Can Hearing Aids Delay Time to Diagnosis of Dementia, Depression, or Falls in Older Adults?

Abstract

OBJECTIVE To examine the association between hearing aids (HAs) and time to diagnosis of Alzheimer disease (AD) or dementia, anxiety or depression, and injurious falls among adults, aged 66 years and older, within 3 years of hearing loss (HL) diagnosis. DESIGN Retrospective cohort study. SETTING We used 2008 to 2016 national longitudinal claims data (based on office visit, inpatient, or outpatient healthcare encounters) from a large private payer. We used Kaplan‐Meier curves to examine unadjusted disease‐free survival and crude and adjusted Cox regression models to examine associations between HAs and time to diagnosis of three age‐related/HL‐associated conditions within 3 years of HL diagnosis. All models were adjusted for age, sex, race/ethnicity, census divisions, and prior diagnosis of cardiovascular conditions, hypertension, hypercholesterolemia, obesity, and diabetes. PARTICIPANTS The participants included 114 862 adults, aged 66 years and older, diagnosed with HL. MEASUREMENT Diagnosis of (1) AD or dementia; (2) depression or anxiety; and (3) injurious falls. INTERVENTION Use of HAs. RESULTS Large sex and racial/ethnic differences exist in HA use. Approximately 11.3% of women vs 13.3% of men used HAs (95% confidence interval [CI] difference = −0.024 to −0.016). Approximately 13.6% of whites (95% CI = 0.13‐0.14) vs 9.8% of blacks (95% CI = 0.09‐0.11) and 6.5% of Hispanics (95% CI = 0.06‐0.07) used HAs. The risk‐adjusted hazard ratios of being diagnosed with AD/dementia, anxiety/depression, and injurious falls within 3 years after HL diagnosis, for those who used HAs vs those who did not, were 0.82 (95% CI = 0.76‐0.89), 0.89 (95% CI = 0.86‐0.93), and 0.87 (95% CI = 0.80‐0.95), respectively. CONCLUSIONS Use of HAs is associated with delayed diagnosis of AD, dementia, depression, anxiety, and injurious falls among older adults with HL. Although we have shown an association between use of HAs and reduced risk of physical and mental decline, randomized trials are needed to determine whether, and to what extent, the relationship is causal. J Am Geriatr Soc 67:2362–2369, 2019

Cost-utility analysis of hearing aid device for older adults in the community: a delayed start study

“…Research shows that use of HAs among older adults with hearing loss was associated with lesser healthcare utilization as compared to those who did not use the device [49]. HA use was also found to reduce risk of dementia, depression and falls related injury by up to 18% in the following three years after hearing loss diagnosis [50]. The current study only included short-term costs associated with hearing loss, thus potentially overestimating the ICER.…”

The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function?

“…Given that social isolation is associated with physiological changes such as increased systolic blood pressure and glucocorticosteroid levels [56] and is as strong a risk factor for morbidity and mortality as other well-known risk factors such as smoking, obesity, and a sedentary lifestyle [57], it is also possible that decreased social isolation due to hearing aid use may improve physical health and thereby reduce the risk of cognitive decline. Although there are contradictory reports in the literature, some studies have documented slower rates of cognitive decline in users of hearing aids as compared with non-users [5,13,22].…”

“…As discussed previously, there are mixed reports in the literature regarding the effects of hearing aid use on cognition in older adults, with some studies reporting a positive effect on cognition [13,[19][20][21][22], and others finding no significant effects [20,23,24]. Although the first systematic review and meta-analysis of research in this field concluded that people with treated hearing loss had better overall cognition than did those who remained untreated [12], this conclusion was based on limited results which were subject to publication bias.…”

“…However, the effect of hearing aid use on cognition is still unclear, as reports to date of the effects of hearing aid use have yielded mixed results. Although some cross-sectional cohort studies have reported either improved cognition from baseline or a slower rate of decline with hearing aid use [13,[19][20][21][22], others have found no significant effect [20,23,24]. Further, a narrative review concluded that although hearing aid use could impact immediate cognitive function, there was no evidence long-term usage affected long-term cognition [25].…”

Seven days in medicine: 11-17 September 2019

“…Hearing loss is linked to an increased likelihood of dementia, depression, anxiety, and falls, but wearing a hearing aid reduces these risks, a study published in the Journal of American Geriatrics Society found 4. Researchers tracked 114 862 adults aged over 66 with diagnosed hearing loss.…”