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Medel V, Delano PH, Belkhiria C, Leiva A, De Gatica C, Vidal V, Navarro CF, Martín SS, Martínez M, Gierke C, García X, Cerda M, Vergara R, Delgado C, Farías GA. Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12467. [PMID: 38312514 PMCID: PMC10835081 DOI: 10.1002/dad2.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Age-related hearing loss is an important risk factor for cognitive decline. However, audiogram thresholds are not good estimators of dementia risk in subjects with normal hearing or mild hearing loss. Here we propose to use distortion product otoacoustic emissions (DPOAEs) as an objective and sensitive tool to estimate the risk of cognitive decline in older adults with normal hearing or mild hearing loss. METHODS We assessed neuropsychological, brain magnetic resonance imaging, and auditory analyses on 94 subjects > 64 years of age. RESULTS We found that cochlear dysfunction, measured by DPOAEs-and not by conventional audiometry-was associated with Clinical Dementia Rating Sum of Boxes (CDR-SoB) classification and brain atrophy in the group with mild hearing loss (25 to 40 dB) and normal hearing (<25 dB). DISCUSSION Our findings suggest that DPOAEs may be a non-invasive tool for detecting neurodegeneration and cognitive decline in the older adults, potentially allowing for early intervention.
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Affiliation(s)
- Vicente Medel
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Latin American Brain Health Institute (BrainLat) Universidad Adolfo Ibáñez Santiago Chile
| | - Paul H Delano
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Servicio Otorrinolaringología Hospital Clínico de la Universidad de Chile Santiago Chile
- Advanced Center for Electrical and Electronical Engineer (AC3E) Valparaíso Chile
- Biomedical Neuroscience Institute (BNI) Facultad de Medicina Universidad de Chile Santiago Chile
| | - Chama Belkhiria
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
| | - Alexis Leiva
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
| | - Cristina De Gatica
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
| | - Victor Vidal
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
| | - Carlos F Navarro
- Biomedical Neuroscience Institute (BNI) Facultad de Medicina Universidad de Chile Santiago Chile
- Integrative Biology Program Institute of Biomedical Sciences Center for Medical Informatics and Telemedicine Faculty of Medicine Universidad de Chile Santiago Chile
| | - Simon San Martín
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Biomedical Neuroscience Institute (BNI) Facultad de Medicina Universidad de Chile Santiago Chile
| | - Melissa Martínez
- Servicio Neurología y Neurocirugía Hospital Clínico de la Universidad de Chile Santiago Chile
| | - Christine Gierke
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Servicio Neurología y Neurocirugía Hospital Clínico de la Universidad de Chile Santiago Chile
| | - Ximena García
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Advanced Clinical Research Center (CICA) Hospital Clínico Universidad de Chile Santiago Chile
| | - Mauricio Cerda
- Biomedical Neuroscience Institute (BNI) Facultad de Medicina Universidad de Chile Santiago Chile
- Integrative Biology Program Institute of Biomedical Sciences Center for Medical Informatics and Telemedicine Faculty of Medicine Universidad de Chile Santiago Chile
| | - Rodrigo Vergara
- Facultad de Psicología y Humanidades Universidad San Sebastián Sede Valdivia Chile
- Centro Nacional de Inteligencia Artificial (CENIA), Chile
| | - Carolina Delgado
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Servicio Neurología y Neurocirugía Hospital Clínico de la Universidad de Chile Santiago Chile
| | - Gonzalo A Farías
- Departamento de Neurociencia Facultad de Medicina Universidad de Chile Santiago Chile
- Servicio Neurología y Neurocirugía Hospital Clínico de la Universidad de Chile Santiago Chile
- Advanced Clinical Research Center (CICA) Hospital Clínico Universidad de Chile Santiago Chile
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Ferguson MA, Nakano K, Jayakody DMP. Clinical Assessment Tools for the Detection of Cognitive Impairment and Hearing Loss in the Ageing Population: A Scoping Review. Clin Interv Aging 2023; 18:2041-2051. [PMID: 38088948 PMCID: PMC10713803 DOI: 10.2147/cia.s409114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Objective There is a strong association between cognitive impairment and hearing loss, both highly prevalent in the ageing population. Early detection of both hearing loss and cognitive impairment is essential in the management of these conditions to ensure effective and informed decisions on healthcare. The main objective was to identify existing and emerging cognitive and auditory assessment tools used in clinical settings (eg, memory clinics, audiology clinics), which manage the ageing population. Methods A scoping review of peer-reviewed publications and results were reported according to the PRISMA-ScR guidelines. Results A total of 289 articles were selected for data extraction. The majority of studies (76.1%) were conducted in 2017 or later. Tests of global cognitive function (ie, Mini-Mental State Exam, Montreal Cognitive Assessment) were the most commonly used method to detect cognitive impairment in hearing healthcare settings. Behavioral hearing testing (ie, pure-tone audiometry) was the most commonly used method to detect hearing loss in cognitive healthcare settings. Objective, physiological measures were seldom used across disciplines. Conclusion Preferences among clinicians for short, accessible tests likely explain the use of tests of global cognitive function and behavioral hearing tests. Rapidly evolving literature has identified inherent limitations of administering global cognitive function tests and pure-tone testing in an ageing population. Using electrophysiological measures as an adjunct to standard methods of assessment may provide more reliable information for clinical recommendations in those with cognitive and hearing impairment, and subsequently achieve better healthcare outcomes.
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Affiliation(s)
- Melanie A Ferguson
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, University of Western Australia, Perth, Australia
| | - Kento Nakano
- Ear Science Institute Australia, Perth, Australia
| | - Dona M P Jayakody
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, University of Western Australia, Perth, Australia
- Ear Science Institute Australia, Perth, Australia
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Fu X, Eikelboom RH, Liu B, Wang S, Jayakody DMP. The longitudinal relationship between hearing loss and cognitive decline in tonal language-speaking older adults in China. Front Aging Neurosci 2023; 15:1122607. [PMID: 37009456 PMCID: PMC10063895 DOI: 10.3389/fnagi.2023.1122607] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
IntroductionPrevious longitudinal studies indicate that hearing loss and cognitive impairment are associated in non-tonal language-speaking older adults. This study aimed to investigate whether there is a longitudinal association between hearing loss and cognitive decline in older adults who speak a tonal language.MethodsChinese-speaking older adults aged 60 years and above were recruited for baseline and 12 month follow-up measurements. All participants completed a pure tone audiometric hearing test, Hearing Impaired-Montreal Cognitive Assessment Test (HI-MoCA), and a Computerized Neuropsychological Test Battery (CANTAB). The De Jong Gierveld Loneliness Scale was used to measure loneliness, and the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure aspects of mental health. Associations between baseline hearing loss and various cognitive, mental and psychosocial measures were evaluated using logistic regression.ResultsA total of 71 (29.6%) of the participants had normal hearing, 70 (29.2%) had mild hearing loss, and 99 (41.2%) had moderate or severe hearing loss at baseline, based on mean hearing thresholds in the better ear. After adjusting for demographic and other factors, baseline moderate/severe audiometric hearing loss was associated with an increased risk of cognitive impairment at follow-up (OR: 2.20, 95% CI: 1.06, 4.50). When pure-tone average (PTA) was modeled continuously, an average difference of 0.24 in HI-MoCA scores for every 10 dB increase in BE4FA existed, and an average difference of 0.07 in the change of HI-MoCA scores in a 12 month period.DiscussionThe results revealed a significant longitudinal relationship between age-related hearing loss and cognitive decline in this cohort of tonal language-speaking older adults. Steps should also be taken to incorporate hearing assessment and cognitive screening in clinical protocols for older adults 60 years and above in both hearing and memory clinics.
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Affiliation(s)
- Xinxing Fu
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
- *Correspondence: Xinxing Fu,
| | - Robert H. Eikelboom
- Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Bo Liu
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Bo Liu,
| | - Shuo Wang
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dona M. P. Jayakody
- Centre for Ear Sciences, Medical School, The University of Western Australia, Crawley, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
- Curtin Medical School, Curtin University, Bentley, WA, Australia
- WA Centre for Health and Ageing, The University of Western Australia, Crawley, WA, Australia
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