise ratios (3 and 8 dB) and processed through a hearing aid simulator. Preference for full factorial combinations of three common hearing aid processing features (two levels each) was elicited using a paired-comparison task. Participants completed two versions of the experiment: The lab version was completed in a sound-treated booth using a custom MATLAB application on a desktop computer; the remote version was completed in a quiet room in the participant's home, using a custom MATLAB executable application on a tablet. Both versions used the same calibrated headphones. Strict infection control protocols were followed. RESULTS McNemar's test showed no association between preference and data collection method for the majority of the conditions. Percentage agreement and kappa scores were moderate/fair across most conditions. The results indicated that the remote versus lab versions did not have a systematic effect on preference. However, the relatively low agreement and kappa scores suggested within-subject variability in the outcome (preference). CONCLUSION The tablet-based version of remote experimentation was comparable to the lab-based version for eliciting preference for hearing aid signal processing features.
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Affiliation(s)
- Varsha Rallapalli
- Roxelyn and Richard Pepper Department of Communication Sciences & Disorders, Northwestern University, Evanston, IL
| | - Pamela Souza
- Roxelyn and Richard Pepper Department of Communication Sciences & Disorders, Northwestern University, Evanston, IL.,Knowles Hearing Center, Northwestern University, Evanston, IL
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Bottalico P, Piper RN, Legner B. Lombard effect, intelligibility, ambient noise, and willingness to spend time and money in a restaurant amongst older adults. Sci Rep 2022; 12:6549. [PMID: 35449186 PMCID: PMC9023576 DOI: 10.1038/s41598-022-10414-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/01/2022] [Indexed: 12/01/2022] Open
Abstract
Dining establishments are an essential part of the social experience. However, they are often characterized by high levels of background noise, which represents a barrier to effective communication. This particularly affects people suffering from hearing problems. Moreover, noise level exceeding normal conversational levels causes a phenomenon called the Lombard Effect, an involuntary tendency to increase the amount of vocal effort when talking in the presence of noise. Adults over 60 years represent the second largest population in the US and the majority of them suffer from some degree of hearing loss. The primary aim of the current study was to understand the effect of noise on vocal effort and speech intelligibility in a restaurant setting for adults over 60 years old with and without hearing loss. The secondary aim was to evaluate their perception of disturbance in communication and their willingness to spend time and money in a restaurant was affected by the varying levels of background noise. The results of this study showed background noise levels lower than 50 dB(A) will allow senior customers to minimize their vocal effort and to maximize their understanding of conversations, even for those with moderate to severe hearing loss. By setting a limit, it will also keep perceived disturbance low and willingness to spend time and money high among dining patrons.
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Affiliation(s)
- Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois, 901 S. 6th St., Urbana-Champaign, IL, 61820, USA.
| | - Rachael N Piper
- Department of Speech and Hearing Science, University of Illinois, 901 S. 6th St., Urbana-Champaign, IL, 61820, USA
| | - Brianna Legner
- Department of Speech and Hearing Science, University of Illinois, 901 S. 6th St., Urbana-Champaign, IL, 61820, USA
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12
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Goodwin MV, Hogervorst E, Maidment DW. Test Your Health at Home: Comparing Online Screening Tests of Hearing, Cognition, and Cardiovascular Health. Am J Audiol 2022; 31:950-960. [PMID: 35239423 DOI: 10.1044/2021_aja-21-00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the extent to which validated online screening measures of cognitive impairment, psychosocial well-being, and cardiovascular health are associated with a validated hearing screener in a sample of adults based in the United Kingdom. METHOD Sixty-one adults (43 female; M age = 44.7 years) participated in a cross-sectional study delivered remotely. Participants completed the hearWHO smartphone application, a digits-in-noise hearing screener, and the Modified Telephone Interview for Cognitive Status (TICS-M), a screening tool for cognitive impairment. Psychosocial well-being (social isolation and loneliness) and cardiovascular health were assessed through self-report. RESULTS Separate independent analyses of variance, with age, gender, and education as covariates, demonstrated participants who failed the hearWHO screener had poorer scores on the TICS-M, engaged in less physical activity, and reported more sedentary behavior and greater social isolation. Multivariate regression analyses revealed that lower TICS-M scores, having obtained less education, identifying as female, and reporting greater sedentary behavior and social isolation were the strongest predictors of lower hearWHO scores. CONCLUSIONS The results from this study suggest that poorer hearing, as measured by the hearWHO screener, is independently associated with having worse cognitive function, more time spent being sedentary, and greater social isolation. Thus, this study demonstrates the potential of online screening measures to identify additional health conditions that confer risk to chronic disease as hearing loss manifests. This could help to inform the development of tailored treatment and support to improve an individual's readiness to seek help for and manage both their general and hearing health. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19251956.
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Affiliation(s)
- Maria V. Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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13
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Abstract
Hearing impairment commonly co-occurs with dementia. Audiologists, therefore, need to be prepared to address the specific needs of people living with dementia (PwD). PwD have needs in terms of dementia-friendly clinical settings, assessments, and rehabilitation strategies tailored to support individual requirements that depend on social context, personality, background, and health-related factors, as well as audiometric HL and experience with hearing assistance. Audiologists typically receive limited specialist training in assisting PwD and professional guidance for audiologists is scarce. The aim of this review was to outline best practice recommendations for the assessment and rehabilitation of hearing impairment for PwD with reference to the current evidence base. These recommendations, written by audiology, psychology, speech-language, and dementia nursing professionals, also highlight areas of research need. The review is aimed at hearing care professionals and includes practical recommendations for adapting audiological procedures and processes for the needs of PwD.
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Zwolan TA, Basura G. Determining Cochlear Implant Candidacy in Adults: Limitations, Expansions, and Opportunities for Improvement. Semin Hear 2021; 42:331-341. [PMID: 34912161 PMCID: PMC8660165 DOI: 10.1055/s-0041-1739283] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The safety, efficacy, and success of cochlear implants (CIs) are well established and have led to changes in criteria used by clinicians to determine who should receive a CI. Such changes in clinical decision-making have out-paced the slower-occurring changes that have taken place with regulatory bodies' and insurers' indications. We review the historical development of indications for CIs, including those of the U.S. Food and Drug Administration (FDA), Medicare, Medicaid, and private insurers. We report on expansion to include patients with greater residual hearing, such as those who receive Hybrid and EAS devices, and report on recent FDA approvals that place less emphasis on the patient's best-aided condition and greater emphasis on the ear to be treated. This includes expansion of CIs to patients with single-side deafness and asymmetric hearing loss. We review changes in the test materials used to determine candidacy, including transition from sentences in quiet to sentences in noise to the recent use of monosyllabic words and cognitive screening measures. Importantly, we discuss the recent trend to recommend CIs despite a patient not meeting FDA or insurers' indications (a practice known as “off-label”), which serves as attestation that current indications need to be updated.
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Affiliation(s)
- Teresa A Zwolan
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan
| | - Gregory Basura
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, Michigan
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15
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Kestens K, Degeest S, Miatton M, Keppler H. Visual and Verbal Working Memory and Processing Speed Across the Adult Lifespan: The Effect of Age, Sex, Educational Level, Awakeness, and Hearing Sensitivity. Front Psychol 2021; 12:668828. [PMID: 34721133 PMCID: PMC8551836 DOI: 10.3389/fpsyg.2021.668828] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To strengthen future methodological choices regarding the measurement of cognition within the field of audiology, the current study aimed to examine the effect of, among other things, hearing sensitivity on the backward corsi tapping task (i.e., visual working memory and processing speed) and the letter-number sequencing task (i.e., verbal working memory and processing speed). Design and Study Sample: The backward corsi tapping task and the letter-number sequencing task were administered to 184 participants, aged between 18 and 69 years. The effect of age, sex, educational level, awakeness, and hearing sensitivity on verbal and visual working memory and processing speed was assessed using stepwise multiple regression analyses. Results: For all outcome variables, a decrease in performance was observed with increasing age. For visual and verbal working memory, males outperformed females, whereas no clear sex effect was observed for visual and verbal processing speed. Hearing sensitivity had only a significant impact on visual processing speed. Conclusion: The importance to evaluate cognitive construct validity within audiological research was highlighted. Further research should focus on investigating the associations between speech understanding on the one hand and the backward corsi tapping task and letter-number sequencing task on the other hand.
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Affiliation(s)
- Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Marijke Miatton
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
- Department of Oto-Rhino-Laryngology, Ghent University Hospital, Ghent, Belgium
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16
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Mamo SK, Helfer KS. Speech Understanding in Modulated Noise and Speech Maskers as a Function of Cognitive Status in Older Adults. Am J Audiol 2021; 30:642-654. [PMID: 34314238 DOI: 10.1044/2021_aja-20-00177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives The purpose of this study was to investigate the impact of different types of maskers on speech understanding as a function of cognitive status in older adults. The hypothesis tested was that individuals with a diagnosis of mild cognitive impairment (MCI) or mild dementia would perform like their age- and hearing status-matched control counterparts in modulated noise but would perform more poorly in the presence of competing speech. Design Participants (n = 39; age range: 55-77 years old) performed a speech-in-noise task and completed two cognitive screening tests and a measure of working memory. Sentences were presented in the presence of two types of maskers (i.e., speech envelope-modulated noise and two-talker, same-sex competing speech). Two analyses were undertaken: (a) a between-groups comparison of individuals diagnosed with MCI/dementia, individuals who failed both cognitive screeners (possible MCI), and age- and hearing status-matched neurologically healthy control individuals and (b) a mixed-model analysis of variance of speech perception performance as a function of working memory capacity. Results The between-groups comparison yielded significant group differences for speech understanding in both masking conditions, with the MCI/dementia group performing more poorly than the neurologically healthy controls and possible MCI groups. A single measure of working memory (Size Comparison Span [SICSPAN]) was correlated with performance on the speech perception task in the competing speech conditions. Conclusions Adults with a diagnosis of MCI or mild dementia performed more poorly on a speech perception task than their age- and hearing status-matched control counterparts in the presence of both maskers, with larger group mean differences when the target speech was presented in a two-talker masker. This suggests increased difficulty understanding speech in the presence of distracting backgrounds for people with MCI/dementia. Future studies should consider how to target this potentially vulnerable population as they may be experiencing increased difficulty communicating in challenging environments.
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Affiliation(s)
- Sara K. Mamo
- Department of Communication Disorders, University of Massachusetts Amherst
| | - Karen S. Helfer
- Department of Communication Disorders, University of Massachusetts Amherst
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17
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Yue T, Chen Y, Zheng Q, Xu Z, Wang W, Ni G. Screening Tools and Assessment Methods of Cognitive Decline Associated With Age-Related Hearing Loss: A Review. Front Aging Neurosci 2021; 13:677090. [PMID: 34335227 PMCID: PMC8316923 DOI: 10.3389/fnagi.2021.677090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022] Open
Abstract
Strong links between hearing and cognitive function have been confirmed by a growing number of cross-sectional and longitudinal studies. Seniors with age-related hearing loss (ARHL) have a significantly higher cognitive impairment incidence than those with normal hearing. The correlation mechanism between ARHL and cognitive decline is not fully elucidated to date. However, auditory intervention for patients with ARHL may reduce the risk of cognitive decline, as early cognitive screening may improve related treatment strategies. Currently, clinical audiology examinations rarely include cognitive screening tests, partly due to the lack of objective quantitative indicators with high sensitivity and specificity. Questionnaires are currently widely used as a cognitive screening tool, but the subject's performance may be negatively affected by hearing loss. Numerous electroencephalogram (EEG) and magnetic resonance imaging (MRI) studies analyzed brain structure and function changes in patients with ARHL. These objective electrophysiological tools can be employed to reveal the association mechanism between auditory and cognitive functions, which may also find biological markers to be more extensively applied in assessing the progression towards cognitive decline and observing the effects of rehabilitation training for patients with ARHL. In this study, we reviewed clinical manifestations, pathological changes, and causes of ARHL and discussed their cognitive function effects. Specifically, we focused on current cognitive screening tools and assessment methods and analyzed their limitations and potential integration.
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Affiliation(s)
- Tao Yue
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Tianjin International Engineering Institute, Tianjin University, Tianjin, China
| | - Yu Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
| | - Qi Zheng
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
| | - Zihao Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wei Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China
| | - Guangjian Ni
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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18
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Souza PE, Ellis G, Marks K, Wright R, Gallun F. Does the Speech Cue Profile Affect Response to Amplitude Envelope Distortion? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2053-2069. [PMID: 34019777 PMCID: PMC8740712 DOI: 10.1044/2021_jslhr-20-00481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/13/2020] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Purpose A broad area of interest to our group is to understand the consequences of the "cue profile" (a measure of how well a listener can utilize audible temporal and/or spectral cues for listening scenarios in which a subset of cues is distorted. The study goal was to determine if listeners whose cue profile indicated that they primarily used temporal cues for recognition would respond differently to speech-envelope distortion than listeners who utilized both spectral and temporal cues. Method Twenty-five adults with sensorineural hearing loss participated in the study. The listener's cue profile was measured by analyzing identification patterns for a set of synthetic syllables in which envelope rise time and formant transitions were varied. A linear discriminant analysis quantified the relative contributions of spectral and temporal cues to identification patterns. Low-context sentences in noise were processed with time compression, wide-dynamic range compression, or a combination of time compression and wide-dynamic range compression to create a range of speech-envelope distortions. An acoustic metric, a modified version of the Spectral Correlation Index, was calculated to quantify envelope distortion. Results A binomial generalized linear mixed-effects model indicated that envelope distortion, the cue profile, the interaction between envelope distortion and the cue profile, and the pure-tone average were significant predictors of sentence recognition. Conclusions The listeners with good perception of spectro-temporal contrasts were more resilient to the detrimental effects of envelope compression than listeners who used temporal cues to a greater extent. The cue profile may provide information about individual listening that can direct choice of hearing aid parameters, especially those parameters that affect the speech envelope.
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19
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Saunders GH, Vercammen C, Timmer BHB, Singh G, Pelosi A, Meis M, Launer S, Kramer SE, Gagné JP, Bott A. Changing the narrative for hearing health in the broader context of healthy living: a call to action. Int J Audiol 2021; 60:86-91. [PMID: 33794720 DOI: 10.1080/14992027.2021.1905892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To discuss the steps necessary to facilitate hearing health care in the context of well-being and healthy living. DESIGN Common themes among the articles in this special supplement of the International Journal of Audiology were used to identify issues that must be addressed if audiology is to move from being hearing-focussed to taking a holistic perspective of hearing care in the context of healthy aging. These are discussed within the context of other published literature. RESULTS AND CONCLUSIONS Three needs were identified: (i) Increased interdisciplinary education to raise awareness of the interplay between hearing and health. (ii) Increased emphasis on counselling education in audiology programs so that audiologists are equipped with the knowledge, competence and confidence to provide counselling and emotional support to their patients, beyond care. (iii) Redefinition of therapeutic goal setting and hearing outcomes to include aspects of well-being, so that audiologists can capture and patients realise that that good hearing outcomes can have a direct positive impact on a person's quality of life that extends beyond their improved ability to hear. It was emphasised that each of these needs to be considered within the context of the audiologists' scope of practice and audiologists' well-being.
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Affiliation(s)
- Gabrielle H Saunders
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| | | | - Barbra H B Timmer
- Sonova AG, Stafa, Switzerland.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Gurjit Singh
- Phonak Canada, Mississauga, Canada.,Ryerson University, Toronto, Canada.,University of Toronto, Toronto, Canada
| | | | - Marcus Meis
- Hörzentrum Oldenburg gGmbH, Oldenburg, Germany.,Cluster of excellence Hearing4all, University of Oldenburg, Germany
| | - Stefan Launer
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK.,Sonova AG, Stafa, Switzerland.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Sophia E Kramer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Oldenburg, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Jean-Pierre Gagné
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada.,Fondation Caroline Durand en audition et vieillissement de l'Universtié de Montréal, Montréal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - Anthea Bott
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.,GN Hearing A/S, Ballerup, Denmark
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20
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Whicker JJ, Ong CW, Muñoz K, Twohig MP. The Relationship Between Psychological Processes and Indices of Well-Being Among Adults With Hearing Loss. Am J Audiol 2020; 29:728-737. [PMID: 32916060 DOI: 10.1044/2020_aja-20-00035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose The purpose of this study was to explore the role of psychological processes (i.e., internalized shame, self-efficacy, psychological inflexibility) regarding hearing loss in the well-being of adults who have hearing loss. Method This study used a cross-sectional survey design. Two hundred sixty-four surveys were submitted for analysis. Data were collected using a survey posted to online social media support, in audiology clinics across the country, and through national organizations supporting individuals who have hearing loss. Regressions were used to determine whether internalized shame, self-efficacy, or psychological inflexibility held any predictive value over subjects' well-being. Results Shame, self-efficacy, and psychological inflexibility significantly predicted different aspects of well-being. Conclusion Audiologists should consider the role of internalized thoughts and emotions regarding patients' hearing loss on how patients understand and manage their hearing health.
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Affiliation(s)
- John J. Whicker
- Department of Rehabilitation, Primary Children's Hospital, Salt Lake City, UT
| | | | - Karen Muñoz
- Department of Communicative Disorders and Deaf Education, Utah State University, Logan
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21
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Utoomprurkporn N, Woodall K, Stott J, Costafreda SG, Bamiou DE. Hearing-impaired population performance and the effect of hearing interventions on Montreal Cognitive Assessment (MoCA): Systematic review and meta-analysis. Int J Geriatr Psychiatry 2020; 35:962-971. [PMID: 32458435 DOI: 10.1002/gps.5354] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Older adults are at high risk of developing age-related hearing loss (HL) and/or cognitive impairment. However, cognitive screening tools rely on oral administration of instructions and stimuli that may be impacted by HL. This systematic review aims to investigate (a) whether people with HL perform worse than those without HL on the Montreal Cognitive Assessment (MoCA), a widely used screening tool for cognitive impairment, and what the effect size of that difference is (b) whether HL treatment mitigates the impact of HL. METHOD We conducted a systematic review and meta-analysis including studies that reported mean MoCA scores and SDs for individuals with HL. RESULTS People with HL performed significantly worse on the MoCA (4 studies, N = 533) with a pooled mean difference of -1.66 points (95% confidence interval CI -2.74 to -0.58). There was no significant difference in MoCA score between the pre- vs post-hearing intervention (3 studies, N = 75). However, sensitivity analysis in the cochlear implant studies (2 studies, N = 33) showed improvement of the MoCA score by 1.73 (95% CI 0.18 to 3.28). CONCLUSION People with HL score significantly lower than individuals with normal hearing on the standard orally administered MoCA. Clinicians should consider listening conditions when administering the MoCA and report the hearing status of the tested individuals, if known, taking this into account in interpretation or make note of any hearing difficulty during consultations which may warrant onward referral. Cochlear implants may improve the MoCA score of individuals with HL, and more evidence is required on other treatments. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Nattawan Utoomprurkporn
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK.,Otoneurology Unit, Otolaryngology Department, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Katherine Woodall
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK
| | - Joshua Stott
- Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
| | - Doris Eva Bamiou
- UCL Ear Institute, Faculty of Brain Science, University College London, London, UK.,Hearing and Deafness, NIHR Biomedical Research Centre, London, UK
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22
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Füllgrabe C. On the Possible Overestimation of Cognitive Decline: The Impact of Age-Related Hearing Loss on Cognitive-Test Performance. Front Neurosci 2020; 14:454. [PMID: 32581666 PMCID: PMC7296091 DOI: 10.3389/fnins.2020.00454] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Individual differences and age-related normal and pathological changes in mental abilities require the use of cognitive screening and assessment tools. However, simultaneously occurring deficits in sensory processing, whose prevalence increases especially in old age, may negatively impact cognitive-test performance and thus result in an overestimation of cognitive decline. This hypothesis was tested using an impairment-simulation approach. Young normal-hearing university students performed three memory tasks, using auditorily presented speech stimuli that were either unprocessed or processed to mimic some of the perceptual consequences of age-related hearing loss (ARHL). Both short-term-memory and working-memory capacities were significantly lower in the simulated-hearing-loss condition, despite good intelligibility of the test stimuli. The findings are consistent with the notion that, in case of ARHL, the perceptual processing of auditory stimuli used in cognitive assessments requires additional (cognitive) resources that cannot be used toward the execution of the cognitive task itself. Researchers and clinicians would be well advised to consider sensory impairments as a confounding variable when administering cognitive tasks and interpreting their results.
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Affiliation(s)
- Christian Füllgrabe
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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23
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Raymond MJ, Lee AC, Schader LM, Moore RH, Raol NR, Vivas EX. Practices and perceptions of cognitive assessment for adults with age-related hearing loss. Laryngoscope Investig Otolaryngol 2020; 5:137-144. [PMID: 32128440 PMCID: PMC7042642 DOI: 10.1002/lio2.339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/04/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To investigate the landscape of cognitive impairment (CI) screening for adults with age-related hearing loss (ARHL) among otolaryngologists and audiologists. To identify provider factors and patient characteristics that impact rates of CI screening and referral. METHODS A 15 question online survey was sent to members of the Georgia Society of Otolaryngology (GSO), Georgia Academy of Audiology (GAA), American Otological Society and American Neurotology Society (AOS/ANS), and posted on the web forum for two hearing disorders special interest groups within the American-Speech-Language-Hearing Association (ASHA). Responses were collected anonymously. Chi-square tests were used to compare responses. RESULTS Of the 66 included respondents, 61% (n = 40) were otolaryngologists and 35% (n = 23) were audiologists. Respondents were significantly more likely to refer patients for CI assessment than to screen (64% vs 21%, respectively, P < .001). The complaint of a neurological symptom, such as memory loss, would prompt screening or referral for only 27.3% (n = 18) and 51.52% (n = 34) of respondents, respectively. Forty-two percent (n = 28) of respondents suggested CI screening with the MMSE vs 20% (n = 13) with the Montreal Cognitive Assessment. CONCLUSIONS Despite recommendations for cognitive assessment in high-risk populations, such as older adults with ARHL, the practice of CI screening and referral is not yet commonplace among otolaryngologists and audiologists. These providers have a unique opportunity to assess adults with ARHL for CI and ensure appropriate referral. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- Mallory J. Raymond
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Annika C. Lee
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Lindsey M. Schader
- Department of Biostatistics and Bioinformatics, School of Medicine Biostatistics Collaboration CoreEmory University, Rollins School of Public HealthAtlantaGeorgia
| | - Renee H. Moore
- Department of Biostatistics and Bioinformatics, School of Medicine Biostatistics Collaboration CoreEmory University, Rollins School of Public HealthAtlantaGeorgia
| | - Nikhila R. Raol
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
| | - Esther X. Vivas
- Department of Otolaryngology – Head and Neck SurgeryEmory University School of MedicineAtlantaGeorgia
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24
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Mamo SK, Reed NS, Sharrett AR, Albert MS, Coresh J, Mosley TH, Knopman D, Lin FR, Deal JA. Relationship Between Domain-Specific Cognitive Function and Speech-in-Noise Performance in Older Adults: The Atherosclerosis Risk in Communities Hearing Pilot Study. Am J Audiol 2019; 28:1006-1014. [PMID: 31825642 DOI: 10.1044/2019_aja-19-00043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this study was to investigate associations between performance on a clinical speech-in-noise measure with a comprehensive neurocognitive battery of tests. Method A group of older adults (N = 250, M age = 77 years, age range: 67.3-89.1 years) enrolled in the Atherosclerosis Risk in Communities Neurocognitive Study took part in the hearing pilot study (2013) that included testing for audiometric thresholds and speech-in-noise performance (Quick Speech-in-Noise Test; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004). This research study analyzed the associations between domain-specific cognitive function and speech-in-noise performance after adjusting for hearing thresholds and other demographic and cardiovascular factors. Results Multivariable-adjusted associations were found between all cognitive domains and speech-in-noise performance in the full sample, but the observed associations varied when participants with varying levels of moderate to moderately severe hearing loss were excluded from the analysis. Conclusions The findings are discussed in terms considering the cognitive status of older adults in relation to their speech-in-noise performance during audiological evaluation and implications for aural rehabilitation.
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Affiliation(s)
- Sara K. Mamo
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
| | - Nicholas S. Reed
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Cochlear Center for Hearing and Public Health, Baltimore, MD
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Josef Coresh
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
- George W. Comstock Center for Public Health Research and Prevention, Johns Hopkins Bloomberg School of Public Health, Hagerstown, MD
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Thomas H. Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson
| | | | - Frank R. Lin
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Cochlear Center for Hearing and Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jennifer A. Deal
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Cochlear Center for Hearing and Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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25
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Castiglione A, Casa M, Gallo S, Sorrentino F, Dhima S, Cilia D, Lovo E, Gambin M, Previato M, Colombo S, Caserta E, Gheller F, Giacomelli C, Montino S, Limongi F, Brotto D, Gabelli C, Trevisi P, Bovo R, Martini A. Correspondence Between Cognitive and Audiological Evaluations Among the Elderly: A Preliminary Report of an Audiological Screening Model of Subjects at Risk of Cognitive Decline With Slight to Moderate Hearing Loss. Front Neurosci 2019; 13:1279. [PMID: 31920475 PMCID: PMC6915032 DOI: 10.3389/fnins.2019.01279] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 11/11/2019] [Indexed: 11/25/2022] Open
Abstract
Epidemiological studies show increasing prevalence rates of cognitive decline and hearing loss with age, particularly after the age of 65 years. These conditions are reported to be associated, although conclusive evidence of causality and implications is lacking. Nevertheless, audiological and cognitive assessment among elderly people is a key target for comprehensive and multidisciplinary evaluation of the subject’s frailty status. To evaluate the use of tools for identifying older adults at risk of hearing loss and cognitive decline and to compare skills and abilities in terms of hearing and cognitive performances between older adults and young subjects, we performed a prospective cross-sectional study using supraliminal auditory tests. The relationship between cognitive assessment results and audiometric results was investigated, and reference ranges for different ages or stages of disease were determined. Patients older than 65 years with different degrees of hearing function were enrolled. Each subject underwent an extensive audiological assessment, including tonal and speech audiometry, Italian Matrix Sentence Test, and speech audiometry with logatomes in quiet. Cognitive function was screened and then verified by experienced clinicians using the Montreal Cognitive Assessment Score, the Geriatric Depression Scale, and further investigations in some. One hundred twenty-three subjects were finally enrolled during 2016–2019: 103 were >65 years of age and 20 were younger participants (as controls). Cognitive functions showed a correlation with the audiological results in post-lingual hearing-impaired patients, in particular in those affected by slight to moderate hearing loss and aged more than 70 years. Audiological testing can thus be useful in clinical assessment and identification of patients at risk of cognitive impairment. The study was limited by its sample size (CI 95%; CL 10%), strict dependence on language, and hearing threshold. Further investigations should be conducted to confirm the reported results and to verify similar screening models.
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Affiliation(s)
- Alessandro Castiglione
- Department of Neurosciences, University of Padua, Padua, Italy.,Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Mariella Casa
- Regional Center for the Study and Treatment of the Aging Brain, Department of Internal Medicine, Padua, Italy
| | - Samanta Gallo
- Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Flavia Sorrentino
- Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Sonila Dhima
- Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Dalila Cilia
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Elisa Lovo
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Marta Gambin
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Maela Previato
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Simone Colombo
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Ezio Caserta
- Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Flavia Gheller
- Department of Neurosciences, University of Padua, Padua, Italy
| | | | - Silvia Montino
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Federica Limongi
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - Davide Brotto
- Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Carlo Gabelli
- Regional Center for the Study and Treatment of the Aging Brain, Department of Internal Medicine, Padua, Italy
| | - Patrizia Trevisi
- Department of Neurosciences, University of Padua, Padua, Italy.,Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Roberto Bovo
- Department of Neurosciences, University of Padua, Padua, Italy.,Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
| | - Alessandro Martini
- Department of Neurosciences, University of Padua, Padua, Italy.,Complex Operative Unit of Otolaryngology, Hospital of Padua, Padua, Italy
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26
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Early phase trials of novel hearing therapeutics: Avenues and opportunities. Hear Res 2019; 380:175-186. [DOI: 10.1016/j.heares.2019.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 06/27/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022]
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27
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Shen J, Sherman M, Souza PE. Test Administration Methods and Cognitive Test Scores in Older Adults with Hearing Loss. Gerontology 2019; 66:24-32. [PMID: 31242497 DOI: 10.1159/000500777] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/06/2019] [Indexed: 12/19/2022] Open
Abstract
In light of the high prevalence of hearing loss and cognitive impairment in the aging population, it is important to know how cognitive tests should be administered for older adults with hearing loss. The purpose of the present study is to examine this question with a cognitive screening test and a working memory test. Specifically, we asked the following questions in 2 experiments. First, does a controlled amplification method affect cognitive test scores? Second, does test modality (visual vs. auditory) impact cognitive test scores? Three test administration conditions were created for both Montreal Cognitive Assessment (MoCA) and working memory test (a word recognition and recall test): auditory amplified, auditory unamplified, and visual. The auditory administration was implemented through a computer program to control for presentation level while the visual condition was implemented through timed computer slides. Data were collected from older individuals with mild-to-moderate sensorineural hearing loss. We did not find any effect of amplification or test modality on the total score of the cognitive screening test (i.e., MoCA). Amplification improved working memory performance as measured by word recall performance, but test modality (auditory vs. visual) did not. These results are consistent with literature in demonstrating a downstream effect of audibility on working memory performance. From a clinical perspective, these findings are informative for developing clinical administration protocols of these tests for older individuals with hearing loss.
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Affiliation(s)
- Jing Shen
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo, Michigan, USA,
| | | | - Pamela E Souza
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
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Dupuis K, Reed M, Bachmann F, Lemke U, Pichora-Fuller MK. The Circle of Care for Older Adults With Hearing Loss and Comorbidities: A Case Study of a Geriatric Audiology Clinic. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1203-1220. [PMID: 31026196 DOI: 10.1044/2018_jslhr-h-ascc7-18-0140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Older adults seeking audiologic rehabilitation often present with medical comorbidities, yet these realities of practice are poorly understood. Study aims were to examine (a) the frequency of identification of selected comorbidities in clients of a geriatric audiology clinic, (b) the influence of comorbidities on audiology practice, and (c) the effect of comorbidities on rehabilitation outcomes. Method The records of 135 clients ( M age = 86 years) were examined. Information about comorbidities came from audiology charts (physical paper files) and hospital electronic health records (EHRs). Data about rehabilitation recommendations and outcomes came from the charts. Focus groups with audiologists probed their views of how comorbidities influenced their practice. Results The frequency of identification was 68% for visual, 50% for cognitive, and 42% for manual dexterity issues; 84% had more than one comorbidity. Also noted were hypertension (43%), falls (33%), diabetes (13%), and depression (16%). Integrating information from the audiology chart and EHR provided a more complete understanding of comorbidities. Information about hearing in the EHR included logs of outpatient audiology visits (75% of 135 cases), audiologists' care notes for inpatients and long-term care residents (25%), and entries by other health professionals (60%). Modifications to audiology practice were common and varied depending on comorbidity. High rates of success were achieved regardless of comorbidities. Conclusions In this clinic, successful outcomes were achieved by modifying audiology practice for clients with comorbidities. Increased interprofessional communication among clinicians in the circle of care could improve care planning and outcomes for older adults with hearing loss.
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Affiliation(s)
- Kate Dupuis
- Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Ontario, Canada
- Sheridan Centre for Elder Research, Sheridan College, Oakville, Ontario, Canada
| | - Marilyn Reed
- Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | | | - M Kathleen Pichora-Fuller
- Department of Psychology, University of Toronto, Ontario, Canada
- Rotman Research Institute, Toronto, ON, Canada
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McPherson B. Self-Reported Benefit and Satisfaction with a Beamforming Body-Worn Hearing Aid for Elderly Adults. Int J Otolaryngol 2018; 2018:2046894. [PMID: 30515217 PMCID: PMC6236654 DOI: 10.1155/2018/2046894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/17/2018] [Accepted: 10/11/2018] [Indexed: 11/18/2022] Open
Abstract
Hearing impairment is a leading cause of disability globally and is particularly prevalent in elderly populations. Hearing aids are commonly recommended to mitigate the adverse effects on communication associated with hearing loss. However, the acceptability of hearing aids to elderly individuals is low and the majority of potential users do not wear hearing aids. Most hearing aids are designed with a discreet form factor in mind, to minimize device visibility. Given the range of comorbidities associated with hearing loss in the elderly, this conventional form factor may not always be optimal. The present study examined the experiences of elderly individuals with a recently developed, unconventional, body-worn hearing instrument, the EasyHear™ Grand (Logital Co. Ltd., Hong Kong). The bilaterally fitted instrument incorporates large controls, a color display, beamforming sound processing, and Bluetooth capabilities. Forty-three elderly participants (mean age=71; range 46-88 years) were surveyed to gauge level of benefit and satisfaction with the device and opinions regarding the hearing aid. They were assessed using three standardized questionnaires (the International Outcome Inventory-Hearing Aids, the Profile of Hearing Aid Benefit, and the Client Oriented Scale of Improvement) and through open-ended, structured interviews. Participants rated their EasyHear device fitting highly for hours of use and improved quality of life and rated the device favorably for improved communication and benefit in background noise. A majority of users felt the device improved listening ability in their expressed area of greatest need, and also for their second highest prioritized area of greatest need. Less than 10% of users felt their listening was only occasionally or hardly ever improved when using the body-worn device. Benefit and satisfaction ratings with the EasyHear Grand were comparable to those in studies involving conventional form factor devices. Interviews highlighted areas where users felt the device could be improved-extra noise reduction, changes to device dimensions, receiver/eartip fit, and cableless technology were among the areas mentioned. Many participants valued smartphone linkage and Bluetooth capability. The EasyHear Grand, with its body-worn design and large, simple controls, was well accepted by the majority of participants. Hearing aids that break from conventional design formats may benefit many elderly individuals with hearing impairment and promote increased user acceptability.
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Damirchi A, Hosseini F, Babaei P. Mental Training Enhances Cognitive Function and BDNF More Than Either Physical or Combined Training in Elderly Women With MCI: A Small-Scale Study. Am J Alzheimers Dis Other Demen 2018; 33:20-29. [PMID: 28946752 PMCID: PMC10852433 DOI: 10.1177/1533317517727068] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
INTRODUCTION The effects of mental, physical, and combination of these two trainings were investigated on cognitive performance, serum level of brain derived neurotrophic factor (BDNF), and irisin in women diagnosed with mild cognitive impairment (MCI). MATERIAL AND METHODS Forty-four participants were randomized into 4 groups: physical training (PH; 8 weeks' aerobic training, n = 11), mental training (ME; special computer gaming, n = 11), combined (PH + ME; n = 13), and control group (CO; n = 9). RESULTS Analysis of variance with Tukey post hoc test revealed a significant increase in working memory ( P = .012) and BDNF ( P = 0.024) in the ME compared with the CO group. Also the ME group in comparison with the PH group demonstrated better working memory ( P = .014) and processing speed ( P = .024). CONCLUSION Positive effect of mental training on the cognitive parameters, parallel with BDNF elevation, suggests that mental training is a more useful, safe, and persistent strategy to attenuate the progression of MCI probably via BDNF elevation, but the effect size is relatively small elevation.
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Affiliation(s)
- Arsalan Damirchi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Fatemeh Hosseini
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran
| | - Parvin Babaei
- Cellular & Molecular Research Center, Guilan University of Medical Science, Rasht, Iran
- Neuroscience Research Center, Guilan University of Medical Science, Rasht, Iran
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