Addressing Hearing Loss as a Common Unmet Contributor to Neuropsychiatric Symptoms

解决听力损失作为神经精神症状的常见未得到解决的原因

• 批准号: 10641903
• 负责人: CARRIE L NIEMAN
• 金额: $ 80.69万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10641903
• 关键词: Address; Admission activity; Adult; Adverse event; Age; Agitation; Alzheimer' s Disease; Alzheimer' s disease patient; Alzheimer' s disease related dementia; Ambulatory Care; Attenuated; Behavior Therapy; Caring; Characteristics; Clinic; Clinical; Communication; Communication impairment; Consultations; Control Groups; Dementia; Devices; Disease; Disease Progression; Distress; Elderly; Elements; Ensure; Environmental Risk Factor; Equation; Equipment and supply inventories; Ethnic Origin; Etiology; Exposure to; Goals; Health; Hearing; Hearing Aids; Hearing Tests; Heterogeneity; High Prevalence; Home; Impaired cognition; Individual; Institution; Intervention; Interview; Knowledge; Link; Maintenance; Manuals; Measures; Mental Depression; Methodology; Methods; Modeling; Nature; Nursing Homes; Outcome; Outcome Measure; Outpatients; Patients; Perception; Personal Satisfaction; Pharmaceutical Preparations; Pilot Projects; Presbycusis; Prevalence; Process; Protocols documentation; Public Health; Quality of life; Questionnaires; Race; Randomized, Controlled Trials; Recommendation; Research; Role; Safety; Series; Severities; Sleep disturbances; Specific qualifier value; Structure; Surveys; Symptoms; Target Populations; Technology; Testing; Therapeutic; Time; Translating; Waiting Lists; Work; cohort; comorbidity; cost; dementia care; efficacy trial; experience; functional decline; hearing impairment; holistic approach; human old age (65+); implementation barriers; improved; innovation; insight; intervention refinement; mild cognitive impairment; neuropsychiatric symptom; neuropsychiatry; post intervention; primary outcome; recruit; reduce symptoms; responders and non-responders; response; socioeconomics; symptom management; tertiary prevention; theories; therapy design

PROJECT SUMMARY As the number of adults age 65 and older continue to increase, the prevalence of Alzheimer’s disease and other related dementias (ADRD) is also expected to increase in the U.S. Neuropsychiatric symptoms (NPS) such as agitation, apathy, depression, and sleep disturbance are highly prevalent in patients with ADRD, with up to 97% of the individuals suffering at least one NPS over the disease course. NPS requires considerable management and time by care partners, and are associated with rapid cognitive and functional decline, worse quality of life, greater care partner burden, and earlier nursing home admissions. Although nonpharmacological intervention for NPS is recommended, psychotropic medications continue to be widely prescribed, resulting in adverse events. Similar to ADRD, the prevalence of hearing loss increases with age. However, hearing care as tertiary prevention for older adults who have already developed cognitive impairment has largely been ignored. MPIs and the Co-Is of the current proposal have been working together for many years, demonstrating that i) there is a high prevalence of hearing loss among indiviudals with mild cognitive impairment (MCI) and ADRD, ii) increasing severity of hearing loss is associated with greater number of NPS and NPS severity, and that iii) a user-centered hearing care intervention that utilizes emerging over-the-counter (OTC) hearing technology may ameliorate NPS. The current proposal is based upon a prior NIA Stage 1b trial that involved an initial pilot study of a hearing care intervention that utilized OTC hearing devices and was delivered in an outpatient setting. The proposed study returns to Stage 1a and 1b to refine and test the preliminary efficacy of a revised hearing care intervention strategy that targets NPS and examines the underlying mechanism(s) of action. Aim 1 seeks to refine the hearing care intervention through a Stage 1a study that involves consultation with experts and end-users to develop a revised intervention protocol that integrates the latest evidence-informed approaches to NPS along with alignment with theoretical frameworks, consideration of implementation challenges encountered in the initial pilot study, and the ability to deliver the intervention in various settings, including the home. Aim 2 will then assess the preliminary efficacy of the revised hearing care intervention through a larger Stage 1b randomized controlled trial, which will allow for greater rigor in assessing the intervention than prior work. Aim 3 will employ a mixed methods approach to characterize response heterogeneity and underlying mechanism(s) of action. The proposed study embraces the iterative and multidirectional nature of the NIA Stage Model with the goal of developing impactful behavioral interventions that reach the maximum level of potency and potentially implementable to the maximum number of older adults. This proposal builds critical foundational knowledge regarding the role of hearing care as an integral component of managing NPS. These findings will directly translate to a larger Stage 2/3 efficacy trial.

项目成果

ACR Appropriateness Criteria® Tinnitus: 2023 Update.

ACR 适当性标准® 耳鸣：2023 年更新。

• DOI: 10.1016/j.jacr.2023.08.017
• 发表时间: 2023-11-01
• 期刊: Journal of the American College of Radiology : JACR
• 作者: Vikas Jain;B. Policeni;A. Juliano;O. Adunka;Mohit Agarwal;Prachi Dubey;Elliott R Friedman;M. Gule;Mari Hagiwara;Christopher H Hunt;Bruce M Lo;Esther S Oh;Tanya J Rath;J. K. Roberts;David Schultz;M. R. Taheri;D. Z;er;er;Judah Burns
• 通讯作者: Judah Burns