Hearing loss, brain aging, and speech-in-noise performance in the ACHIEVE study

ACHIEVE 研究中的听力损失、大脑老化和噪声中的言语表现

• 批准号: 9768308
• 负责人: FRANK R LIN
• 金额: $ 62.18万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9768308
• 关键词: Address; Adult; Affect; Aging; Ancillary Study; Area; Atherosclerosis Risk in Communities; Atrophic; Attenuated; Auditory; Brain; Brain imaging; Brain scan; Characteristics; Cognition; Cognitive; Communities; Control Groups; Counseling; Data; Diffuse; Education; Elderly; Evaluation; Funding; Future; Goals; Health; Hearing; Hearing Aids; Image; Impaired cognition; Intervention; Investigation; Lateral; Link; Magnetic Resonance Imaging; Measures; Modeling; Nature; Neurocognitive; Noise; Participant; Pathway interactions; Performance; Predictive Factor; Psychology; Public Health; Pure-Tone Audiometry; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Sample Size; Self-Help Devices; Site; Structure; Temporal Lobe; aging brain; attenuation; base; cognitive function; cohort; epidemiology study; follow-up; hearing impairment; insight; interest; normal hearing; randomized trial; recruit; speech in noise; white matter

The interrelationships between hearing, brain structure and function (cognition), and the ability to communicate and understand speech-in-noise remain poorly understood. Characterizing these pathways is important for understanding how interventions such as hearing aids could affect the aging brain, cognitive function, and our ability to communicate in noise. The goal of this proposal is to understand the nature of these interrelationships through conducting a brain MRI ancillary study in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomized controlled trial (RCT). The ACHIEVE trial (R01AG055426) is a first-in-kind RCT that will begin recruitment in 2018 of 70-84 year-old adults with mild-moderate hearing loss and normal cognition to investigate whether a hearing intervention (hearing aids, counselling, other assistive devices) versus a successful aging education control intervention reduces rates of cognitive decline. Approximately half of the n = 850 participants will be recruited from the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC- NCS), a longitudinal bi-racial cohort of 15,792 adults who have been followed for >30 years. For this proposal, MRI brain scans will be conducted at baseline and 3 years later in a subset (n = 400) of ACHIEVE participants and in an additional subset (n = 200) of ARIC participants with normal hearing. By leveraging the randomized ACHIEVE study, we will have the opportunity to understand how brain structural characteristics may affect the way hearing, cognition, and hearing aid use predict speech-in-noise performance. In parallel, we will investigate how intervention with hearing aids may causally affect brain structure, thereby providing insights into potential future strategies to mitigate brain aging. The present juncture with the ACHIEVE RCT beginning active recruitment in 2018 offers a singular opportunity to incorporate brain imaging into a randomized trial that may never be repeated again on this scale in order to understand how hearing aids and brain structural characteristics interact with hearing, cognition, and speech-in-noise performance. We propose the following Aims: Aim 1 To investigate the cross-sectional associations of hearing (based on pure tone audiometry), brain MRI structural characteristics, and cognitive function with speech-in-noise performance in ACHIEVE and normal hearing ARIC participants at baseline (N = 600). Aim 2 To investigate the association of hearing aid use with improvement from unaided to aided speech-in-noise performance over 3 year follow-up and to identify which baseline factors predict the magnitude of improvement in ACHIEVE participants randomized to the hearing intervention (N = 200). Aim 3 To determine whether baseline hearing and initiation of hearing aid use are associated with changes in brain structure from baseline to 3 year follow-up (N = 600).

听力、大脑结构和功能（认知）以及沟通能力之间的相互关系 和理解噪声中的语音仍然知之甚少。表征这些途径对于 了解助听器等干预措施如何影响衰老的大脑、认知功能和我们的行为 在噪音中进行交流的能力。该提案的目标是了解这些相互关系的本质 通过进行脑部 MRI 辅助研究来评估老年人的衰老和认知健康 （ACHIEVE）随机对照试验（RCT）。 ACHIEVE 试验 (R01AG055426) 是一项同类首个随机对照试验， 将于 2018 年开始招募 70-84 岁的轻度至中度听力损失和正常认知的成年人 调查听力干预（助听器、咨询、其他辅助设备）是否与听力干预相比 成功的老龄化教育控制干预可降低认知能力下降的速度。大约n的一半 = 850 名参与者将从社区神经认知研究中的动脉粥样硬化风险 (ARIC- NCS），这是一个由 15,792 名成年人组成的纵向双种族队列，随访时间超过 30 年。对于这个提案， MRI 脑部扫描将在基线时和 3 年后对 ACHIEVE 参与者的子集（n = 400）进行 以及听力正常的 ARIC 参与者的另一个子集 (n = 200)。通过利用随机 完成研究后，我们将有机会了解大脑结构特征如何影响 听力、认知和助听器的使用方式可预测噪声中的语音表现。与此同时，我们将 研究助听器干预如何影响大脑结构，从而提供见解 探讨减轻大脑衰老的潜在未来策略。当前 ACIEVE RCT 开始的时刻 2018 年的积极招募提供了一个将脑成像纳入随机试验的独特机会， 为了了解助听器和大脑的结构，可能永远不会再以这种规模重复 特征与听力、认知和噪声中的语音表现相互作用。我们提出以下建议 目标： 目标 1 研究听力（基于纯音测听）、大脑的横截面关联 MRI 结构特征以及 ACHIEVE 和 中的认知功能与噪声中的语音表现 基线时听力正常的 ARIC 参与者 (N = 600)。目标2 调查助听器协会 在 3 年的随访中，从无辅助到有辅助的情况下的语音表现得到改善，并确定 哪些基线因素可以预测 ACHIEVE 参与者随机分配到的改善程度 听力干预（N = 200）。目标 3 确定听力基线和助听器使用是否开始 与从基线到 3 年随访期间大脑结构的变化相关 (N = 600)。