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Hearing Loss and Cognitive Decline in Older Adults
Open accessAbstract
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, ≥80) 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. Mixed-effects 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 >25 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 -0.65 (95% CI, -0.73 to -0.56) vs -0.46 (95% CI, -0.55 to -0.36) points per year (P = .004). On the Digit Symbol Substitution test, the annual score changes were -0.83 (95% CI, -0.94 to -0.73) vs -0.63 (95% CI, -0.75 to -0.51) 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.
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“Loss of hearing can significantly impact QoL and generally contributes to isolation, depression, and cognitive retardation 6 .”
From The effect of psychological inflexibility on health-related quality of life, depression, and anxiety in patients with chronic tinnitus without hearing loss (2023) · cites this paper as [6]
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Metadata
- Authors
- Lin, F. R., Yaffe, K., Xia, J., Xue, Q.-L., Harris, T. B., Purchase-Helzner, E., Satterfield, S., Ayonayon, H. N., Ferrucci, L., Simonsick, E. M., & Health ABC Study Group, F. T.
- Affiliations
- Johns Hopkins University (US)
- University of California, San Francisco (US)
- National Institute on Aging (US)
- State University of New York (US)
- University of Tennessee Health Science Center (US)
- Corresponding author
- Lin, Frank R.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2013-02-25
- Volume
- 173
- Issue
- 4
- Pages
- 293
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC3869227
- OpenAlex
- W2122522567
- Cited by
- 4,017
- References
- 64
- Citations by year
- 2026: 105 · 2025: 194 · 2024: 296 · 2023: 360 · 2022: 351 · 2021: 355 · 2020: 330 · 2019: 331 · 2018: 345 · 2017: 307 · 2016: 326 · 2015: 332 · 2014: 134 · 2013: 56
- FWCI
- 155.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (n01ag062101-007, n01ag062103-006, n01ag062106-007)
- National Institute on Aging (R01AG028050, P30AG02133, N01 AG062106, N01 AG062103, N01 AG062101)
- National Institute on Deafness and Other Communication Disorders (K23DC011279)
- National Institute of Nursing Research (R01NR012459)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Hearing Loss and Rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Keywords
- hearing loss, cognitive decline, cognitive impairment, older adults, pure-tone average, executive function, incident cognitive impairment, hearing loss severity, community-dwelling older adults, Health ABC Study, audiometry, Modified Mini-Mental State Examination, Digit Symbol Substitution Test, cardiovascular risk factors, dementia risk, Alzheimer's disease risk, stroke risk
- MeSH terms
- Aged, Aged, 80 and over, Aging, Audiometry, Cognition Disorders, Female, Humans, Male, Neuropsychological Tests, Prospective Studies, Risk Factors, Incidence, Linear Models, Proportional Hazards Models, Hearing Loss
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