Abstract
Hearing loss is a modifiable risk factor for dementia in older adults. Whether hearing aid use can delay the onset of cognitive decline is unknown. Participants in this study (aged 62–82 years) were assessed before and 18 months after hearing aid fitting on hearing, cognitive function, speech perception, quality of life, physical activity, loneliness, isolation, mood, and medical health. At baseline, multiple linear regression showed hearing loss and age predicted significantly poorer executive function performance, while tertiary education predicted significantly higher executive function and visual learning performance. At 18 months after hearing aid fitting, speech perception in quiet, self-reported listening disability and quality of life had significantly improved. Group mean scores across the cognitive test battery showed no significant decline, and executive function significantly improved. Reliable Change Index scores also showed either clinically significant improvement or stability in executive function for 97.3% of participants, and for females for working memory, visual attention and visual learning. Relative stability and clinically and statistically significant improvement in cognition were seen in this participant group after 18 months of hearing aid use, suggesting that treatment of hearing loss with hearing aids may delay cognitive decline. Given the small sample size, further follow up is required.
Highlights
By 2050, the number of people affected by dementia is predicted to double to over 131 million [1]
The results demonstrate a significant improvement in average executive function (GML) over the 18 months of hearing aid use, with raw scores improving from 58.8 to 51.0 (p = 0.001; paired t test)
The initial findings of the current study of significant improvement in cognition associated with hearing aid use in older adults add significantly to the literature, as the methodology of the current study addresses almost all of the previously discussed limitations in objectively examining hearing loss, hearing aid use and benefits of hearing aid use over time, while controlling for the effects of other known risk factors of cognitive decline
Summary
By 2050, the number of people affected by dementia is predicted to double to over 131 million [1]. Age-related hearing loss (hearing thresholds greater than 25 dB HL; [2]) is highly prevalent in older adults from middle age, with a doubling of incidence reported with each decade [3]. The incidence of reported hearing loss ranges from 30%–60% for people aged over 65 years to 70%–90% over 85 years [4–6]. Hearing loss is associated with many co-morbidities, including poorer physical health, anxiety, depression, loneliness and isolation [7–10]. Despite its high prevalence and significant negative impact on quality of life and burden to society, hearing loss is undertreated. A recent report in the U.S showed only one in seven adults aged 50 and older used hearing aids, with fewer than 1 in 20 working adults aged 50–70 years doing so [11]
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