R01AG077725

Mediators and Moderators of Auditory Training

This proposal seeks to understand mechanisms of auditory training (AT) and the potential of AT to mitigate hearing issues that promote the risk of developing Alzheimer's disease and related dementias (ADRD). Reports from the Lancet Commission (Livingstone and colleagues, 2020) and others show that midlife hearing loss is one of the greatest predictors of late-life dementia, and hearing aids protect against the development of ADRD. However, research from Gates and colleagues (2011) suggests that central hearing processes may be greater predictors of the onset of ADRD than peripheral hearing addressed through hearing aids.

Central auditory processing abilities are fundamental to understanding speech, appreciating music, and separating competing environmental sound sources. Challenges with hearing, especially understanding speech in noisy environments, increase frustration with interpersonal verbal communication and have detrimental long-term effects on functional independence, cognitive abilities, and overall quality of life. Furthermore, they increase the risk for ADRD.

Despite extensive research conducted across multiple fields, clinicians and researchers still disagree about the best ways to address the diversity of hearing difficulties individuals face throughout their lives. The guiding premise of the current proposal is the need for robust and reliable datasets to clarify the underlying mechanisms of AT and to identify the mediators and moderators that impact training outcomes.

The overarching goal of this proposal is to better understand the mechanisms of AT, with a focus on speech in competition, in order to address the most prevalent hearing complaints reported by people as they age and, in turn, mitigate the transition to ADRD. To address this, we will recruit a large and diverse sample of older adults, including those with prodromal ADRD, and a comparison group of younger adults (1260 participants across training conditions, including separate samples of young and older adults).

We will research how baseline cognitive and hearing measures predict training outcomes (moderators) and how these interact with training methods (mediators). To enhance rigor and reproducibility, we will release datasets and training/assessment tools to enable other researchers to conduct analyses, replicate our studies, and test their own training methods using common outcome measures.

The proposed research will address four specific aims:

AIM 1 – Determine the relationship of stimulus complexity and AT outcomes.
AIM 2 – Determine the relationship of AT training structures and AT outcomes.
AIM 3 – Determine relationships between participant characteristics (moderators) and AT approaches (mediators) on training outcomes.
AIM 4 – Create an AT platform that facilitates faithful replication and modeling.

Through the collection and dissemination of a large, unique, and comprehensive dataset, this proposal has the potential for transformative impact by clarifying moderators and mediators of AT. It will also afford translational opportunities to contribute to the mitigation of hearing and cognitive decline in individuals who may be at risk for the development of ADRD.

Northeastern University

NOT APPLICABLE

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Boston, Massachusetts 021155005 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the total obligations have increased 393% from $747,901 to $3,685,720.