فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی

ارتباط پیرگوشی با افزایش خطر زوال عقل و نقش توانبخشی شنوایی: یک مطالعه مروری

نوع مقاله : مقاله مروری

نویسندگان
الهام توانای 1
علیرضا نمازی شبستری 2
فاطمه السادات میرزاده 3
1 استادیار گروه شنوایی شناسی، دانشکده توانبخشی ، دانشگاه علوم پزشکی تهران، تهران، ایران
2 دانشیار گروه طب سالمندی، دانشکده پزشکی؛ دانشگاه علوم پزشکی تهران، تهران، ایران
3 استادیار گروه طب سالمندی، دانشکده پزشکی؛ دانشگاه علوم پزشکی تهران، تهران، ایران
10.22038/jpsr.2025.86549.2689
چکیده
هدف:
رابطه بین کم شنوایی ناشی از سن و مشکلات شناختی در مطالعات اخیر بسیار مورد بررسی قرار گرفته است. از آنجایی که تشخیص زودهنگام تنها راه درمان اختلالات شناختی در دوران سالمندی است، بنابراین، استفاده از روش های توانبخشی شنیداری ممکن است برای پیشگیری از این اختلالات مفید واقع شود. تاکنون مقاله مروری فارسی در این زمینه منتشر نشده است. این مقاله قصد دارد به بررسی رابطه پیرگوشی و زوال عقل، توصیف مکانیسم‌های زیربنائی آن و نقش مداخلات توانبخشی شنوایی در پیشگیری از این اختلالات بپردازد.
روش بررسی:
در این مقاله، پایگاه های اطلاعاتی PubMed، Scopus، Google Scholar، و پایگاه‌داده مرورهای سیستماتیک با کلیدواژه های "کم شنوایی ناشی از سن"، "پیر گوشی"، "اختلالات شناختی"، "آلزایمر"، "زوال عقل"، "سمعک "و " کاشت حلزون" برای شناسایی مقالات مرتبط منتشر شده در سال های اخیر جستجو شدند و مقالات مرتبط استخراج شده و مورد نقد و بررسی قرار گرفتند.
یافته ها:
پژوهش های رفتاری و الکتروفیزیولوژیک و همچنین تصویربرداری ها نشان داده‌اند که کم شنوایی با بروز زوال عقل قویاً ارتباط دارد. توانبخشی های شنوایی که عمدتاً با استفاده از سمعک و کاشت انجام می پذیرند، نقش موثری را در پیشگیری از اختلالات شناختی در دوران سالمندی نشان داده‌اند. مکانیسم مطرح شده این است که تجربه شنوایی افزایش یافته از طریق استفاده از سمعک، می تواند منجر به پلاستیسیتی در سیستم شنوایی، افزایش دامنه پتانسیل های برانگیخته و عملکرد حافظه کاری شود که در نهایت عملکرد کلی شناختی را بهبود می بخشد. در مورد روش توانبخشی های شنوایی دیگر مانند تربیت شنوایی مطالعات محدود است و نیاز به مطالعات بیشتری در این زمینه است. 
نتیجه گیری:
نتایج پژوهش ها نشان می دهد که کم شنوایی در بروز زوال عقل نقش مهمی دارد و استفاده از وسایل کمک شنوایی در کم شنوایان مانند سمعک، میتواند خطر نسبی اختلالات شناختی مانند زوال عقل و آلزایمر را در سالمندان کاهش دهد. مطالعات بیشتری مورد نیاز است تا مشخص شود که سمعک باید با چه ویژگی های خاصی تنظیم شود تا اثر بیشتری بر پیشگیری از اختلالات شناختی و یا حتی بهبود آن ها داشته باشد.

کلیدواژه‌ها
پیرگوشی
اختلالات شناختی
زوال عقل
آلزایمر
سمعک
کاشت حلزون
  1. Tavanai E, Mohammadkhani G. Role of antioxidants in prevention of age-related hearing loss: a review of literature. Eur Arch Otorhinolaryngol 2017; 274(4): 1821-1834.
  2. Lee KY. Pathophysiology of age-related hearing loss (peripheral and central). Korean J Audiol 2013; 17(2): 45-49.
  3. Panza F, Lozupone M, Sardone R, Battista P, et al. Sensorial frailty: age-related hearing loss and the risk of cognitive impairment and dementia in later life. Ther Adv Chronic Dis 2019; 10: 2040622318811000.
  4. Li P, Pang K, Zhang R, Zhang L, Xie H. Prevalence and risk factors of hearing loss among the middle-aged and older population in China: a systematic review and meta-analysis. Eur Arch Oto-Rhino-Laryngol 2023; 280(11): 4723-4737.
  5. Lin FR, Ferrucci L, Metter EJ, An Y, et al. Hearing loss and cognition in the Baltimore Longitudinal Study of Aging. Neuropsychology 2011; 25(6): 763-770.
  6. Loughrey DG, Kelly ME, Kelley GA, Brennan S, Lawlor BA. Association of Age-Related Hearing Loss with Cognitive Function, Cognitive Impairment, and Dementia: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2018; 144(2): 115-126.
  7. Meybodian M, Sohrabpour S. The screening of hearing and the common deafness gene in the elderly in Iran. Pakistan J Med Health Sci. 2021; 15(3): 980-983.
  8. Tavanai E, Rahimi V, Khalili ME, Falahzadeh S, et al. Age-related hearing loss: An updated and comprehensive review of the interventions. Iranian J Basic Med Sci 2024; 27(3): 256-269.
  9. Fuller-Thomson E, Nowaczynski A, MacNeil A. The Association Between Hearing Impairment, Vision Impairment, Dual Sensory Impairment, and Serious Cognitive Impairment: Findings from a Population-Based Study of 5.4 million Older Adults. J Alzheimers Dis Rep 2022; 6(1): 211-222.
  10. Hu W, Wang Y, Wang W, Zhang X, et al. Association of Visual, Hearing, and Dual Sensory Impairment with Incident Dementia. Front Aging Neurosci 2022; 14: 872967.
  11. Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev 2019; 56: 100963.
  12. Lad M, Sedley W, Griffiths TD. Sensory loss and risk of dementia. Neuroscientist 2024; 30(2): 247-259.
  13. Chern A, Golub JS. Age-related Hearing Loss and Dementia. Alzheimer Dis Assoc Disord 2019; 33(3): 285-290.
  14. Golding M, Taylor A, Cupples L, Mitchell P. Odds of demonstrating auditory processing abnormality in the average older adult: The Blue Mountains Hearing Study. Ear Hear 2006; 27(2): 129-138.
  15. Häggström J, Hederstierna C, Rosenhall U, Östberg P, Idrizbegovic E. Prognostic Value of a Test of Central Auditory Function in Conversion from Mild Cognitive Impairment to Dementia. Audiol Neurootol 2020; 25(5): 276-282.
  16. Strouse AL, Hall JW, 3rd, Burger MC. Central auditory processing in Alzheimer's disease. Ear Hear 1995; 16(2): 230-238.
  17. Curhan SG, Willett WC, Grodstein F, Curhan GC. Longitudinal study of hearing loss and subjective cognitive function decline in men. Alzheimer's Dement. 2019; 15(4): 525-533.
  18. Fritze T, Teipel S, Óvári A, Kilimann I, et al. Hearing Impairment Affects Dementia Incidence. An Analysis Based on Longitudinal Health Claims Data in Germany. PLoS One. 2016; 11(7): e0156876
  19. Golub JS, Brickman AM, Ciarleglio AJ, Schupf N, Luchsinger JA. Association of Subclinical Hearing Loss with Cognitive Performance. JAMA Otolaryngol Head Neck Surg 2020; 146(1): 57-67.
  20. Kim SY, Lim JS, Kong IG, Choi HG. Hearing impairment and the risk of neurodegenerative dementia: A longitudinal follow-up study using a national sample cohort. Sci Rep. 2018; 8(1):15266.
  21. Swords GM, Nguyen LT, Mudar RA, Llano DA. Auditory system dysfunction in Alzheimer disease and its prodromal states: A review. Ageing Res Rev. 2018; 44: 49-59.
  22. Edwards JD, Lister JJ, Elias MN, Tetlow AM, et al. Auditory processing of older adults with probable mild cognitive impairment. J Speech Lang Hear Res 2017; 60(5): 1427-1435.
  23. Gates GA, Anderson ML, McCurry SM, Feeney MP, Larson EB. Central auditory dysfunction as a harbinger of Alzheimer dementia. Arch Otolaryngol Head Neck Surg. 2011; 137(4): 390-395.
  24. Idrizbegovic E, Hederstierna C, Dahlquist M, Rosenhall U. Short-term longitudinal study of central auditory function in Alzheimer's disease and mild cognitive impairment. Dement Geriatr Cogn Dis Extra. 2013; 3(1): 468-471.
  25. Jalaei B, Valadbeigi A, Panahi R, Nahrani MH, et al. Central Auditory Processing Tests as Diagnostic Tools for the Early Identification of Elderly Individuals with Mild Cognitive Impairment. J Audiol Otol. 2019; 23(2): 83-88.
  26. Lau K, Dimitriadis PA, Mitchell C, Martyn-St-James M, et al. Age-related hearing loss and mild cognitive impairment: a meta-analysis and systematic review of population-based studies. J Laryngol Otol 2022; 136(2): 103-118.
  27. Davies HR, Cadar D, Herbert A, Orrell M, Steptoe A. Hearing Impairment and Incident Dementia: Findings from the English Longitudinal Study of Ageing. J Am Geriatr Soc. 2017; 65(9): 2074-2081.
  28. Häggström J, Rosenhall U, Hederstierna C, Östberg P, Idrizbegovic E. A longitudinal study of peripheral and central auditory function in Alzheimer’s disease and in mild cognitive impairment. Dement Geriatr Cogn Dis Extra. 2019; 8(3): 393-401.
  29. Lin FR, Metter EJ, O'Brien RJ, Resnick SM, et al. Hearing loss and incident dementia. Arch Neurol. 2011; 68(2): 214-220.
  30. Jayakody DMP, Friedland PL, Martins RN, Sohrabi HR. Impact of Aging on the Auditory System and Related Cognitive Functions: A Narrative Review. Front Neurosci. 2018; 12: 125.
  31. Idrizbegovic E, Hederstierna C, Dahlquist M, Kämpfe Nordström C, et al. Central auditory function in early Alzheimer's disease and in mild cognitive impairment. Age Ageing. 2011; 40(2): 249-254.
  32. Nixon G, Sarant JZ, Tomlin D, Dowell R. The relationship between peripheral hearing loss and higher order listening function on cognition in older Australians. Int J Audiol 2019; 58(12): 933-944.
  33. Utoomprurkporn N, Hardy CJD, Stott J, Costafreda SG, et al. "The Dichotic Digit Test" as an Index Indicator for Hearing Problem in Dementia: Systematic Review and Meta-Analysis. J Am Acad Audiol 2020; 31(9): 646-655.
  34. Howe AS, Bani-Fatemi A, De Luca V. The clinical utility of the auditory P300 latency subcomponent event-related potential in preclinical diagnosis of patients with mild cognitive impairment and Alzheimer’s disease. Brain Cogn 2014; 86: 64-74.
  35. Mohamed M, Mohamed N, Kim JG. P300 Latency with Memory Performance: A Promising Biomarker for Preclinical Stages of Alzheimer’s Disease. Biosensors. 2024; 14(12): 616.
  36. Griffiths TD, Lad M, Kumar S, Holmes E, et al. How can hearing loss cause dementia? Neuron 2020; 108(3): 401-412.
  37. Armstrong NM, An Y, Doshi J, Erus G, et al. Association of midlife hearing impairment with late-life temporal lobe volume loss. JAMA otolaryngology–head & neck surgery. 2019; 145(9): 794-802.
  38. Cao X, Liu Q, Liu J, Yang B, Zhou J. The impact of hearing loss on cognitive impairment: the mediating role of depressive symptoms and the moderating role of social relationships. Front Public Health 2023; 11: 1149769.
  39. Castiglione A, Benatti A, Velardita C, Favaro D, et al. Aging, cognitive decline and hearing loss: effects of auditory rehabilitation and training with hearing aids and cochlear implants on cognitive function and depression among older adults. Audiol Neurotol 2016; 21(Suppl. 1): 21-28.
  40. Conceição Santos de Oliveira D, Gomes-Filho IS, Araújo EM, Xavier Ramos MdS, et al. Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study. Plos One. 2023; 18(11): e0288099.
  41. Ford AH, Hankey GJ, Yeap BB, Golledge J, et al. Hearing loss and the risk of dementia in later life. Maturitas 2018; 112: 1-11.
  42. Fortunato S, Forli F, Guglielmi V, De Corso E, et al. A review of new insights on the association between hearing loss and cognitive decline in ageing. Acta Otorhinolaryngol Ital 2016; 36(3): 155-166.
  43. Glick HA, Sharma A. Cortical Neuroplasticity and Cognitive Function in Early-Stage, Mild-Moderate Hearing Loss: Evidence of Neurocognitive Benefit from Hearing Aid Use. Front Neurosci. 2020; 14: 93.
  44. Heywood R, Gao Q, Nyunt MSZ, Feng L, et al. Hearing loss and risk of mild cognitive impairment and dementia: findings from the Singapore longitudinal ageing study. Dement Geriatr Cogn Disord 2017; 43(5-6): 259-268.
  45. Jayakody DM, Friedland PL, Eikelboom RH, Martins RN, Sohrabi HR. A novel study on association between untreated hearing loss and cognitive functions of older adults: baseline non‐verbal cognitive assessment results. Clin Otolaryngol 2018; 43(1): 182-191.
  46. Brewster KK, Hu M-C, Zilcha-Mano S, Stein A, et al. Age-related hearing loss, late-life depression, and risk for incident dementia in older adults. J Gerontol A Biol Sci Med Sci. 2021; 76(5): 827-834.
  47. Thomson RS, Auduong P, Miller AT, Gurgel RK. Hearing loss as a risk factor for dementia: A systematic review. Laryngoscope Investig Otolaryngol 2017; 2(2): 69-79.
  48. Tai C-J, Tseng T-G, Hsiao Y-H, Kuo T-A, et al. Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA). BMC geriatrics 2021; 21: 1-10.
  49. Acar B, Yurekli MF, Babademez MA, Karabulut H, Karasen RM. Effects of hearing aids on cognitive functions and depressive signs in elderly people. Arch Gerontol Geriatr 2011; 52(3): 250-252.
  50. Amieva H, Ouvrard C, Giulioli C, Meillon C, et al. Self‐reported hearing loss, hearing aids, and cognitive decline in elderly adults: a 25‐year study. J Am Geriatr Soc 2015; 63(10): 2099-20104.
  51. Mahmoudi E, Basu T, Langa K, McKee MM, et al. Can hearing aids delay time to diagnosis of dementia, depression, or falls in older adults? J Am Geriatr Soc 2019; 67(11): 2362-2369.
  52. Dawes P, Cruickshanks KJ, Fischer ME, Klein BE, et al. Hearing-aid use and long-term health outcomes: Hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality. Int J Audiol 2015; 54(11): 838-844.
  53. Dillard LK, Pinto A, Mueller KD, Schubert CR, et al. Associations of hearing loss and hearing aid use with cognition, health-related quality of life, and depressive symptoms. J Aging Health. 2023; 35(7-8): 455-465.
  54. Laird EC, Bennett RJ, Barr CM, Bryant CA. Experiences of hearing loss and audiological rehabilitation for older adults with comorbid psychological symptoms: A qualitative study. Am J Audiol 2020; 29(4): 809-824.
  55. Maharani A, Dawes P, Nazroo J, Tampubolon G, et al. Longitudinal relationship between hearing aid use and cognitive function in older Americans. J Am Geriatr Soc 2018; 66(6): 1130-1136.
  56. Sugiura S, Nishita Y, Uchida Y, Shimono M, et al. Longitudinal associations between hearing aid usage and cognition in community-dwelling Japanese older adults with moderate hearing loss. PloS One. 2021; 16(10): e0258520.
  57. Karawani H, Jenkins K, Anderson S. Neural plasticity induced by hearing aid use. Front Aging Neurosci 2022; 14: 884917.
  58. Atef RZ, Michalowsky B, Raedke A, Platen M, et al. Impact of hearing aids on progression of cognitive decline, depression, and quality of life among people with cognitive impairment and dementia. J Alzheimer's Dis 2023; 92(2): 629-638.
  59. Yang Z, Ni J, Teng Y, Su M, et al. Effect of hearing aids on cognitive functions in middle-aged and older adults with hearing loss: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14: 1017882.
  60. Dawes P, Emsley R, Cruickshanks KJ, Moore DR, et al. Hearing loss and cognition: the role of hearing AIDS, social isolation and depression. PloS One. 2015; 10(3): e0119616.
  61. Ghiringhelli R, Iorio MCM. Hearing aids and recovery times: a study according to cognitive status. Braz J Otorhinolaryngol 2013; 79(2): 177-84.
  62. Curhan SG, Willett WC, Grodstein F, Curhan GC. Longitudinal study of self-reported hearing loss and subjective cognitive function decline in women. Alzheimer's dement 2019; 16(4): 610-620.
  63. Henshaw H, Ferguson M, editors. Assessing the benefits of auditory training to real-world listening: identifying appropriate and sensitive outcomes. Proceedings of the International Symposium on Auditory and Audiological Research; 2013.
  64. Ferguson MA, Henshaw H, Clark DP, Moore DR. Benefits of phoneme discrimination training in a randomized controlled trial of 50-to 74-year-olds with mild hearing loss. Ear Hear 2014; 35(4): e110-e21.
  65. Krishnamurti S, Tingle D, Bannon H, Armstrong M. Role of auditory training in intervention of individuals with cognitive decline and hearing impairment. Perspectives on Gerontology 2015; 20(2): 58-64.
  66. Mamo SK, Nirmalasari O, Nieman CL, McNabney MK, et al. Hearing care intervention for persons with dementia: a pilot study. Am J Geriatr Psychiatry 2017; 25(1): 91-101.
  67. Reis M, McMahon CM, Távora-Vieira D, Humburg P, Boisvert I. Effectiveness of computer-based auditory training for adult cochlear implant users: A randomized crossover study. Trends Hear 2021; 25: 23312165211025938.
  68. Saunders GH, Smith SL, Chisolm TH, Frederick MT, et al. A randomized control trial: Supplementing hearing aid use with listening and communication enhancement (LACE) auditory training. Ear hear 2016; 37(4): 381-396.
  69. Frost E, Porat T, Malhotra P, Picinali L. A novel auditory-cognitive training app for delaying or preventing the onset of dementia: participatory design with stakeholders. JMIR Hum Factors 2020; 7(3): e19880.
  70. Lawrence BJ, Jayakody DM, Henshaw H, Ferguson MA, et al. Auditory and cognitive training for cognition in adults with hearing loss: A systematic review and meta-analysis. Trends Hear 2018; 22: 2331216518792096.
  71. Yusof Y, Mukari SZS, Dzulkifli MA, Chellapan K, et al. Efficacy of a newly developed auditory-cognitive training system on speech recognition, central auditory processing and cognitive ability among older adults with normal cognition and with neurocognitive impairment. Geriatr Gerontol Int 2019; 19(8): 768-773.
فصلنامه علمی- پژوهشی علوم پیراپزشکی وتوانبخشی
دوره 14، شماره 2
تابستان 1404
صفحه 97-107