老年人噪声下言语识别的影响因素及听觉认知训练

doi:10.3969/j.issn.1006-9771.2019.02.005

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (2): 151-155.doi: 10.3969/j.issn.1006-9771.2019.02.005

老年人噪声下言语识别的影响因素及听觉认知训练

王贞¹,龚树生²

1. 北京博爱医院听力语言科，北京市 100068
2. 首都医科大学北京友谊医院耳鼻喉头颈外科，北京市 100050

收稿日期:2018-11-18 修回日期:2019-01-25 出版日期:2019-02-25 发布日期:2019-04-01
通讯作者: 龚树生。E-mail: gongss1962@163.com
作者简介:王贞(1979-)，女，汉族，河北文安县人，硕士研究生，主治医师，主要研究方向：听力语言障碍的康复治疗。
基金资助:
1.中央级公益性科研院所基本科研业务费专项基金项目(No. 2015CZ-35)

Factors Influencing Speech Perception in Noise, and Auditory and Cognitive Training in the Elderly (review)

WANG Zhen¹, GONG Shu-sheng²

1. Department of Speech and Hearing Therapy, Beijing Bo’ai Hospital, Beijing 100068, China
2. Department of Otolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2018-11-18 Revised:2019-01-25 Published:2019-02-25 Online:2019-04-01
Contact: GONG Shu-sheng. E-mail: gongss1962@163.com
Supported by:
Special Fund for Fundamental Research Business Expenses of Central Public Welfare Research Institutions (No. 2015CZ-35)

摘要/Abstract

摘要： 老年人多存在噪声下交流困难的情况，无论是否存在听力下降。噪声下言语识别能力下降是听觉中枢处理能力下降的主要表现。同时，外周听力水平和认知水平与其明显相关，彼此相互影响。三者相互作用的机制包括：共同原因、降低-补偿假说、信息退化假说、感觉剥夺假说和认知负荷假说。简而言之，听觉中枢处理能力同认知水平有明确的关系，随年龄的增长同时下降。降级的感觉输入(听力下降或者在噪声下交流)给认知系统带来更多的负荷，占据更多的认知资源，影响认知即时的处理。随着时间的流逝，长期的感觉剥夺会导致认知能力的全面下降。认知水平下降反过来从上而下影响对听觉中枢处理的补偿作用。明确三者之间的相互关系后，再探讨听觉训练和认知训练对噪声下言语识别能力的康复效果。大量研究证实，听觉训练程序在改善听力损失患者的听觉中枢处理和认知功能方面的治疗意义，同时认知训练可以通过训练认知的部分领域(记忆能力)改善认知和听觉中枢处理能力。

关键词: 老龄, 听力下降, 听觉中枢处理, 认知, 噪声下言语识别, 综述

Abstract: The elderly are more likely to have difficulty in communicating in noise, regardless of hearing loss. The decline of speech perception ability in noise is the main manifestation of the decline of central auditory processing ability. Hearing and cognition are significantly correlated with central auditory processing. The mechanisms of interaction among them are common cause, reduction-compensation hypothesis, information degradation hypothesis, sensory deprivation hypothesis and cognitive load hypothesis. In short, central auditory processing is clearly related with cognition, which decreases with age. The sensory input of degradation (hearing loss or communication in noise) brings more loads to the cognitive system, occupies more cognitive resources and affects the immediate processing of cognition. Over time, chronic sensory deprivation causes an overall decline in cognitive ability. Cognitive decline in turn affects the compensatory effect on perception from top to down, thereby affecting central auditory processing ability. After confirming the mutual relations between them, the effects of auditory and cognitive training on speech resolution in noise were explored. A number of studies have confirmed that the hearing training programs can improve central auditory processing and cognitive function in patients with hearing loss, and cognitive training can be trained part of the cognitive domain (memory) to improve cognition and auditory perception.

Key words: aging, hearing loss, central auditory processing, cognition, speech perception in noise, review

中图分类号:

R767.92

王贞, 龚树生. 老年人噪声下言语识别的影响因素及听觉认知训练[J]. 《中国康复理论与实践》, 2019, 25(2): 151-155.

WANG Zhen, GONG Shu-sheng. Factors Influencing Speech Perception in Noise, and Auditory and Cognitive Training in the Elderly (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(2): 151-155.

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老年人噪声下言语识别的影响因素及听觉认知训练

Factors Influencing Speech Perception in Noise, and Auditory and Cognitive Training in the Elderly (review)

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