年龄和认知功能对老年人助听效果的影响  

Effects of Age and Cognitive Ability on Hearing Aid Benefits in the Elderly

作　　者：任寸寸 林颖 徐卓 张馨雨 高泽军 查定军 REN Cuncun;LIN Ying;XU Zhuo;ZHANG Xinyu;GAO Zejun;ZHA Dingjun(Department of Otolaryngology,Head and Neck Surgery,Xijing Hospital,PLA Air Force Military Medical University)

机构地区：[1]空军军医大学第一附属医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2023年第2期170-174,共5页Chinese Journal of Otology

基　　金：国家重点研发计划(2020YFC005200)课题三(2020YFC2005203);学校科技发展基金项目(2022XC037)。

摘　　要：目的探讨年龄和认知功能对老年人佩戴助听器后效果的影响,为老年人听力损失后的干预咨询和佩戴后效果评价提供参考。方法研究对象为88例选配气导助听器的听力损失患者,其中60岁以上患者为老年组,共45例,平均年龄72.14±8.52岁;20-60岁患者为中青年组,共43例,平均年龄39.96±12.18岁。测试患者裸耳纯音听力、最大言语识别率,助听听阈以及助听后声场下65dB SPL的言语识别率(words recognition scores,WRS);并采用中文版助听器效果国际性问卷(the international outcome inventory for hearing aids,IOI-HA问卷)获得助听器在实际聆听环境下的使用效果;采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评价患者的认知功能。采用独立样本t检验分析年龄和认知能力对助听效果的影响。结果老年组和中青年组患者平均裸耳听阈和助听听阈之间差异均无统计学意义(P>0.05)。老年组的裸耳最大WRS和助听后WRS均显著低于中青年组(P<0.05)。IOI-HA总分老年组和中青年组之间差异无统计学意义(P=0.538)。MoCA得分正常的老年组患者的裸耳平均听阈和助听听阈与得分异常的老年组患者之间差异无统计学意义(P>0.05),但助听后WRS和对助听器的使用效果量表得分显著高于得分异常的老年组患者(P<0.05)。结论听力损失程度相当时,老年人佩戴助听器后的言语识别能力明显低于中青年人,但助听器的日常使用效果自我评价差别不大。听力损失程度相当时,老年人的认知能力对助听后的言语识别能力以及助听器的使用效果均有较大影响。提示年龄和认知功能会影响助听器的使用效果,故成人听力损失患者也需要早发现、早诊断、早干预。Objective To study the influence of age and cognitive ability on benefits of hearing aids(HA)in the elderly,and to improve intervention and evaluation of HA benefits in the elderly with hearing loss.Methods Patients with hearing loss and wearing air conduction HA(n=88)were divided into an elderly group(over 60 years,average age=72.14±8.52 years,n=45)and a young and middle-aged group(20-60 years,average age=39.96±12.18 years,n=43).Pure tone hearing thresholds,maximum word recognition scores(WRS),aided thresholds and speech recognition score in in the sound field at 65 dB SPL were obtained.The Chinese version of the international outcome inventory for hearing aids(IOI-HA)was used to assess effects of HA in actual listening environment;The Montreal Cognitive Assessment(MoCA)was used to evaluate cognitive function.Unpaired t-test was used to analyze the influence of age and cognitive ability on HA benefits.Results Average hearing threshold and aided threshold were not significantly different between the elderly group and the young and middle-aged group(P>0.05),although WRS was significantly lower in the former than in the latter(P<0.05).Total IOI-HA score was not significantly different between the two groups(P=0.538).While average hearing threshold and aided threshold were not significantly different between the subjects with normal MoCA scores and those with abnormal scores in the elderly group(P>0.05),WRS and IOI-HA scores in the former were significantly higher than in the latter(P<0.05).Conclusion With comparable hearing loss,speech recognition ability with HA is significantly lower in the elderly than in the young and middle-aged,despite similar self-reported benefits of daily HA use.With equal degree of hearing loss,cognitive ability has a great impact on speech recognition ability with HA as well as overall benefits of HA in the elderly,suggesting the effects of age and cognitive function on the usefulness of HA and therefore the importance of early detection,early diagnosis and early intervention.

关 键 词：年龄 认知能力 助听效果 

分 类 号：R764[医药卫生—耳鼻咽喉科]