老年性聋患者认知功能障碍初探

Preliminary study on cognitive dysfunction in presbycusis

摘要:

目的 分析老年性聋患者认知功能障碍情况，初步探讨老年性聋患者认知功能障碍的干预措施。方法 以2018年10月-2020年4月于空军特色医学中心行听力测试及言语识别能力调查的55例60岁及以上老年性聋患者为研究对象，其中男27例，女28例；年龄60~95岁。所有研究对象完成纯音听阈测试（PTA）、简易智能精神状态量表（MMSE）评估及普通话快速噪声下言语测试（M-Quick SIN），分析不同年龄、不同听力损失程度和信噪比损失（SNR loss）程度下老年性聋患者的MMSE得分情况。结果 ①60~69岁组MMSE得分（27.89±1.82）分，高于70~79岁组（26.35±2.03）分和≥ 80岁组（25.19±2.07）分的得分，差异具有统计学意义（P<0.05）；70~79岁组和≥ 80岁组间MMSE量表得分的差异不具有统计学意义（P>0.05）；②不同听力损失组间MMSE量表得分的差异不具有统计学意义（P>0.05）；③轻度SNR loss组的MMSE量表得分（27.13±1.80）分高于重度SNR loss组（24.20±1.64）分（P<0.05）；轻度SNR loss组和中度SNR loss组、中度SNR loss组和重度SNR loss组间MMSE量表得分的差异不具有统计学意义（P>0.05）。结论 老年性聋患者认知功能障碍以SNR loss为主要特征，在听力损失早期进行干预是最佳时机。

Abstract:

Objective To analyze the situation of cognitive impairment in patients with presbycusis, and to explore the intervention measures of cognitive impairment.Methods A total of 55 presbycusis aged 60 years and above (27 males and 28 females), aged 60~95 years old, were selected as subjects in Air Force Special Medical Center from October 2018 to April 2020. All patients underwent hearing test and speech recognition ability survey. All patients completed pure tone audiometry (PTA), Mini-Mental State Examination (MMSE) and Mandarin fast speech under noise test (M-Quick SIN). It was analyzed for MMSE scores of presbycusis with different age, hearing loss and SNR (signal-to-noise ratio, SNR) loss.Results ①The MMSE score of 60~69 years old group 27.89±1.82 was higher than that of 70~79 years old group 26.35±2.03 and ≥ 80 years old 25.19±2.07 (P<0.05); there was no significant difference in MMSE scores between 70~79 years old group and ≥ 80 years old group (P>0.05). ②There was no significant difference in MMSE score among different hearing loss groups (P>0.05). ③The MMSE score of mild SNR loss group 27.13±1.80 was higher than that of severe SNR Loss group 24.20±1.64 (P<0.05); there was no significant difference in MMSE score between mild SNR loss group and moderate SNR loss group, moderate SNR loss group and severe SNR loss group (P>0.05).Conclusion The main feature of cognitive impairment in patients with presbycusis is SNR loss. It is the best time to intervene in the early stage of hearing loss.