Mild or disabling hearing loss (HL) among adults ages 45 to 69 may be associated with cognitive impairment, according to a report in JAMA Open Network. Further, wearing a hearing aid does not appear to significantly change the risk for cognitive impairment.
Baptiste Grenier, M.D., of the Universite Paris Cite, and colleagues noted that the prevalence of cognitive impairment is increasing, with up to 150 million individuals worldwide expected to be living with dementia by 2050. “Given the major burden of cognitive decline and the absence of curative treatment, identifying modifiable risk factors is of importance,” they wrote.
Grenier and colleagues analyzed data on 62,072 older participants (average age 57.4 years; 52% female) in the French CONSTANCES cohort, a population-based epidemiological cohort that recruited more than 200,000 randomly selected adults ages 18 to 69 from the French National Insurance Fund between January 1, 2012, and December 31, 2020.
Overall, 49% of participants (n = 30,624) had normal hearing, 38% (n= 23,768) had mild HL, 10% (n = 6,012) had disabling HL without use of a hearing aid, and 3% (n = 1,668) used a hearing aid; hearing status was objectively assessed with audiometric testing.
Upon enrollment, all participants ages 45 and older also underwent an extensive cognitive evaluation from trained neuropsychologists. The researchers computed a global cognitive score for the participants based on three of the tests:
- Digit Symbol Substitution Test of attention, psychomotor speed, and reasoning
- Free and Cued Selective Reminding Test of episodic verbal memory
- Trail Making Test of shifting abilities and executive function
Across all ages, 27% of individuals with mild HL and 37% of those with disabling HL had global cognitive scores indicative of impairment, compared with 16% among those with normal hearing. The authors found no statistical difference in cognitive impairment risk between all individuals with disabling HL who used a hearing aid and those who did not. A secondary analysis suggested that hearing aids may reduce the risk of cognitive impairment in individuals with disabling hearing loss and depression.
The authors said that HL may cause cognitive decline because of social isolation, prolonged deprivation of auditory input, and/or shared neurodegenerative processes in the brain associated with hearing loss and cognitive deterioration. HL is also associated with loss of brain volume in critical sections of the brain.
Prescription of hearing aids for patients with disabling HL “should be guided by their established benefits on quality of life and social isolation, but not to mitigate cognitive decline for which further research is needed,” the authors wrote.
For related information, see the Psychiatric News article “Late Life Anxiety Linked to Cognitive Decline.”
(Image: Getty Images/iStock/bymuratdeniz)
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