Implicações da memória operacional no aproveitamento da estimulação acústica com próteses auditivas e na qualidade de vida de idosos
Data
2022-07-05
Autores
Baruzzi, Maria Beatriz [UNIFESP]
Orientadores
Martinelli, Maria Cecilia [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Diante do aumento da expectativa de vida, o envelhecimento ativo é o paradigma atual, em especial em países em desenvolvimento, onde se verificam alta prevalência de doenças crônicas e níveis socioeconômicos e educacionais mais baixos. A perda auditiva pode afetar a funcionalidade, a interação social e a qualidade de vida de idosos. Objetivo: verificar a correlação entre a memória operacional e as variáveis demográficas, bem como as implicações dessa correlação no aproveitamento da estimulação acústica com próteses auditivas e na qualidade de vida de idosos. Métodos: estudo retrospectivo longitudinal, composto por 48 participantes (52,1% do sexo feminino) entre 60 e 94 anos de idade, com escolaridade variando de zero a 19 anos (média ± DP: 7,8 ± 5,2), sem sintomas de demência (CASI-S ≥ 23 pontos; média ± DP: 29,2 ± 2,5) e com perda auditiva relacionada ao envelhecimento (grau leve a moderado). Coletaram-se dados referentes à escala de depressão geriátrica (EDG), testes de memória operacional (MO), gaps-in-noise test (GIN), teste de lista de sentenças em português (LSP) e questionário de qualidade de vida (SF-36) aplicados antes e após quatro meses do uso efetivo de próteses auditivas (dispensação gratuita). Ao término desse período, incluíram-se o registro do tempo médio de uso diário (DL) das próteses auditivas e os resultados do questionário autoavaliação (QI-AASI). A análise estatística envolveu medidas repetidas do mesmo indivíduo e se fixou o nível de significância de 0,05 para cada teste de hipótese. Resultados: houve maior concentração na classe socioeconômica C2 (41,7%) (ABEP), tendo essa variável correlação positiva com a escolaridade e os testes de MO. Melhores resultados no GIN estiveram relacionados a idades mais baixas, mais tempo de escolaridade, classe socioeconômica mais alta e a escores superiores nos testes de MO. Houve melhora significativa nas médias das pontuações no GIN e na LSP com o uso da amplificação sonora. Após quatro meses de intervenção auditiva, houve redução dos sintomas depressivos, mas sem diferença significativa no SF-36. O DL (7 a 15 horas/dia) e o QI-AASI (31,9±2,3) apresentaram bons resultados, e observou-se correlação negativa entre o DL, a escolaridade e a pontuação no digit span-D, e entre o QI-AASI, a escolaridade, o ABEP e a pontuação no running span. Conclusões: foi evidenciada correlação positiva entre as variáveis: escolaridade, ABEP, resolução temporal auditiva e MO. O uso da amplificação sonora esteve associado à redução dos sintomas depressivos e a melhores resultados na resolução temporal e no reconhecimento de sentenças no ruído, porém não houve impacto significativo na qualidade de vida. O uso e o benefício das próteses auditivas apresentaram correlação negativa com a escolaridade e não apresentaram correlação estreita com a maioria dos testes de MO.
Given the increase in life expectancy, active aging is the current paradigm, especially in developing countries, with a high prevalence of chronic diseases and lower socioeconomic and educational levels. Hearing loss can affect functionality, social interaction, and quality of life of older people. Objective: to verify the correlation between working memory (WM) and various variables, as well as the implications of this correlation in the use of acoustic stimulation with hearing aids and in the quality of life of the elderly. Methods: longitudinal retrospective study; composed of 48 participants (52,1% women), aged 60 to 94 years, with schooling from zero to 19 years (mean ± SD: 7.8 ± 5.2), without symptoms of dementia (CASI-S ≥ 23 points; mean ± SD: 29.2 ± 2,5) and with age-related hearing loss (mild to moderate degree). Data were collected on the geriatric depression scale (GDS), working memory (WM) tests, gap- in-noise test (GIN), Portuguese sentence list test (LSP) and the quality-of-life questionnaire (SF-36) applied before and after four months of effective use of hearing aid (free dispensing). At the end of this period, data logging information (DL) and the International Outcome Inventory for Hearing Aids (QI-AASI) were also added. Statistical analysis involved repeated measurements from the same individual and the level of significance was set at 0.05 for each hypothesis test. Results: there was a higher concentration in socioeconomic class C2 (41,7%). Higher socioeconomic classes and education were associated with better performance in working memory tests. Better results in the GIN were relates to younger ages, higher education, ABEP and higher socres in WM tests. There was a significant improvement in mean GIN and LSP scores with the use of sound amplification. After four months of hearing intervention there was a reduction in depressive symptoms but not significant difference on the SF-36. The DL (7 to 15 hours/day) and the QI-AASI (31.9 ± 2.3) showed good results, there was a negative correlation between DL, formal education and the score obtained in the digit span-D, and between the QI-AASI, formal education, ABEP and the running span score. Conclusions: there was a positive correlation between the variables: education, ABEP, auditory temporal resolution and WM. The use of sound amplification was associated with a reduction in depressive symptoms and better results in auditory temporal resolution and sentence recognition in noise., however, there was no significant impact on quality of life. Hearing aid use and benefit showed a negative correlation with education and did not show a close correlation with most WM tests.
Given the increase in life expectancy, active aging is the current paradigm, especially in developing countries, with a high prevalence of chronic diseases and lower socioeconomic and educational levels. Hearing loss can affect functionality, social interaction, and quality of life of older people. Objective: to verify the correlation between working memory (WM) and various variables, as well as the implications of this correlation in the use of acoustic stimulation with hearing aids and in the quality of life of the elderly. Methods: longitudinal retrospective study; composed of 48 participants (52,1% women), aged 60 to 94 years, with schooling from zero to 19 years (mean ± SD: 7.8 ± 5.2), without symptoms of dementia (CASI-S ≥ 23 points; mean ± SD: 29.2 ± 2,5) and with age-related hearing loss (mild to moderate degree). Data were collected on the geriatric depression scale (GDS), working memory (WM) tests, gap- in-noise test (GIN), Portuguese sentence list test (LSP) and the quality-of-life questionnaire (SF-36) applied before and after four months of effective use of hearing aid (free dispensing). At the end of this period, data logging information (DL) and the International Outcome Inventory for Hearing Aids (QI-AASI) were also added. Statistical analysis involved repeated measurements from the same individual and the level of significance was set at 0.05 for each hypothesis test. Results: there was a higher concentration in socioeconomic class C2 (41,7%). Higher socioeconomic classes and education were associated with better performance in working memory tests. Better results in the GIN were relates to younger ages, higher education, ABEP and higher socres in WM tests. There was a significant improvement in mean GIN and LSP scores with the use of sound amplification. After four months of hearing intervention there was a reduction in depressive symptoms but not significant difference on the SF-36. The DL (7 to 15 hours/day) and the QI-AASI (31.9 ± 2.3) showed good results, there was a negative correlation between DL, formal education and the score obtained in the digit span-D, and between the QI-AASI, formal education, ABEP and the running span score. Conclusions: there was a positive correlation between the variables: education, ABEP, auditory temporal resolution and WM. The use of sound amplification was associated with a reduction in depressive symptoms and better results in auditory temporal resolution and sentence recognition in noise., however, there was no significant impact on quality of life. Hearing aid use and benefit showed a negative correlation with education and did not show a close correlation with most WM tests.