Alzheimer Disease Clinical Trial
Official title:
Effect of Hearing Loss and Vestibular Decline on Cognitive Function in Older Subjects: Correlation With Cortical Auditory Evoked Potentials and MRI Brain Volume Changes
The world population has been growing and aging dramatically, with a rising prevalence of
dementia. Worldwide, around 50 million people have dementia, with 10 million new cases added
every year. Despite the epidemic scale of dementia, until now no cure or disease-modifying
therapy has been identified. Therefore, the World Health Organization (WHO) has recognized
dementia as a public health priority. Several large studies have demonstrated that hearing
impairment is associated with a greater risk of cognitive impairment. Hearing rehabilitation
could potentially provide a disease-modifying therapy to delay cognitive decline. Although
auditory behavioral research has not yet revealed a reliable indicator of early cognitive
impairment, cortical-evoked auditory potentials (CAEP) have shown promising evidence as a
non-invasive way to identify early-stage cognitive impairment.
The peripheral vestibular apparatus is located in the inner ear and codes rotation and
translation of the head to preserve a stable view. Increasing evidence suggests that
bilateral vestibular function loss, also known as bilateral vestibulopathy (BVP), leads to
hippocampal atrophy and reduced spatial cognitive skills, as well as structural and
functional alterations in parieto-insular and parieto-temporal regions. Many studies have
demonstrated that vestibular function declines with age. Vestibular dysfunction can be linked
to reduced topographical orientation and memory and has been suggested as a risk factor to
AD, due to increased risk of falling and deficits in activities of daily life (ADL).
Our first aim is to study the effect of SNHL and vestibular decline on CAEP, spatial and
non-spatial cognitive functioning and trajectories in cognitively healthy older subjects, as
well as patients with mild cognitive impairment (MCI) and AD. Our second aim is to study if
MRI brain volume changes can be observed in the hippocampus, entorhinal cortex, and auditory
and vestibular key regions in these populations and correlate with CAEP and cognitive
functioning.
The expected outcome is important to society because it will provide data from a cognitive
assessment protocol adapted for a potentially hearing-impaired population, objective outcome
measures (incl. CAEP and MRI brain volume changes) to identify older subjects with SNHL and
BVP at risk for cognitive decline, and will support screening and interventional studies to
assess the impact of rehabilitation on slowing down cognitive decline.
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