Hearing and dementia

Abstract

Hearing deficits associated with cognitive impairment have attracted much recent interest, motivated by emerging evidence that impaired hearing is a risk factor for cognitive decline. However, dementia and hearing impairment present immense challenges in their own right, and their intersection in the auditory brain remains poorly understood and difficult to assess. Here, we outline a clinically oriented, symptom-based approach to the assessment of hearing in dementias, informed by recent progress in the clinical auditory neuroscience of these diseases. We consider the significance and interpretation of hearing loss and symptoms that point to a disorder of auditory cognition in patients with dementia. We identify key auditory characteristics of some important dementias and conclude with a bedside approach to assessing and managing auditory dysfunction in dementia.

Donepezil enhances understanding of degraded speech in Alzheimer's disease

“…Sinewave speech provides a quantifiable metric for speech perception under challenging listening conditions; our findings are potentially relevant to a variety of daily life situations (for example, accented speech, noisy telephone lines, and cocktail party scenarios) that stress speech perception mechanisms and present particular difficulties for patients with AD 1, 2, 3, 4. The relative selectivity of the present effect suggests that the pairing of procholinergic therapy with specific, dynamic auditory stimuli such as degraded speech may be required to train and to measure perceptual benefit.…”

“…Alzheimer's disease (AD) is associated with impaired higher cortical auditory function and communication, particularly in complex, dynamic acoustic environments, and the role of hearing impairment in cognitive decline is currently the focus of intense interest 1. Patients with AD frequently struggle to understand spoken information in the presence of background noise or when delivered in unfamiliar accents or voices,2, 3, 4 restricting communication and quality of life.…”

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

“…Gates [35] recommends that older patients with difficulty hearing in noise should be tested for CAD. Specific auditory characteristics have been identified in the major neurodegenerative dementias that could potentially be used as markers [36]. By better understanding the relationship between MCI and peripheral or central auditory dysfunction, auditory testing may become a useful part of a cognitive test battery.…”

Functional neuroanatomy of speech signal decoding in primary progressive aphasias

“…Indeed, presentations with word deafness and auditory agnosia have been well-attested since the earliest descriptions of PPA (Fletcher et al., 2013, Mesulam, 1982, Serieux, 1893, Uttner et al., 2006). This is likely to reflect shared neural resources for processing speech and other complex auditory signals, consistent with evidence in the healthy brain (Binder et al., 2000, Goll et al., 2012, Griffiths and Warren, 2002, Hardy et al., 2016, Warren and Griffiths, 2003). It has been proposed that generic deficits of auditory signal processing may be intrinsic to PPA syndromes and could underpin neurolinguistic impairment in these syndromes (Goll et al., 2010, Grube et al., 2016).…”