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- Title
Cross-Sectional Associations of Peripheral Hearing, Brain Imaging, and Cognitive Performance With Speech-in-Noise Performance: The Aging and Cognitive Health Evaluation in Elders Brain Magnetic Resonance Imaging Ancillary Study.
- Authors
Kening Jiang; Albert, Marilyn S.; Coresh, Josef; Couper, David J.; Gottesman, Rebecca F.; Hayden, Kathleen M.; Jack Jr., Clifford R.; Knopman, David S.; Mosley, Thomas H.; Pankow, James S.; Pike, James R.; Reed, Nicholas S.; Sanchez, Victoria A.; Sharrett, A. Richey; Lin, Frank R.; Deal, Jennifer A.
- Abstract
Purpose: Population-based evidence in the interrelationships among hearing, brain structure, and cognition is limited. This study aims to investigate the cross-sectional associations of peripheral hearing, brain imaging measures, and cognitive function with speech-in-noise performance among older adults. Method: We studied 602 participants in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) brain magnetic resonance imaging (MRI) ancillary study, including 427 ACHIEVE baseline (2018--2020) participants with hearing loss and 175 Atherosclerosis Risk in Communities Neurocognitive Study Visit 6/7 (2016--2017/2018--2019) participants with normal hearing. Speech-in-noise performance, as outcome of interest, was assessed by the Quick Speech-in-Noise (QuickSIN) test (range: 0--30; higher = better). Predictors of interest included (a) peripheral hearing assessed by pure-tone audiometry; (b) brain imaging measures: structural MRI measures, white matter hyperintensities, and diffusion tensor imaging measures; and (c) cognitive performance assessed by a battery of 10 cognitive tests. All predictors were standardized to z scores. We estimated the differences in QuickSIN associated with every standard deviation (SD) worse in each predictor (peripheral hearing, brain imaging, and cognition) using multivariable-adjusted linear regression, adjusting for demographic variables, lifestyle, and disease factors (Model 1), and, additionally, for other predictors to assess independent associations (Model 2). Results: Participants were aged 70-84 years, 56% female, and 17% Black. Every SD worse in better-ear 4-frequency pure-tone average was associated with worse QuickSIN (-4.89, 95% confidence interval, CI [-5.57, -4.21]) when participants had peripheral hearing loss, independent of other predictors. Smaller temporal lobe volume was associated with worse QuickSIN, but the association was not independent of other predictors (-0.30, 95% CI [-0.86, 0.26]). Every SD worse in global cognitive performance was independently associated with worse QuickSIN (-0.90, 95% CI [-1.30, -0.50]). Conclusions: Peripheral hearing and cognitive performance are independently associated with speech-in-noise performance among dementia-free older adults. The ongoing ACHIEVE trial will elucidate the effect of a hearing intervention that includes amplification and auditory rehabilitation on speech-in-noise understanding in older adults.
- Subjects
HEARING disorder diagnosis; TREATMENT of hearing disorders; ATHEROSCLEROSIS risk factors; CROSS-sectional method; PEARSON correlation (Statistics); POISSON distribution; NOISE; SECONDARY analysis; RESEARCH funding; BODY mass index; BRAIN; MULTIPLE regression analysis; SEX distribution; SMOKING; HYPERTENSION; MAGNETIC resonance imaging; AUDIOMETRY; DESCRIPTIVE statistics; CHI-squared test; AGE distribution; LONGITUDINAL method; RACE; AGING; LOUDNESS; SPEECH perception; AUDITORY perception; DATA analysis software; CONFIDENCE intervals; STROKE; COGNITION; EDUCATIONAL attainment; DIABETES; OLD age
- Publication
American Journal of Audiology, 2024, Vol 33, Issue 3, p683
- ISSN
1059-0889
- Publication type
Article
- DOI
10.1044/2024_AJA-23-00108