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ABSTRACT
Addressing midlife hearing loss could prevent up to 9% of new cases of dementia, the highest of any potentially modifiable risk factor identified in the 2017 commissioned report in The Lancet. In Australia, hearing loss is the second-most common chronic health condition in older people, affecting 74% of people aged over 70. Estimates indicate that people with severe hearing loss are up to 5-times more likely to develop dementia, but these estimates vary between studies due to methodological limitations. Using data from the Sydney Memory and Aging Study, in which 1,037 Australian men and women aged between 70 and 90 years were enrolled and completed biennial assessments from 2005-2017, investigations between hearing loss and baseline cognitive performance as well as longitudinal risk of neurocognitive disorder were undertaken. Individuals who reported moderate-to-severe hearing difficulties had poorer cognitive performances in the domains of Attention/Processing Speed and Visuospatial Ability, and on an overall index of Global Cognition, and had a 1.5-times greater risk for the neurocognitive disorder during 6-years’ follow-up. Hearing loss independently predicted risk for MCI but not dementia. The presence of hearing loss is an important consideration for neuropsychological case formulation in older adults with cognitive impairment. Hearing loss may increase cognitive load, resulting in observable cognitive impairment on neuropsychological testing. Individuals with hearing loss who demonstrate impairment in non-amnestic domains may experience benefits from the provision of hearing devices; This study provides support for a randomized control trial of hearing devices for improvement of cognitive function in this group.
Acknowledgments
PAS Conceptualized the study. PS, NK, BD, and HB facilitated cross-institutional collaboration and data access. PAS led the statistical analyses. PAS and GB drafted the manuscript, with input from AB and GS, with additional expert input provided by PS, NK, BD, and HB. All authors contributed to manuscript revision and read and approved the submitted version.
The authors acknowledge and thank the men and women from the Sydney Memory and Ageing Study, whose ongoing contributions, generosity, and commitment to science have allowed us to further understand risk factors associated with cognitive decline and neurocognitive disorders.
Disclosure statement
The authors declare no conflicts of interest in relation to this study.
Cognitive domain scores
Raw scores were converted to Z-scores using the baseline mean and standard deviation (SD) values for a reference group (723 healthy MAS participants who were fluent in English before 10 years old and free of dementia, neurological and psychiatric disorders, and CNS medications at baseline). If necessary, the signs of the z-scores were reversed so that higher scores reflect better performance. Domain scores were calculated by averaging z-scores of the component tests with the exception of the Visuospatial domain represented by a single test. Global Cognition scores were calculated by averaging the domain scores. All domain and Global Cognition scores were standardized so that the reference group had means and SDs of 0 and 1.
Supplemental data
Supplemental data for this article can be accessed here.