A novel study on association between untreated hearing loss and cognitive functions of older adults: Baseline non-verbal cognitive assessment results (original) (raw)
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Screening of Cognitive Function and Hearing Impairment in Older Adults: A Preliminary Study
BioMed Research International, 2014
Background. Previous research has found that hearing loss is associated with poorer cognitive function. The question is that when a hearing impairment is being compensated for by appropriately fitted monaural hearing aids, special precautions are still needed when screening cognitive function in older adults. Objective. This research examined cognitive function in elderly hearing aid users who used monaural hearing aids and whether the presence of a hearing impairment should be accounted for when screening cognitive function in these individuals. Methods. Auditory thresholds, sentence reception thresholds, and self-reported outcomes with hearing aids were measured in 34 older hearing aid users to ensure hearing aids were appropriately fitted. Mini-Mental State Examination (MMSE) results obtained in these participants were then compared to normative data obtained in a general older population exhibiting similar demographic characteristics. Stepwise multiple regression analyses were used to examine the effects of demographic and auditory variables on MMSE scores. Conclusions. Results showed that, even with appropriately fitted hearing aids, cognitive decline was significant. Besides the factors commonly measured in the literature, we believed that auditory deprivation was not being fully compensated for by hearing aids. Most importantly, screening of cognitive function should take into account the effects of hearing impairment, even when hearing devices have been appropriately fitted.
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.
Title Screening of cognitive function and hearing impairment in olderadults : A preliminary study
2014
Background. Previous research has found that hearing loss is associated with poorer cognitive function. The question is that when a hearing impairment is being compensated for by appropriately fitted monaural hearing aids, special precautions are still needed when screening cognitive function in older adults. Objective. This research examined cognitive function in elderly hearing aid users who used monaural hearing aids and whether the presence of a hearing impairment should be accounted for when screening cognitive function in these individuals. Methods. Auditory thresholds, sentence reception thresholds, and self-reported outcomes with hearing aids were measured in 34 older hearing aid users to ensure hearing aids were appropriately fitted. Mini-Mental State Examination (MMSE) results obtained in these participants were then compared to normative data obtained in a general older population exhibiting similar demographic characteristics. Stepwise multiple regression analyses were u...
Frontiers in Neuroscience, 2021
Objective: The relation between cognition and hearing loss has been increasingly paid high attention, however, few studies have focused on the role of high-frequency hearing loss in cognitive decline. This study is oriented to role of hearing loss especially highfrequency hearing loss in cognitive impairment among elderly people (age ≥ 60 years). Methods: The Montreal Cognitive Assessment Scale (MoCA) and pure tone audiometry were used to investigate the hearing loss and cognitive function of 201 elderly people older than 60 years. Factors possibly related to cognitive impairment including age, years of education, occupation, living conditions, history of otologic diseases, and high blood pressure were registered. This study consisted of two parts. First, univariate analysis and multiple linear regressions were performed to analyze the possible influencing factors of cognitive function among the 201 elderly people. Second, average hearing thresholds of low frequencies (250, 500 Hz), intermediate frequencies (1 k, 2 kHz), and high frequencies (4 k, 8 kHz) were calculated to screen out 40 cases with high-frequency hearing loss alone and 18 cases with normal hearing. Univariate analysis was used to compare the general condition, cognitive function, and each cognitive domain between the two groups, analyzing the relation between high-frequency hearing loss and cognitive function. Result: We found that age, years of education, pure tone average (PTA), occupation, living condition, history of otologic diseases, years of self-reported hearing loss, and hypertension history were related to cognitive function. Furthermore, age, education experience, duration of self-reported hearing loss, and hypertension were independent factors (p < 0.05). PTA was negatively related with attention, orientation, and general cognition (p < 0.05). There were only 18 cases (9.0%) with normal hearing, and 40 cases (19.9%) with abnormal high-frequency hearing alone. The overall cognitive function
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...
Frontiers in Neuroscience
Epidemiological studies show increasing prevalence rates of cognitive decline and hearing loss with age, particularly after the age of 65 years. These conditions are reported to be associated, although conclusive evidence of causality and implications is lacking. Nevertheless, audiological and cognitive assessment among elderly people is a key target for comprehensive and multidisciplinary evaluation of the subject's frailty status. To evaluate the use of tools for identifying older adults at risk of hearing loss and cognitive decline and to compare skills and abilities in terms of hearing and cognitive performances between older adults and young subjects, we performed a prospective cross-sectional study using supraliminal auditory tests. The relationship between cognitive assessment results and audiometric results was investigated, and reference ranges for different ages or stages of disease were determined. Patients older than 65 years with different degrees of hearing function were enrolled. Each subject underwent an extensive audiological assessment, including tonal and speech audiometry, Italian Matrix Sentence Test, and speech audiometry with logatomes in quiet. Cognitive function was screened and then verified by experienced clinicians using the Montreal Cognitive Assessment Score, the Geriatric Depression Scale, and further investigations in some. One hundred twenty-three subjects were finally enrolled during 2016-2019: 103 were >65 years of age and 20 were younger participants (as controls). Cognitive functions showed a correlation with the audiological results in post-lingual hearing-impaired patients, in particular in those affected by slight to moderate hearing loss and aged more than 70 years. Audiological testing can thus be useful in clinical
Age-Related Hearing Loss, Neuropsychological Performance, and Incident Dementia in Older Adults
Journal of Alzheimer's Disease, 2021
Background: Age-related hearing loss (HL) has been associated with dementia, though the neurocognitive profile of individuals with HL is poorly understood. Objective: To characterize the neurocognitive profile of HL. 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 No HL. Outcomes included executive function (Trail Making Test [TMT] Part B), episodic memory (Immediate/Delayed Recall), language fluency (Vegetables, Boston Naming Test), and conversion to dementia. Regression models were fit to examine associations between HL and neurocognitive performance at baseline. Cox proportional hazards models examined the links between HL, neurocognitive scores, and development of dementia over follow-up. Results: At baseline, those with Untreated HL (versus No HL) had worse neurocognitive performance per standardized difference on executive function (TMT Part B [mean d...
International Journal of Audiology, 2019
Objective: Cognitive performance of older adults with severe to profound sensorineural hearing loss and indication for cochlear implantation was evaluated compared to peers with age appropriate hearing. Design: Prospective matched case control study. Study sample: Study group consisted of n ¼ 30 patients aged between 60 and 80 years, with adult onset, severe to profound sensorineural hearing loss on both sides and indication for cochlear implantation. Matched control group consisted of n ¼ 30 peers with age-adjusted hearing abilities, based on ageappropriate norms. Results: Differences in Constructional Praxis and Recall, Trail Making Test A and Stroop were not significant between both groups. However, the differences in Clock Drawing Test, Word Lists and Trail Making Test B were significant. The impairment in TMT B (cognitive flexibility) was mediated via the severity of depressive problems. Cognitive performance was not related to word recognition, the percentage and duration of hearing loss and hearing aid use. Conclusion: Severely hearing-impaired older adults show widespread impairments in cognitive performance.
Relationship between Auditory and Cognitive Abilities in Older Adults
PloS one, 2015
The objective was to evaluate the association of peripheral and central hearing abilities with cognitive function in older adults. Recruited from epidemiological studies of aging and cognition at the Rush Alzheimer's Disease Center, participants were a community-dwelling cohort of older adults (range 63-98 years) without diagnosis of dementia. The cohort contained roughly equal numbers of Black (n=61) and White (n=63) subjects with groups similar in terms of age, gender, and years of education. Auditory abilities were measured with pure-tone audiometry, speech-in-noise perception, and discrimination thresholds for both static and dynamic spectral patterns. Cognitive performance was evaluated with a 12-test battery assessing episodic, semantic, and working memory, perceptual speed, and visuospatial abilities. Among the auditory measures, only the static and dynamic spectral-pattern discrimination thresholds were associated with cognitive performance in a regression model that inc...
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.