AUDIOCOGNITIVE AXIS OF AGING: AN INTEGRATED VIEW OF THE PATHOGENESIS OF PRESBYCUSIS AND DEMENTIA
DOI:
https://doi.org/10.32782/health-2026.1.3Keywords:
sensorineural hearing loss; cognitive function; auditory deprivation; oxidative stress; hyperlipidemia; neurodegenerationAbstract
The global increase in life expectancy driven by socioeconomic and medical advances has resulted in rapid population aging and a growing prevalence of age-related conditions, including presbycusis and dementia. According to projections of the World Health Organization, in the coming years one in six individuals worldwide will be aged over 60 years, underscoring the rising burden of multimorbidity and cognitive decline. The aim of this article is to systematize and critically analyze contemporary evidence regarding the shared molecular-biological, vascular–metabolic, and neurofunctional mechanisms underlying presbycusis and cognitive disorders. To achieve this objective, scientific publications from the past decade were reviewed using the MEDLINE/PubMed electronic database of biomedical research.Particular emphasis was placed on English-language studies with a high citation index. Age-related hearing loss is characterized by progressive degeneration of outer and inner hair cells, cochlear synaptopathy, secondary neuronal atrophy, and cortical reorganization. Neuroimaging studies demonstrate disrupted functional connectivity between auditory, cognitive, and associative cortical regions, correlating with impairments in memory and executive function. Concomitant vascular pathology and metabolic disturbances, particularly hyperlipidemia, contribute to cerebral and cochlear hypoperfusion, endothelial dysfunction, redox imbalance, and altered ion transport, thereby establishing a shared ischemic-metabolic substrate for audiocognitive neurodegeneration. Sensory deprivation imposes sustained cognitive load and contributes to the progressive depletion of cognitive reserve, thereby increasing the risk of developing dementia. The analysis demonstrated that presbycusis and cognitive disorders should be regarded as interrelated manifestations of a unified pathophysiological continuum of aging. Early audiological assessment, timely correction of hearing impairment, and optimization of vascular-metabolic risk factors, including lipid profile management, may represent key components of preventive strategies aimed at mitigating age-related cognitive decline
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