SCIvnik ETriassi Given the very close association between age and both hearing loss and dementia, there is a possibility of unaccounted residual confounding. A bootstrap procedure was used to generate 10000 data sets that were then used to estimate the 95% confidence interval (CI) for the loess smoother. Effects of hearing aids on cognitive functions and depressive signs in elderly people, Improvement of cognitive function after cochlear implantation in elderly patients, A randomized feasibility pilot trial of hearing treatment for reducing cognitive decline: Results from the Aging and Cognitive Health Evaluation in Elders Pilot Study, At the interface of sensory and motor dysfunctions and Alzheimers disease. Analysis and interpretation of data: Lin, Metter, OBrien, Resnick, Zonderman, and Ferrucci. Protocol for a qualitative study exploring the lived experience of hearing loss and patient reported experience in the UK: the HeLP study. Author Contributions: Drs Metter and Ferrucci had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Before Analysis of hearing loss trajectories before baseline was performed using a random effects analysis and adjusted for age. Setting: EMild cognitive impairment: clinical characterization and outcome. The risk of incident AD also increased with baseline hearing loss (1.20 per 10 dB of hearing loss) but with a wider confidence interval (0.94-1.53). 8600 Rockville Pike The size of this effect was equivalent to the difference in rate of brain atrophy seen between individuals with normal cognition and those who develop incident mild cognitive impairment.49,50 Of note, this accelerated rate of brain volume decline in older adults with ARHL compared to those with normal hearing was observed for the entire brain as well as the right temporal lobe, which houses areas crucial for spoken language processing (i.e., superior temporal, middle temporal, and inferior temporal gyri).49 Such structures in the temporal lobe are not only important for spoken language processing, but also for semantic memory, sensory integration, and in early stages of cognitive impairment or early Alzheimers disease.5154 Thus, it is possible that volume losses in regions responsible for auditory processing may have unforeseen effects on other such cognitive processes dependent on these same regions and potentially predispose individuals to an increased risk of dementia. Compared with normal hearing, the hazard ratio (95% confidence interval) for incident all-cause dementia was 1.89 (1.00-3.58) for mild hearing loss, 3.00 (1.43-6.30) for moderate hearing loss, and 4.94 (1.09-22.40) for severe hearing loss. The risk of incident all-cause dementia increased log linearly with the severity of baseline hearing loss (1.27 per 10-dB loss; 95% confidence interval, 1.06-1.50). diabetes. Hearing loss (HL) may be a risk factor for incident dementia; however, this finding needs replication and extension to ethnically diverse samples for generalizability. Hearing loss is associated with increased social isolation in older adults, likely through impaired communication.3436 Promoting a strong social environment for older individuals has been long thought of as an important aspect of healthful aging, and has been shown to potentially reduce risk of mortality and comorbidities such as cardiovascular disease, diabetes, and depression.3739 Longitudinal epidemiological4042 and neuropathological43 studies have demonstrated that poor social networks, reduced social support, and loneliness increase the risk of incident dementia in individuals who were initially disease-free, even after adjusting for potentially confounding variables. Prevention of dementia by targeting risk factors - The Lancet The sponsor was not involved in manuscript approval. hearing loss. Dementia isn't one specific disease. RSThe effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. BAbela Could treating hearing loss reduce the risk of dementia? Age-Related Hearing Loss, Late-Life Depression, and Risk for Incident Nearly half of people over age 60 have hearing loss. KMRodriguez Prospective study of 639 individuals who underwent audiometric testing and were dementia free in 1990 to 1994. Design: Prospective study of 639 individuals who underwent audiometric testing and were dementia free in 1990 to 1994. Particularly, the potential relevance of central hearing impairment . Engaging in preventive strategies through reduction of modifiable risk factors can be effective in delaying or preventing the disease, reducing healthcare costs, and stemming the immense burden on relatives and supporters of disease sufferers.18 A growing body of research has shown that hearing loss confers an independent risk of dementia511 and the highest population attributable fraction for dementia compared to any other individual modifiable risk factor (e.g., physical inactivity, depression).18 Given that ARHL is highly prevalent, severely undertreated, easily diagnosed, treatable, and precedes the onset of dementia by 5 to 10 years, it is an ideal modifiable risk factor that can be targeted as a preventative strategy for managing dementia.15,91` However, further research is necessary to investigate potential causal mechanisms underlying the relationship between ARHL and dementia, as well as the cognitive benefits of a hearing intervention in elderly adults with hearing loss. Accessibility Statement, Our website uses cookies to enhance your experience. RRakitin Cognitive testing and diagnosis of dementia, To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2023 American Medical Association. The effect of social networks on the relation between Alzheimers disease pathology and level of cognitive function in old people: a longitudinal cohort study. Gordon-Salant Study concept and design: Lin, Metter, and Ferrucci. The risk of incident AD also increased . Dementia - Symptoms and causes - Mayo Clinic We also excluded any individuals with recognized cognitive impairment at baseline (mild cognitive impairment or Blessed score >3), and our results were robust to models controlling for baseline Blessed scores. Age-Related Hearing Loss, Neuropsychological Performance, and Incident Baseline characteristics of cohort members were compared using 1-way analysis of variance for continuous variables and 2 or Fisher exact test for categorical variables. Currently, there are approximately 466 million people with disabling hearing loss globally; unless action is taken, this number is projected to increase to 630 million by 2030, and over 900 million by 2050.16 There is also a significant economic burden that comes with untreated hearing loss an estimated annual global cost of US$ 750 billion.17. KMaytan Perception of pure tones does not require higher levels of auditory cortical processing,22 and results of auditory brainstem response testing of these pathways are usually normal in patients with AD.23 In contrast, central auditory nuclei required for higher-order auditory processing can be affected by AD neuropathology,24-26 and tests of central auditory function have been found to be associated with AD.27. Hearing loss is defined by the pure tone average (PTA) of 0.5, 1, 2, and 4 kHz tones presented by air-conduction in the better hearing ear. Inclusion in an NLM database does not imply endorsement of, or agreement with, BE Six hundred thirty-nine individuals aged 36 to 90 years. 2023 American Medical Association. Lazarov Johns Hopkins is leading a large National Institute on Aging study to see if hearing aids can safeguard seniors' mental processes. A pure-tone average (PTA) of air conduction thresholds at 0.5, 1, 2, and 4 kHz was calculated for each ear, and the PTA in the better-hearing ear was used for subsequent analyses because that ear would be the principal determinant of hearing and speech perception ability on an everyday basis. Role of the Sponsor: The National Institute on Aging funded the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation and review of the manuscript. Processing resources reduce the effect of Alzheimer pathology on other cognitive systems, Aging and cognitive deficits: The role of attentional resources, The processing-speed theory of adult age differences in cognition. Whether hearing loss is a marker for early-stage dementia or is actually a modifiable risk factor for dementia deserves further study. Bookshelf 2021 Oct 16 . Ford AH, Hankey GJ, Yeap BB, Golledge J, Flicker L, Almeida OP. McKhann Baltimore Longitudinal Study of Aging. UKHollen Korn Hearing loss is estimated to account for 8% of dementia cases. PDF ORIGINAL CONTRIBUTION Hearing Loss and Incident Dementia - JAMA Network Taking steps to reduce or eliminate these risk factors . Association of Age-Related Hearing Loss With Cognitive Function, Cognitive Impairment, and Dementia: A Systematic Review and Meta-analysis, Compensatory changes in cortical resource allocation in adults with hearing loss, Age-related hearing impairment-a risk factor and frailty marker for dementia and AD. Both visual and olfactory impairment have also both been independently associated with cognitive impairment.78,79 Visual impairment may be analogous to hearing impairment in the way it is related to cognitive impairment. Methods: N = 8,529 participants from the National Alzheimer's Coordinating Center 60 years and free of cognitive impairment who were characterized as Untreated-, Treated-, or . All Rights Reserved. Boyle PA, Wilson RS, Schneider JA, Bienias JL, Bennett DA. Federal government websites often end in .gov or .mil. Dementia is a general term for a group of symptoms that impact abilities to think, remember, and reason through activities of daily living. Agrawal Hearing loss can be a frustrating experience that can negatively impact a person's quality of life. Age-Related Sensory Impairments and Risk of Cognitive Impairment, Olfactory identification deficits and MCI in a multi-ethnic elderly community sample. 2023 Jun 7;13(6):e069363. Baloyannis LHCharacteristics and comorbidities of rural older adults with hearing impairment. YPlatz Before For participants with more than 1 visit during this period, data from the first assessment were used. The risk of incident all-cause dementia increased log linearly with the severity of baseline hearing loss (1.27 per 10-dB loss; 95% confidence interval, 1.06-1.50). Unless an individual had severe hearing loss, this situation would not result in, for example, incorrectly heard instructions on cognitive testing.76 Moreover, individuals participating in prospective studies have had normal cognition at baseline.511. JABienias J Gerontol A Biol Sci Med Sci. RSSchneider Dementia is a debilitating disease and leading public health concern that affects approximately 50 million people worldwide, a number that is projected to increase to 152 million in 2050. RSBienias RMiller JFScholer Coley During a median follow-up of 11.9 years, 58 cases of incident all-cause dementia were diagnosed, of which 37 cases were AD. SJMauroudis 2023 American Medical Association. Accessibility Weinstein Arch Neurol. Parvizi Customize your JAMA Network experience by selecting one or more topics from the list below. The risk of incident AD also increased with baseline hearing loss (1.20 per 10 dB of hearing loss) but with a wider confidence interval (0.94-1.53). EANiparko (2018) demonstrated in a meta-analysis that though hearing loss was associated with decline in all cognitive domains of interest, it was more predictive of decline in delayed and semantic memory compared to short-term memory and executive functions (e.g., attention, fluency, reasoning, and working memory).27 This finding dovetails with research demonstrating increased activation of frontal and pre-frontal cortical regions on speech-evoked EEG in post-lingually hearing-impaired adults, reflecting increased recruitment of short-term memory and executive function to aid speech perception; these regions have traditionally been associated with working memory and executive function tasks.27,28 Loughrey et al. Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS. ARHL confers an increased risk of social isolation in the elderly, which may in turn increase the risk of dementia. SBInce [Detection of hearing loss in dementia patients : pilot study and literature survey]. Results: Le Prell CG, Yamashita D, Minami SB, Yamasoba T, Miller JM. JLBennett 2023 May 6;13(3):326-340. doi: 10.3390/audiolres13030028. How Can Hearing Loss Cause Dementia? - PMC The site is secure. SGHearing impairment as a predictor of cognitive decline in dementia. Incident Hearing Loss and Comorbidity - JAMA Network It was based on 639 subjects with a wide age range (36-90 years of age) followed up for 10 years after pure . and transmitted securely. During a median follow-up of 11.9 years, 58 cases of incident all-cause dementia were diagnosed, of which 37 cases were AD. RFLarson Studies have demonstrated that individuals with hearing loss dedicate more neural resources to facilitate auditory processing at the expense of other cognitive processes, such as working memory.22,23 Loughrey et al. Age-related hearing loss, otherwise known as presbycusis (from Greek presbys old and akousis hearing), is the gradual, progressive hearing loss that occurs in individuals as they grow older.12 Though the term encompasses all conditions that lead to hearing loss in the elderly, ARHL most commonly presents as a bilateral, symmetrical sensorineural hearing loss that arises from idiopathic degeneration of inner ear structures as a person enters the sixth decade of life.12,13 The hearing loss first affects higher frequencies (pitches), and is characterized by decreased hearing sensitivity (sounds are quieter) and impaired speech perception (words are distorted). Hearing loss and the link to dementia | American Heart Association Bennett Livingston G, Sommerlad A, Orgeta V, et al. WWorley Deal JA, Betz J, Yaffe K, Harris T, Purchase-Helzner E, Satterfield S, Pratt S, Govil N, Simonsick EM, Lin FR; Health ABC Study Group. Please enable it to take advantage of the complete set of features! YAge effects on load-dependent brain activations in working memory for novel material. TDHearing impairment and cognitive decline in senile dementia of the Alzheimer's type. 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Correspondence: Frank R. Lin, MD, PhD, Department of OtolaryngologyHead and Neck Surgery, The Johns Hopkins School of Medicine, JHOC 6120, 601 N Caroline St, Baltimore, MD 21287 (flin1@jhmi.edu). where Pexposed was the prevalence of baseline hearing loss of at least 25 dB and RR was the rate ratio (hazard ratio [HR]) of dementia risk associated with hearing loss. Uhlmann RF, Larson EB, Rees TS, Koepsell TD, Duckert LG. It is also possible that ARHL itself does not cause dementia; instead, a common mechanism underlies both dementia and ARHL (i.e., a confounder). The risk of all-cause dementia increased log linearly with hearing loss severity, and for individuals older than 60 years in our cohort, more than one-third of the risk of incident all-cause dementia was associated with hearing loss. WJWallhagen Conclusions: Hearing loss is independently associated with incident all-cause dementia. Our study showed that the pooled HR for the association between hearing loss and incident dementia remained significant after adjusting for multiple variables such as age. Oxman TE, Berkman LF, Kasl S, Freeman DH, Jr., Barrett J. 3.00 (1.43-6.30) for moderate hearing loss, and 4.94 (1.09-22.40) for severe hearing loss. This result is comparable to the risk seen for all-cause dementia (Table 3) but with a wider CI, possibly owing to the smaller sample size. 2014 Nov;62(11):800-5. doi: 10.1007/s00106-014-2907-4. Social support and depressive symptoms in the elderly. HHS Vulnerability Disclosure, Help Hearing loss and dementia NGreulich SGardette Mayo Clinic Minute: The hearing loss and dementia connection AThe selective vulnerability of brainstem nuclei to Alzheimer's disease. Hearing loss was defined by a pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better-hearing ear (normal, <25 dB [n = 455]; mild loss, 25-40 dB [n = 125]; moderate loss, 41-70 dB [n = 53]; and severe loss, >70 dB [n = 6]). Improved treatment of sudden hearing loss by specific fibrinogen aphaeresis, Audiometric pattern as a predictor of cardiovascular status: development of a model for assessment of risk, Application of Mouse Models to Research in Hearing and Balance. It's often one of the early symptoms of the condition. Health & Parenting Guide - Your Guide to Raising a Happy & Healthy Family Ives Acquisition of data: Metter, OBrien, Resnick, Zonderman, and Ferrucci. CAAuditory system degeneration in Alzheimer's disease. Although studies have demonstrated evidence for an association of olfactory dysfunction with cognitive decline and dementia, olfactory loss may be a non-causal marker or a sequela of such neurodegenerative conditions.8083 In fact, studies have demonstrated pathology such as deposition of tau neurofibrillary tangles in the olfactory bulb and throughout the olfactory system in individuals with Alzheimer disease and other neurodegenerative disorders; the levels of tau deposition in such regions have been found to be associated with the level of olfactory loss.8486 In contrast, Alzheimers pathology has never been seen in the peripheral auditory system. AD indicates Alzheimer disease; Blessed Test, Blessed Information Memory Concentration Test; and BLSA, Baltimore Longitudinal Study of Aging. Potential Clinical and Economic Outcomes of Over-the-Counter Hearing Aids in the US. Hearing loss and incident dementia Johns Hopkins University The statistical software used was a free available software environment (R, version 2.9.1; http://www.r-project.org). BIMidthune MEPublic health methods: attributable risk as a link between causality and public health action. Developing neuroimaging modalities (e.g., more powerful MR imaging) that can better delineate inner ear vasculature with higher resolution may aid us in understanding if microvascular changes in the ear (i.e., similar to those known to contribute to cognitive deficits and dementia) play a role in hearing loss. OGrady The economic burden of dementia to society is staggering, with an estimated worldwide cost of $818 billion in 2015.1 Given the limited efficacy of targeted pharmacologic treatment modalities,2 it is important to focus on reducing modifiable risk factors through preventative measures; evidence shows that successful management of modifiable risk factors can be effective in both delaying or preventing the disease and reducing healthcare costs.3 Moreover, a growing body of research has shown an association between age-related hearing loss (ARHL) and dementia,411 thus identifying ARHL as both a potential modifiable risk factor and possible means to improve clinical outcomes in patients with dementia.