Otology & Neurotology

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Otology & Neurotology:
doi: 10.1097/MAO.0000000000000313
Sensorineural Hearing Loss & Tinnitus

Relationship of Hearing Loss and Dementia: A Prospective, Population-Based Study

Gurgel, Richard Klaus*; Ward, Preston Daniel*; Schwartz, Sarah; Norton, Maria C.†‡§; Foster, Norman L.; Tschanz, JoAnn T.†§

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Objective: To determine whether baseline hearing loss increases cognitive decline and risk for all-cause dementia in a population of elderly individuals.

Study design: Longitudinal cohort study.

Setting: Community-based, outpatient.

Patients: Men and women aged 65 years or older without dementia at baseline.

Intervention(s): All subjects completed the Modified Mini-Mental Status Exam (3MS-R) at baseline and over 3 triennial follow-up visits. Hearing loss (HL) at baseline was based on observation of hearing difficulties during testing or interview. Incident dementia was determined by clinical assessment and expert consensus.

Main Outcome Measure(s): Dementia and 3MS-R score.

Results: At baseline, 4,463 subjects were without dementia, 836 of whom had HL. Of those with HL, 16.3% developed dementia, compared with 12.1% of those without HL (p < 0.001). Mean time to dementia was 10.3 years in the HL group versus 11.9 years for non-HL (log rank test p < 0.001). In Cox regression analyses controlling for sex, presence of APOE- [Latin Small Letter Open E]4 allele, education, and baseline age, and cardiovascular risk factors, HL was an independent predictor of developing dementia (hazard ratio = 1.27, p = 0.026 [95% CI, 1.03–1.56]). Linear mixed models controlling for similar covariates showed HL was associated with faster decline on the 3MS-R, at a rate of 0.26 points/year worse than those without HL.

Conclusion: Elderly individuals with HL have an increased rate of developing dementia and more rapid decline on 3MS-R scores than their nonhearing impaired counterparts. These findings suggest that hearing impairment may be a marker for cognitive dysfunction in adults age 65 years and older.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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