Computerbasierte Testung neurokognitiver Aspekte im Rahmen der audiologischen Diagnostik

Zusammenfassung

Hintergrund Im Hinblick auf den demographischen Wandel der Gesellschaft gewinnen in der Hörrehabilitation neurokognitive Fähigkeiten immer mehr an Bedeutung.

Fragestellung Ziel der Studie war es zu untersuchen, inwiefern eine neurokognitive Testung mittels PC-gestützter Aufgaben zur Evaluation der unterschiedlichen Bereiche der Kognition auch für ältere Patienten mit und ohne Hörstörung geeignet ist und wie sich diese in den klinischen Alltag des HNO-Arztes integrieren lässt.

Patientenbeschreibung 171 Patienten ≥ 50 Jahren mit und ohne eine beidseitige Hörbeeinträchtigung wurden eingeschlossen: n = 90 im Alter zwischen 50 und 64 Jahren (57,0 ± 4,5) und 81 Ältere ab 65 (72,5 ± 5,4).

Methode Eine computerbasierte Testung mit rein visuellen Instruktionen beinhaltete neben der Aufmerksamkeit, der Verarbeitungsgeschwindigkeit, dem Kurz- und Langzeitgedächtnis auch exekutive Funktionen. Zuvor erfolgte ein Probedurchgang unter Anleitung einer geschulten Mitarbeiterin.

Ergebnisse Auch wenn die Testung unabhängig von Alter oder Hörstatus in allen Fällen eigenständig möglich war, benötigten Hörgeschädigte 15 Minuten länger zur Durchführung und beurteilten diese als anstrengender als Hörgesunde (71 % versus 63 %). Patienten mittleren Alters sahen die Durchführbarkeit für Menschen des höheren Lebensalters mit 30 % signifikant (p = 0,02) kritischer als die betroffene Altersgruppe selbst (10 %).

Schlussfolgerung Eine umfassende kognitive Testung älterer Schwerhöriger mit computerbasierten Aufgaben lässt sich problemlos in den klinischen HNO Alltag integrieren und könnte eine wertvolle Ergänzung der audiologischen Diagnostik im Hinblick auf eine bestmögliche Hörrehabilitation darstellen.

Abstract

Introduction Due to the demographic changes neurocognition has become an important issue also in the field of hearing rehabilitation.

Background The present study aimed to evaluate the feasibility of a neurocognitive test using computer based tasks with regard to the elderly with and without hearing loss and its practicability for the daily clinical ENT setting.

Patients 171 patients of both genders with normal hearing or a profound hearing loss were enrolled in the study: 90 middleaged persons were between 50 and 64 years (57.0 ± 4.5 years) and 81 elderly persons 65 years and older (72.5 ± 5.4).

Method A set of computer-based neurocognitive tasks with only visual instructions covering attention, processing speed, short- and longterm memory as well as executive functions was applied. A presession under the supervision of a trained assistant was included.

Results All patients were capable to complete the assessment by themselves regardless of age and hearing status, however the hearing impaired required 15 minutes more to finish the pretest and reported about a higher level of effort than normal hearing subjects (71 % versus 63 %). Interestingly 90 % of the older individuals claimed the test to fit with all ages, whereas 30 % of the middleaged participants remained skeptical (p = 0.02).

Conclusion The presented neurocognitive assessment might be a useful instrument which can be easily included into the daily clinical ENT. It may give important hints to the otolaryngologist in order to develop the most effective hearing rehabilitation strategy.

Schlüsselwörter

Kognition - computerbasierte Testung - Schwerhörigkeit - Audiologie - Altern

Key words

cognition - computer based testing - hearing impairment - audiology - aging

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