With Age Comes Hearing Loss and Greater Risk of Cognitive Decline

Summary: Researchers report hearing impairment is associated with an increased rate of cognitive decline as we age. However, the study revealed the impact of hearing loss on cognition was lessened for those who had a college level education.

Source: UCSD.

Hearing impairment is a common consequence of advancing age. Almost three-quarters of U.S. adults age 70 and older suffer from some degree of hearing loss. One unanswered question has been to what degree hearing impairment intersects with and influences age-related cognitive decline.

In a new study, researchers at University of California San Diego School of Medicine report that hearing impairment is associated with accelerated cognitive decline with age, though the impact of mild hearing loss may be lessened by higher education.

The findings are published in the February 12, 2019 issue of the Journal of Gerontology: Series A Medical Sciences.

A team of scientists, led by senior author Linda K. McEvoy, PhD, professor in the departments of Radiology and Family Medicine and Public Health, tracked 1,164 participants (mean age 73.5 years, 64 percent women) in the longitudinal Rancho Bernardo Study of Healthy Aging for up to 24 years. All had undergone assessments for hearing acuity and cognitive function between the years 1992 to 1996 and had up to five subsequent cognitive assessments at approximately four-year intervals. None used a hearing aid.

The researchers found that almost half of the participants had mild hearing impairment, with 16.8 percent suffering moderate-to-severe hearing loss. Those with more serious hearing impairment showed worse performance at the initial visit on a pair of commonly used cognitive assessment tests: the Mini-Mental State Exam (MMSE) and the Trail-Making Test, Part B. Hearing impairment was associated with greater decline in performance on these tests over time, both for those with mild hearing impairment and those with more severe hearing impairment.

However, the association of mild hearing impairment with rate of cognitive decline was modified by education. Mild hearing impairment was associated with steeper decline among study participants without a college education, but not among those with higher education. Moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level.

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Mild hearing impairment was associated with steeper decline among study participants without a college education, but not among those with higher education. Moderate-to-severe hearing impairment was associated with steeper MMSE decline regardless of education level. NeuroscienceNews.com image is in the public domain.

“We surmise that higher education may provide sufficient cognitive reserve to counter the effects of mild hearing loss, but not enough to overcome effects of more severe hearing impairment,” said McEvoy.

Degree of social engagement did not affect the association of hearing impairment with cognitive decline. “This was a somewhat unexpected finding” said first author Ali Alattar. “Others have postulated that cognitive deficits related to hearing impairment may arise from social isolation, but in our study, participants who had hearing impairment were as socially engaged as those without hearing loss.”

The findings, said the authors, emphasize the need for physicians to be aware that older patients with hearing impairments are at greater risk for cognitive decline. They also emphasized the importance of preventing hearing loss at all ages, since hearing impairment is rarely reversible. One important way to protect hearing, they said, is to minimize loud noise exposure since this is the largest modifiable risk factor for hearing impairment.

About this neuroscience research article

Funding: UC San Diego School of Medicine Clinical Research Fellowship, National Institutes of Health funded this study.

Source: Scott LaFee – UCSD
Publisher: Organized by NeuroscienceNews.com.
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Hearing impairment and cognitive decline in older, community-dwelling adults” by Ali A Alattar, BS; Jaclyn Bergstrom, MS; Gail A Laughlin, PhD; Donna Kritz-Silverstein, PhD; Erin L Richard, MPH; Emilie T Reas, PhD; Jeffrey P Harris, MD, PhD; Elizabeth Barrett-Connor, MD; and Linda K McEvoy, PhD in Journal of Gerontology: Medical Sciences. Published February 12 2019.
doi:10.1093/gerona/glz035

Cite This NeuroscienceNews.com Article

[cbtabs][cbtab title=”MLA”]UCSD”With Age Comes Hearing Loss and Greater Risk of Cognitive Decline.” NeuroscienceNews. NeuroscienceNews, 12 February 2019.
<https://neurosciencenews.com/hearing-loss-cognition-aging-10730/>.[/cbtab][cbtab title=”APA”]UCSD(2019, February 12). With Age Comes Hearing Loss and Greater Risk of Cognitive Decline. NeuroscienceNews. Retrieved February 12, 2019 from https://neurosciencenews.com/hearing-loss-cognition-aging-10730/[/cbtab][cbtab title=”Chicago”]UCSD”With Age Comes Hearing Loss and Greater Risk of Cognitive Decline.” https://neurosciencenews.com/hearing-loss-cognition-aging-10730/ (accessed February 12, 2019).[/cbtab][/cbtabs]


Abstract

Hearing impairment and cognitive decline in older, community-dwelling adults

Background
Hearing impairment is prevalent among older adults and has been identified as a risk factor for cognitive impairment and dementia. We evaluated the association of hearing impairment with long-term cognitive decline among community-dwelling older adults.

Methods
A population-based longitudinal study of adults not using hearing aids who had hearing acuity and cognitive function assessed in 1992-96, and were followed for a maximum of 24 years with up to five additional cognitive assessments. Hearing acuity was categorized based on pure-tone average (PTA) thresholds: normal (PTA≤25 dB), mild impairment (PTA >25–40 dB), moderate/severe impairment (PTA>40 dB).

Results
Of 1,164 participants (mean age 73.5 years, 64% women), 580 (49.8%) had mild hearing impairment, 196 (16.8%) had moderate/severe hearing impairment. In fully adjusted models, hearing impairment was associated with steeper decline on the Mini-Mental State Exam (MMSE) (mild impairment β=-0.04, p=0.01; moderate/severe impairment β=-0.08; p=0.002) and Trails B (mild impairment β=1.21, p=0.003; moderate/severe impairment β=2.16; p =0.003). Associations did not differ by sex or APOE ϵ4 status and were not influenced by social engagement. The MMSE-hearing association was modified by education: mild hearing impairment was associated with steeper decline on the MMSE among participants without college education but not among those with college education. Moderate/severe hearing impairment was associated with steeper MMSE decline regardless of education level.

Conclusions
Hearing impairment is associated with accelerated cognitive decline with age, and should be screened for routinely. Higher education may provide sufficient cognitive reserve to counter effects of mild, but not more severe, hearing impairment.

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