老年性聋与听觉认知功能障碍

Presbycusis and Auditory Cognitive Dysfunction

在老龄化社会中,老年性聋成为中老年人面临的常见慢性病之一。老年性聋影响广泛,除了影响沟通交流外,还会导致精神情绪问题及安全隐患,甚至产生认知功能下降,引起临床医生的重视和关注。老年性聋对听觉认知功能的影响主要通过改变听觉皮层的形态和功能实现。形态学改变主要包括灰质萎缩和皮质变薄;功能改变主要为不同皮层间和功能网络间连接减少;最终导致认知功能下降。因此,老年性聋的临床表现既包括言语感知、识别能力下降等外周和中枢听觉系统障碍,也包括言语理解困难、信息维持障碍、反应速度下降等中枢认知系统障碍,最终导致社会孤立、老年痴呆等严重不良后果,影响生活质量。本文对老年性聋与认知功能关系、老年性聋导致认知功能障碍的表现以及老年性听觉认知功能障碍评估方法等进行总结。

In the aging society,presbycusis has become a common chronic disease faced by the middle-aged and elderly.In addition to affecting communication,presbycusis can also lead to mental and emotional problems,potential safety hazards,and even cognitive function decline.Presbycusis has a wide range of effects.Its impact on auditory cognitive function is mainly realized by changing the shape and function of auditory cortex,which will further affect the overall cognitive state.The morphological changes mainly include gray matter atrophy and cortical thinning;The main functional changes are the decrease of connections between different cortex and functional networks;which eventually lead to cognitive function decline.Therefore,not only do the clinical manifestations of presbycusis include peripheral and central auditory system disorders such as the decline of speech perception and recognition ability,but also central cognitive system disorders such as speech comprehension difficulties,information maintenance disorders and reaction speed decline,which will eventually lead to serious adverse consequences,such as social isolation and dementia,and significantly affect the quality of life.The present review summarized the relationship between presbycusis and cognitive function,the manifestation of cognitive dysfunction caused by presbycusis and the evaluation methods of senile auditory cognitive dysfunction.