老年人认知障碍与听功能的关系探讨

Relationship between Gerontic Cognition Declination and Hearing Function

目的探讨老年人认知障碍与听功能的关系,并为认知障碍寻找客观的评估方法。方法健康老年人(正常组)、年龄相关认知障碍(agerelatedcognitiondeclination,ARCD)老年患者(ARCD组)以及血管性轻度认知障碍(vascularmildcognitiondeclination,VMCD)的老年患者(VMCD组)各30例,以简易精神状态量表(MMSE)进行认知状态评分,并进行纯音听阈(puretoneaverage,PTA)、听性脑干反应(ABR)及言语测听等听功能检查。结果①纯音听阈、ABR波V反应阈ARCD组及VMCD组较正常组提高,但差异无统计学意义;②言语测听言语识别阈VMCD组显著高于其它组;最大言语识别率VMCD组显著低于其它组,而ARCD组与正常组比较,差异无统计学意义;③ABRIII-V波间期VMCD组显著高于其它组,而ARCD组与正常组比较,差异无统计学意义。结论轻度认知障碍不影响纯音听阈、听性脑干反应等测试结果,系列外周听功能测试方法不能作为评估认知障碍的手段。引起认知障碍的血管病变波及听觉及其它皮层中枢可能导致言语理解障碍。

Objective To investigate the relationship between gerontic cognition declination and hearing function, and to seek an objective method for the related evaluation. Methods Three groups of healthy senior subjects, and related cognition declination（ARCD） and vascular mild cognition declination（VMCD） were selected. For all the volunteers, the cognition status was eval- uated by the mini - mental state- examination, the pure tone average（VIA）, auditory brainstem response （ABR）, speech recognition threshold and phonemically balance test list maximum（Pbmax） score were tested. Results ①PTA and ABR wave V threshold： The ARCD group and VMCD group showed a higher thresholds than the healthy aged group, but the differences had no statistic meanings（ P 〉 0.05） .②The VMCD group had a higher speech recognition threshold than the healthy aged group and the ARCD group（ P 〈 0.05）, and the VMCD group had a lower Pbrnax score than other two groups（ P 〈 0.01 ）. ③ The inter latency of ABR Ⅲ-Ⅴ was obviously longer in VMCD group than that in other two groups（ P 〈 0.01）. But all the difference between the ARCD group and the healthy aged group had no statistic meanings. Conclusion No relationships are found between the cognition declination and the heating functions, a series of peripheral auditory tests can not be used for evaluating cognition status.