Relationship of hearing loss and dementia: a prospective, population-based study

• Published in: Otology & neurotology Vol. 35; no. 5; p. 775
• Main Authors: Gurgel, Richard Klaus, Ward, Preston Daniel, Schwartz, Sarah, Norton, Maria C, Foster, Norman L, Tschanz, JoAnn T
• Format: Journal Article
• Language: English
• Published: United States 01.06.2014
• Subjects: Aged; Aged, 80 and over; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognition Disorders - etiology; Dementia - diagnosis; Dementia - epidemiology; Dementia - etiology; Female; Hearing Loss - complications; Humans; Incidence; Male; Neuropsychological Tests; Prospective Studies; Risk
• ISSN: 1537-4505
• DOI: 10.1097/MAO.0000000000000313

To determine whether baseline hearing loss increases cognitive decline and risk for all-cause dementia in a population of elderly individuals. Longitudinal cohort study. Community-based, outpatient. Men and women aged 65 years or older without dementia at baseline. All subjects completed the Modified Mini-Mental Status Exam (3MS-R) at baseline and over 3 triennial follow-up visits. Hearing loss (HL) at baseline was based on observation of hearing difficulties during testing or interview. Incident dementia was determined by clinical assessment and expert consensus. Dementia and 3MS-R score. At baseline, 4,463 subjects were without dementia, 836 of whom had HL. Of those with HL, 16.3% developed dementia, compared with 12.1% of those without HL (p < 0.001). Mean time to dementia was 10.3 years in the HL group versus 11.9 years for non-HL (log rank test p < 0.001). In Cox regression analyses controlling for sex, presence of APOE- [Latin Small Letter Open E]4 allele, education, and baseline age, and cardiovascular risk factors, HL was an independent predictor of developing dementia (hazard ratio = 1.27, p = 0.026 [95% CI, 1.03-1.56]). Linear mixed models controlling for similar covariates showed HL was associated with faster decline on the 3MS-R, at a rate of 0.26 points/year worse than those without HL. Elderly individuals with HL have an increased rate of developing dementia and more rapid decline on 3MS-R scores than their nonhearing impaired counterparts. These findings suggest that hearing impairment may be a marker for cognitive dysfunction in adults age 65 years and older.