Jennifer A Deal1, Josh Betz2, Kristine Yaffe3,4, Tamara Harris5, Elizabeth Purchase-Helzner6, Suzanne Satterfield7, Sheila Pratt8,9, Nandini Govil10, Eleanor M Simonsick11, Frank R Lin12,13. 1. Department of Epidemiology, and. 2. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 3. Departments of Psychiatry and Neurology, and. 4. Department of Epidemiology and Biostatistics, University of California, San Francisco. 5. Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland. 6. Department of Epidemiology and Biostatistics, State University of New York Downstate Medical Center, Brooklyn. 7. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis. 8. Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pennsylvania. 9. Department of Communication Science & Disorders, University of Pittsburgh School of Health and Rehabilitation Sciences, Pennsylvania. 10. Department of Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania. 11. Intramural Research Program, National Institute on Aging, Bethesda, Maryland. 12. Departments of Otolaryngology-Head & Neck Surgery and Epidemiology, Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland. 13. Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Abstract
BACKGROUND: Age-related peripheral hearing impairment (HI) is prevalent, treatable, and may be a risk factor for dementia in older adults. In prospective analysis, we quantified the association of HI with incident dementia and with domain-specific cognitive decline in memory, perceptual speed, and processing speed. METHODS: Data were from the Health, Aging and Body Composition (Health ABC) study, a biracial cohort of well-functioning adults aged 70-79 years. Dementia was defined using a prespecified algorithm incorporating medication use, hospital records, and neurocognitive test scores. A pure-tone average in decibels hearing level (dBHL) was calculated in the better hearing ear using thresholds from 0.5 to 4kHz, and HI was defined as normal hearing (≤25 dBHL), mild (26-40 dBHL), and moderate/severe (>40 dBHL). Associations between HI and incident dementia and between HI and cognitive change were modeled using Cox proportional hazards models and linear mixed models, respectively. RESULTS: Three-hundred eighty seven (20%) participants had moderate/severe HI, and 716 (38%) had mild HI. After adjustment for demographic and cardiovascular factors, moderate/severe audiometric HI (vs. normal hearing) was associated with increased risk of incident dementia over 9 years (hazard ratio: 1.55, 95% confidence interval [CI]: 1.10, 2.19). Other than poorer baseline memory performance (difference of -0.24 SDs, 95% CI: -0.44, -0.04), no associations were observed between HI and rates of domain-specific cognitive change during 7 years of follow-up. CONCLUSIONS: HI is associated with increased risk of developing dementia in older adults. Randomized trials are needed to determine whether treatment of hearing loss could postpone dementia onset in older adults.
BACKGROUND: Age-related peripheral hearing impairment (HI) is prevalent, treatable, and may be a risk factor for dementia in older adults. In prospective analysis, we quantified the association of HI with incident dementia and with domain-specific cognitive decline in memory, perceptual speed, and processing speed. METHODS: Data were from the Health, Aging and Body Composition (Health ABC) study, a biracial cohort of well-functioning adults aged 70-79 years. Dementia was defined using a prespecified algorithm incorporating medication use, hospital records, and neurocognitive test scores. A pure-tone average in decibels hearing level (dBHL) was calculated in the better hearing ear using thresholds from 0.5 to 4kHz, and HI was defined as normal hearing (≤25 dBHL), mild (26-40 dBHL), and moderate/severe (>40 dBHL). Associations between HI and incident dementia and between HI and cognitive change were modeled using Cox proportional hazards models and linear mixed models, respectively. RESULTS: Three-hundred eighty seven (20%) participants had moderate/severe HI, and 716 (38%) had mild HI. After adjustment for demographic and cardiovascular factors, moderate/severe audiometric HI (vs. normal hearing) was associated with increased risk of incident dementia over 9 years (hazard ratio: 1.55, 95% confidence interval [CI]: 1.10, 2.19). Other than poorer baseline memory performance (difference of -0.24 SDs, 95% CI: -0.44, -0.04), no associations were observed between HI and rates of domain-specific cognitive change during 7 years of follow-up. CONCLUSIONS: HI is associated with increased risk of developing dementia in older adults. Randomized trials are needed to determine whether treatment of hearing loss could postpone dementia onset in older adults.
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