Speech in Noise Perception as a Marker of Cognitive Impairment in HIV Infection.
Yi Zhan, Abigail M Fellows, Tangkai Qi and 6 others
PMID 29112532WHAT IT FOUND
Among HIV+ adults with normal hearing, lower thinking scores went with more trouble understanding speech in background noise.
Age also mattered. This is an association, not proof that a hearing test diagnoses brain effects.
Key findings
01Among 166 HIV+ adults with normal hearing, lower MoCA scores were associated with worse speech-in-noise scores.
02Participants with abnormal cognitive status had worse composite speech-in-noise scores than participants with normal cognitive status.
03Age was also related to speech-in-noise scores, and age plus MoCA score were the only predictors retained in the regression model, which accounted for 22.2% of variation with age alone and 32.2% when MoCA score was added.
STILL TO COME
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What it does not show
The study measured hearing and cognition at one time point, so it cannot show that HIV-related brain effects caused the speech-in-noise difficulty. Age was strongly related to speech-in-noise scores, and only three participants were older than 58 years, so age and HIV effects are hard to separate. No HIV duration or severity data were available, so it is unclear whether the findings reflect longer or more severe HIV disease. All participants had normal hearing up to 4 kHz, so the results do not apply to people with hearing loss. The Hearing In Noise Test is not a pure central auditory test, and subtle cochlear or nerve damage not seen on audiometry could affect results. The MoCA is a brief cognitive screen, not an in-depth neuropsychological assessment. The sample was mostly men and came from one center in China, with no HIV-negative comparison group reported.
Declared interests
The supplied text does not include a conflicts of interest or funding declaration. The article is listed as NIH and non-U.S. government supported.
The easy way to misread this
Do not conclude that speech-in-noise testing diagnoses HIV-related brain impairment. The study shows an association with MoCA scores, but age also contributed, the design cannot prove cause, and the test was not shown to be a validated biomarker.