Cognitive performance in DFNA9 patients

Elise Hens
Persbericht

Hebben mensen met gehoorverlies en evenwichtsproblemen meer kans op dementie?

Iedereen heeft een kans van één op vijf om dementie te ontwikkelen. Bij slechthorenden is deze kans maar liefst vijf keer groter. Door de toenemende vergrijzing verwacht de Wereldgezondheidsorganisatie dat het aantal ouderen met dementie zal verdrievoudigen tegen 2050, zolang er niet snel een behandeling gevonden wordt. Een probleem waar de wereld niet klaar voor is.Iedereen heeft één op vijf kans om dementie te ontwikkelen

Dementie
Iedereen kan wel eens een afspraak vergeten, niet meer op de naam van een oude collega komen of je GSM niet meteen terugvinden. Herkenbaar? Al lachend wordt dan wel eens gezegd dat je dement aan het worden bent, echter gaat het hier meestal om onschuldige vergetelheden. Maar wat is dementie dan wel? Dementie is een parapluterm voor verschillende ziekten, waarbij de hersenen geleidelijk aan niet meer goed gaan functioneren. Dit heeft een impact op het uitoefenen van dagelijkse activiteiten, zoals koken, een boek lezen of een klusje doen. De ziekte van Alzheimer is de meest voorkomende oorzaak (ca. 70%) van dementie. De belangrijkste kenmerken zijn vooral vergeetachtigheid, vergissingen in tijd en plaats, kwijtraken van spullen, veranderingen in karakter en onrustig gedrag. Zo stellen mensen met de ziekte van Alzheimer vaak dezelfde vragen of vertellen ze steeds hetzelfde verhaal. Een probleem dat vooral tot stand komt doordat het voor hen moeilijker is om nieuwe informatie te onthouden.

Het belang van gehoorverlies en evenwicht bij de ziekte van Alzheimer
Uit onderzoek is gebleken dat gehoorverlies de belangrijkste behandelbare risicofactor is van dementie. Ook evenwichtsproblemen zouden het risico kunnen verhogen, maar daar is momenteel meer onderzoek naar nodig. Echter hebben veel onderzoekers over het hoofd gezien dat gehoorverlies en evenwichtsproblemen vaak hand in hand gaan, een interactie die niet te verwaarlozen valt. Daarom heb ik, een masterstudent Biomedische Wetenschappen aan de Universiteit Antwerpen, deze twee factoren bij elkaar gebracht, met een grondig onderzoek naar het denkvermogen in mensen met DFNA9. DFNA9 is een erfelijke aandoening die leidt tot doofheid en ernstige evenwichtsproblemen, zoals duizeligheidsaanvallen. Het gehoorverlies treedt meestal op tussen 30 en 40 jaar en gaat voortdurend achteruit tot de leeftijd van 50 tot 70 jaar. Dan zijn de dragers van DFNA9 vaak geheel doof zijn en is hun evenwichtsfunctie volledig verdwenen. Aangezien gehoor en evenwicht beiden gelinkt zijn met dementie, onderzocht deze masterproef hoe het denkvermogen eruit zag bij mensen met DFNA9. Uit het onderzoek is wel degelijk gebleken dat DFNA9-patiënten meer geheugenproblemen vertoonden dan leeftijdsgenoten zonder gehoor- en evenwichtsproblemen. Maar hoe komt dat juist? Helaas is dat nog niet exact geweten. Er zijn vier mogelijke hypotheses die dit verband zouden kunnen verklaren. De eerste “Use it or Lose it hypothese” zegt dat slechthorenden minder geluidsprikkels krijgen, aangezien je minder goed hoort. Hierdoor gaat een deel van je hersenen minder moet werken en zoals een mooi gezegde ons leert “What you don’t use, you lose”. Vergelijk het met de afname van spieren als je niet meer sport. De tweede hypothese zegt dat slechthorenden of mensen met evenwichtsproblemen zichzelf vaak sociaal gaan afsluiten van de buitenwereld, doordat ze niet meer kunnen volgen bij een gesprek of teveel moeite hebben om ergens te geraken. Hierdoor krijgen ze opnieuw minder prikkels, wat dan weer leidt naar een snellere afname van je hersenfuncties. De derde hypothese luidt dat de hersenen zo hard moeten focussen om toch dat kleine beetje wat je hoort effectief te kunnen horen of om je evenwicht te bewaren, dat je hersenen andere functies, zoals je denkvermogen, wat gaan verwaarlozen. Je kan het vergelijken met als je naar de TV aan het kijken bent en je niet hoort wat er rondom jou gebeurt. De laatste hypothese, namelijk de “common cause” hypothese, zegt dan dat zowel gehoorverlies, evenwichtsproblemen en dementie eigenlijk ouderdomskwaaltjes zijn. Ze beïnvloeden elkaar niet, maar komen samen voor. Wellicht is het de samenhang van deze hypotheses die het effect van gehoorverlies en evenwichtsproblemen op het geheugen verklaren.

Merk jij dat je af en toe eens minder hoort en begin je je al zorgen te maken? Gelukkig is er ook goed nieuws. Studies hebben al kunnen aantonen dat hoorapparaten of een cochleair implantaat weldegelijk het denkvermogen kunnen verbeteren. Een cochleair implantaat is een elektronisch apparaat dat de functie van het deel dat beschadigd is in je oor gaat overnemen. Hierdoor kunnen mensen met ernstige gehoorschade weer horen. Helaas heerst er nog steeds een groot taboe rond het dragen van hoorapparaten. Maar hoe vroeger je eraan begint, hoe beter. Dus aan allen, verspreid het woord! Daarnaast mogen we gehoorbescherming niet vergeten. Draag dus ten allen tijden oordopjes als je gehoor wordt blootgesteld aan luide geluiden. Want als je het eens nagaat bij jongeren draagt slechts een kleine minderheid oordoppen tijdens het feesten. Een probleem waar ook aandacht aan moet worden besteed. Goed zorg dragen voor je gehoor en evenwicht is dus een eerste stap tot het uitstellen van dementie, maar ook de wetenschap biedt een hoopvolle toekomst in dementie preventie.

Bibliografie

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Universiteit of Hogeschool
Master in Klinisch Wetenschappelijk Onderzoek
Publicatiejaar
2022
Promotor(en)
Vincent Van Rompaey, Hanne Gommeren
Kernwoorden
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