Impact of Aging on the Auditory System and Related Cognitive Functions: A Narrative Review (original) (raw)
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Age-related hearing loss and cognitive decline — The potential mechanisms linking the two
Auris Nasus Larynx, 2019
According to the results from the most recent Global Burden of Disease (GBD), hearing loss has become the third leading cause of years lived with disability (YLDs) and a major concern for global health, especially in the elderly population [1]. The attention to age-related hearing loss (ARHL) has been growing Auris Nasus Larynx 46 (2019) 1-9
A review of new insights on the association between hearing loss and cognitive decline in ageing
2016
SUMMARY Age-related hearing loss (ARHL) has a multifactorial pathogenesis and it is an inevitable hearing impairment associated with reduction of communicative skills related to ageing. Increasing evidence has linked ARHL to more rapid progression of cognitive decline and incidental dementia. Many aspects of daily living of elderly people have been associated to hearing abilities, showing that hearing loss (HL) affects the quality of life, social relationships, motor skills, psychological aspects and function and morphology in specific brain areas. Epidemiological and clinical studies confirm the assumption of a relationship between these conditions. However, the mechanisms are still unclear and are reviewed herein. Long-term hearing deprivation of auditory inputs can impact cognitive performance by decreasing the quality of communication leading to social isolation and depression and facilitate dementia. On the contrary, the limited cognitive skills may reduce the cognitive resourc...
Epidemiologic research on the possible link between age-related hearing loss (ARHL) and cognitive decline and dementia has produced inconsistent results. Clarifying this association is of interest because ARHL may be a risk factor for outcomes of clinical dementia. OBJECTIVES: To examine and estimate the association between ARHL and cognitive function, cognitive impairment, and dementia through a systematic review and meta-analysis. DATA SOURCES AND STUDY SELECTION: A search of PubMed, the Cochrane Library, EMBASE, and SCOPUS from inception to April 15, 2016, with cross-referencing of retrieved studies and personal files for potentially eligible studies was performed. Keywords included hearing, cognition, dementia, and Alzheimer disease. Cohort and cross-sectional studies published in peer-reviewed literature and using objective outcome measures were included. Case-control studies were excluded. DATA EXTRACTION AND SYNTHESIS: One reviewer extracted and another verified data. Both reviewers independently assessed study quality. Estimates were pooled using random-effects meta-analysis. Subgroup and meta-regression analyses of study-level characteristics were performed. MAIN OUTCOMES AND MEASURES: Hearing loss measured by pure-tone audiometry only and objective assessment measures of cognitive function, cognitive impairment, and dementia. Cognitive function outcomes were converted to correlation coefficients (r value); cognitive impairment and dementia outcomes, to odds ratios (ORs). RESULTS Forty studies from 12 countries met our inclusion criteria. Of these, 36 unique studies with an estimated 20 264 unique participants were included in the meta-analyses.
Age related hearing loss and cognitive impairment -a current perspective
Age related hearing loss (ARHL) is one of the commonest health conditions of the elderly people which have an important relation with the cognition. Long standing hearing deprivation leads to decline of the cognitive performance. This has impact on quality of communication and result in social isolation, depression and enhances the dementia. Cognitive decline may be misdiagnosed or over-diagnosed when the sensory abilities of the patients are not properly evaluated. Adequate intervention by use of hearing aid or cochlear implant improves the communication, cognitive function, social, emotion function and positively impact on the quality of life. With rise of the elderly population and concomitant increase of ARHL with associated cognitive impairment, it is imperative to discuss this morbid clinical entity in present scenario. Cognitive decline in elderly age have a profound impact on the affected person, on caregivers and society. The financial costs for cognitive impairment in ARHL are also major source of concern for the society. In this review article, we focus on the epidemiology, pathophysiology, hypotheses of etiological mechanisms between the ARHL and cognitive decline or impairment, impact of cognitive impairment on quality of life and prevention.
Hearing loss and cognitive decline in older adults
JAMA internal medicine, 2013
Background: Whether hearing loss is independently associated with accelerated cognitive decline in older adults is unknown. Methods: We studied 1984 older adults (mean age, 77.4 years) enrolled in the Health ABC Study, a prospective observational study begun in 1997-1998. Our baseline cohort consisted of participants without prevalent cognitive impairment (Modified Mini-Mental State Examination [3MS] score, Ն80) who underwent audiometric testing in year 5. Participants were followed up for 6 years. Hearing was defined at baseline using a pure-tone average of thresholds at 0.5 to 4 kHz in the better-hearing ear. Cognitive testing was performed in years 5, 8, 10, and 11 and consisted of the 3MS (measuring global function) and the Digit Symbol Substitution test (measuring executive function). Incident cognitive impairment was defined as a 3MS score of less than 80 or a decline in 3MS score of more than 5 points from baseline. Mixedeffects regression and Cox proportional hazards regression models were adjusted for demographic and cardiovascular risk factors. Results: In total, 1162 individuals with baseline hearing loss (pure-tone average Ͼ25 dB) had annual rates of decline in 3MS and Digit Symbol Substitution test scores that were 41% and 32% greater, respectively, than those among individuals with normal hearing. On the 3MS, the annual score changes were Ϫ0.65 (95% CI, Ϫ0.73 to Ϫ0.56) vs Ϫ0.46 (95% CI, Ϫ0.55 to Ϫ0.36) points per year (P=.004). On the Digit Symbol Substitution test, the annual score changes were Ϫ0.83 (95% CI, Ϫ0.94 to Ϫ0.73) vs Ϫ0.63 (95% CI, Ϫ0.75 to Ϫ0.51) points per year (P=.02). Compared to those with normal hearing, individuals with hearing loss at baseline had a 24% (hazard ratio, 1.24; 95% CI, 1.05-1.48) increased risk for incident cognitive impairment. Rates of cognitive decline and the risk for incident cognitive impairment were linearly associated with the severity of an individual's baseline hearing loss. Conclusions: Hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults. Further studies are needed to investigate what the mechanistic basis of this association is and whether hearing rehabilitative interventions could affect cognitive decline.
Longitudinal Associations of Subclinical Hearing Loss With Cognitive Decline
The Journals of Gerontology: Series A, 2021
BackgroundSeveral studies have demonstrated that age-related hearing loss is associated with cognitive decline. We investigated whether subclinical hearing loss (SCHL) or imperfect hearing traditionally categorized as normal (pure-tone average ≤25 dB) may be similarly linked to cognitive decline and risk of incident mild cognitive impairment (MCI)/dementia.MethodsParticipants from the Baltimore Longitudinal Study of Aging were cognitively normal adults at least 50 years old with cognitive assessments from 1991 to 2019 and pure-tone average ≤25 dB measured between 1991 and 1994 (n = 263). The exposure was hearing based on the better ear pure-tone average. Outcomes were test scores in various cognitive domains. Multivariable linear-mixed effects models were developed to analyze the association between hearing and change in cognition over time, adjusting for age, sex, education, vascular burden, and race. Kaplan–Meier survival curves and Cox proportional hazards models portrayed associ...
Life
In recent years, there has been increasing research interest in the correlation between hearing impairment and cognitive decline, two conditions that have demonstrated a strong association. Hearing loss appears as a risk factor for cognitive impairment, especially among certain populations, notably nursing home residents. Furthermore, hearing loss has been identified as a modifiable age-related condition linked to dementia, and it has been estimated that midlife hearing loss, if eliminated, might decrease the risk of dementia in the general population. Several mechanisms have been suggested to explain the pathologic connections between hearing loss and dementia; however, clear evidence is missing, and the common pathophysiological basis is still unclear. In this review, we discussed current knowledge about the relationship between hearing loss and dementia, and future perspectives in terms of the effects of hearing rehabilitation for early prevention of cognitive decline.
Does Hearing Loss in the Elderly Individuals Conform to Impairment of Specific Cognitive Domains?
Journal of Geriatric Psychiatry and Neurology, 2019
Background: It is well known that age-related hearing loss (ARHL) is strongly associated with dementia. Different hypotheses have been considered to explain this link, including sensorial deprivation, the reduction in cognitive reserve, and the presence of shared pathological pathways (microvascular damage of the brain). Aims: We carried out a study of the audiological and neuropsychological characteristics of a sample of hearing impaired but cognitively healthy individuals (HIH). The aim of our study was to carefully outline the neuropsychological profile of the patients in order to verify whether hearing loss correlated with deficits in specific cognitive domains. Results: Episodic memory is affected by the presence of hearing loss, while semantic competences, syntactic, and grammar skills seem not to be affected. Furthermore, some audiological features linked to the intelligibility of spoken words can predict the presence of executive dysfunction; the same does not apply to memor...