Association of Age-Related Hearing Loss With Cognitive Function, Cognitive Impairment, and Dementia: A Systematic Review and Meta-analysis
Open accessAbstract
Importance: Epidemiologic research on the possible link between age-related hearing loss (ARHL) and cognitive decline and dementia has produced inconsistent results. Clarifying this association is of interest because ARHL may be a risk factor for outcomes of clinical dementia. Objectives: To examine and estimate the association between ARHL and cognitive function, cognitive impairment, and dementia through a systematic review and meta-analysis. Data Sources and Study Selection: A search of PubMed, the Cochrane Library, EMBASE, and SCOPUS from inception to April 15, 2016, with cross-referencing of retrieved studies and personal files for potentially eligible studies was performed. Keywords included hearing, cognition, dementia, and Alzheimer disease. Cohort and cross-sectional studies published in peer-reviewed literature and using objective outcome measures were included. Case-control studies were excluded. Data Extraction and Synthesis: One reviewer extracted and another verified data. Both reviewers independently assessed study quality. Estimates were pooled using random-effects meta-analysis. Subgroup and meta-regression analyses of study-level characteristics were performed. Main Outcomes and Measures: Hearing loss measured by pure-tone audiometry only and objective assessment measures of cognitive function, cognitive impairment, and dementia. Cognitive function outcomes were converted to correlation coefficients (r value); cognitive impairment and dementia outcomes, to odds ratios (ORs). Results: Forty studies from 12 countries met our inclusion criteria. Of these, 36 unique studies with an estimated 20 264 unique participants were included in the meta-analyses. Based on the pooled maximally adjusted effect sizes using random-effects models, a small but significant association was found for ARHL within all domains of cognitive function. Among cross-sectional studies, a significant association was found for cognitive impairment (OR, 2.00; 95% CI, 1.39-2.89) and dementia (OR, 2.42; 95% CI, 1.24-4.72). Among prospective cohort studies, a significant association was found for cognitive impairment (OR, 1.22; 95% CI, 1.09-1.36) and dementia (OR, 1.28; 95% CI, 1.02-1.59) but not for Alzheimer disease (OR, 1.69; 95% CI, 0.72-4.00). In further analyses, study, demographic, audiometric, and analyses factors were associated with cognitive function. Vascular dysfunction and impaired verbal communication may contribute to the association between hearing loss and cognitive decline. Conclusions and Relevance: Age-related hearing loss is a possible biomarker and modifiable risk factor for cognitive decline, cognitive impairment, and dementia. Additional research and randomized clinical trials are warranted to examine implications of treatment for cognition and to explore possible causal mechanisms underlying this relationship.
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A subsequent meta-analysis using the same three prospective studies measuring hearing by audiometry at baseline found an increased risk of dementia (OR 1.3, 95% CI 1.0-1.6) per 10 dB of worsening hearing loss.
“A subsequent meta-analysis using the same three prospective studies measuring hearing using audiometry at baseline, found an increased risk of dementia (OR 1·3, 95% CI 1·0–1·6) per 10 dB of worsening of hearing loss.58”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [58]
The Results (‘Characteristics and Quality of Included Studies’; ‘Hearing Loss and Dementia’, page unavailable) identify three cohort dementia studies and report a pooled OR of 1.28 (95% CI, 1.02–1.59), consistent with the claim’s rounded figures. The Methods require pure-tone audiometry, but our copy does not specify that this pooled OR represents risk per 10 dB of worsening hearing loss. (LLM, conf=0.86)
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Association of subclinical hearing loss with cognitive performance
Golub, J. S., Brickman, A. M., Ciarleglio, A. J., Schupf, N., & Luchsinger, J. A. (2020) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2019.3375 · Cited by 176 · see citing works
Association between cataract extraction and development of dementia
Lee, C. S., Gibbons, L. E., Lee, A. Y., Yanagihara, R. T., Blazes, M. S., Lee, M. L., McCurry, S. M., Bowen, J. D., McCormick, W. C., Crane, P. K., et al. (2022) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2021.6990 · Cited by 163 · see citing works
A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association
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Umbrella review and Delphi study on modifiable factors for dementia risk reduction
Rosenau, C., Köhler, S., Soons, L. M., Anstey, K. J., Brayne, C., Brodaty, H., Engedal, K., Farina, F. R., Ganguli, M., Livingston, G., et al. (2024) · Alzheimer's & Dementia · doi:10.1002/alz.13577 · Cited by 74 · see citing works
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Comprehension of acoustically degraded speech in Alzheimer’s disease and primary progressive aphasia
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Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
Chao, Y.-T., Kuo, F.-H., Lee, Y.-S., Huang, Y.-H., Weng, S.-C., Chou, Y.-Y., Lin, C.-S., & Lin, S.-Y. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010584 · Cited by 14 · see citing works
- Authors
- Loughrey, D. G., Kelly, M. E., Kelley, G. A., Brennan, S., & Lawlor, B. A.
- Affiliations
- Trinity College Dublin (IE)
- National University of Ireland, Maynooth (IE)
- West Virginia University (US)
- Corresponding author
- Loughrey, David G.
- Venue
- JAMA Otolaryngology–Head & Neck Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2018-02-01
- Volume
- 144
- Issue
- 2
- Pages
- 115
- ISSN
- 2168-6181 (ISSN-L)
- PMC
- PMC5824986
- OpenAlex
- W2775253012
- Cited by
- 961
- References
- 87
- Citations by year
- 2026: 136 · 2025: 153 · 2024: 129 · 2023: 131 · 2022: 112 · 2021: 122 · 2020: 87 · 2019: 58 · 2018: 29 · 2017: 2
- FWCI
- 5.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Otolaryngology–Head & Neck Surgery (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
- The Research Repository @ WVU (West Virginia University) (submittedVersion)
- Funders
- Central Remedial Clinic
- National Institute of General Medical Sciences (U54GM104942)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › 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
- age-related hearing loss, cognitive function, cognitive impairment, dementia, Alzheimer's disease, pure tone audiometry, vascular dysfunction, verbal communication, dementia risk factors, older adults, cochlear implants, cochlear nucleus, auditory cortex, neurodegeneration, neuroinflammation, neuroplasticity
- MeSH terms
- Age Factors, Audiometry, Pure-Tone, Cognition, Dementia, Humans, Presbycusis, Risk Factors, Cognitive Dysfunction
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