Abstract
We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40-69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.
Highlights
The proportion of older adults in the global population has been increasing with an increase in the average life span, and Japan is one of the countries with the highest aging populations
We investigated whether baseline hearing status was associated with the degree of cognitive change assessed with four neuropsychological subtests during a 12-year follow-up in a Japanese older population, and reported that the rate of change in cognitive performance over time differed significantly depending on the presence or absence of hearing impairment [6]
The baseline scores for Picture completion and Digit Symbol Substitution (DSST) were significantly higher in hearing aids (HA) users than in non-users, there were no significant differences in Information and Similarities scores
Summary
The proportion of older adults in the global population has been increasing with an increase in the average life span, and Japan is one of the countries with the highest aging populations. The global population of older adults is expected to reach 1.4 billion by 2030 and 2.1 billion by 2050 [1]. Hearing and cognitive impairments are the most common chronic conditions in older adults. One-third of older adults may show hearing impairments [2], while there are over 50 million older adults with dementia worldwide [3]. We investigated whether baseline hearing status was associated with the degree of cognitive change assessed with four neuropsychological subtests during a 12-year follow-up in a Japanese older population, and reported that the rate of change in cognitive performance over time differed significantly depending on the presence or absence of hearing impairment [6]
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