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Relationship between Hearing Loss and Dementia Differs According to the Underlying Mechanism

Journal of Clinical Neurology 2021년 17권 2호 p.290 ~ 299
정진세, 배성훈, 한지혁, 곽상현, 남기성, 이필휴, 손영호, 윤미진, 예병석,
소속 상세정보
정진세 ( Jung Jin-Sei ) - Yonsei University College of Medicine Department of Otorhinolaryngology
배성훈 ( Bae Seong-Hoon ) - Yonsei University College of Medicine Department of Otorhinolaryngology
한지혁 ( Han Ji-Hyuk ) - Yonsei University College of Medicine Department of Otorhinolaryngology
곽상현 ( Kwak Sang-Hyun ) - Yonsei University College of Medicine Department of Otorhinolaryngology
남기성 ( Nam Gi-Sung ) - Yonsei University College of Medicine Department of Otorhinolaryngology
이필휴 ( Lee Phil-Hyu ) - Yonsei University College of Medicine Department of Neurology
손영호 ( Sohn Young-Ho ) - Yonsei University College of Medicine Department of Neurology
윤미진 ( Yun Mi-Jin ) - Yonsei University College of Medicine Department of Nuclear Medicine
예병석 ( Ye Byung-Seok ) - Yonsei University College of Medicine Department of Neurology

Abstract


Background and Purpose: The associations between hearing loss (HL) and the mechanisms underlying cognitive impairment (CI) remain unclear. We evaluated the effects of clinical factors, vascular magnetic resonance imaging (MRI) markers, and CI mechanisms on HL.

Methods: In total, 112 patients with CI (59% demented) and subjective HL prospectively underwent MRI, amyloid positron-emission tomography (PET), hearing evaluations, and neuropsychological tests including a language comprehension test. Patients were categorized into pure-Alzheimer's disease-related CI (ADCI), pure-Lewy-body disease-related CI (LBCI), mixed-ADCI/LBCI, and non-ADCI/LBCI groups based on clinical features and PET biomarkers.

Results: The risk of peripheral HL [defined as a pure-tone average (PTA) threshold >40 dB] was higher in the pure-LBCI group than in the pure-ADCI and mixed-ADCI/LBCI groups, and lower in the presence of ADCI. The non-ADCI/LBCI group had the most-severe vascular MRI markers and showed a higher risk of peripheral HL than did the pure-ADCI and mixed-ADCI/LBCI groups. While the pure-LBCI group had a higher risk of comprehension dysfunction than the pure-ADCI group regardless of the PTA and the score on the Korean version of the Mini Mental State Examination (K-MMSE), those in the pure-LBCI group even with a better K-MMSE score had a risk of comprehension dysfunction comparable to that in the mixed-ADCI/LBCI group due to a worse PTA.

Conclusions: Peripheral HL could be associated with the absence of significant β-amyloid deposition in patients with CI and characteristic of the pure-LBCI and non-ADCI/LBCI groups.

키워드

hearing loss; Alzheimer's disease; Lewy body disease; Parkinson's disease; vascular dementia; cognitive impairments

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