Hearing loss and cognitive decline in older adults: questions and answers

Bernabei, Roberto; Bonuccelli, Ubaldo; Maggi, Stefania; Marengoni, Alessandra; Martini, Alessandro; Memo, Maurizio; Pecorelli, Sërgio; Peracino, A; Quaranta, Nicola; Stella, Roberto; Lin, Frank R.; Adults, Cognitive Decline in Older

doi:10.1007/s40520-014-0266-3

Cited by 54 publications

(23 citation statements)

References 31 publications

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“…Lack of awareness, stigma, persistently high cost, and lack of reimbursement by insurance companies all contribute to the poor uptake of hearing rehabilitation [37]. If hearing rehabilitation can slow or reverse cognitive decline by even a small amount, then it should be promoted aggressively; any intervention that could delay the onset of dementia by just 1 year would result in a more than 10% decrease in the global prevalence of dementia in 2050 [38]. …”

Section: Discussionmentioning

confidence: 99%

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Heywood

Gao

Nyunt

et al. 2017

Dement Geriatr Cogn Disord

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Aim: To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases). Methods: Cross-sectional and longitudinal analyses of baseline and follow-up data were performed in a population-based cohort. The baseline sample of 2,599 adults aged ≥55 included 1,515 cognitively normal subjects who were followed up to 8 years. Hearing loss at baseline was determined by the whispered voice test, and MCI and dementia by Mini-Mental State Examination screening, Clinical Dementia Rating scale, neurocognitive tests, MRI, and panel consensus diagnosis. Results: Hearing impairment was associated with increased prevalence of dementia (odds ratio = 3.63, 95% confidence interval [CI] 1.16-11.4, p = 0.027) but not MCI alone or all cases of MCI or dementia, adjusted for sex, age, ethnicity, education, central obesity, hypertension, diabetes, dyslipidemia, smoking, alcohol, leisure time activity, cardiac diseases, and depressive symptoms. Among participants who were cognitively normal at baseline, those with hearing impairment were more likely to develop MCI or dementia (hazard ratio [HR] = 2.30, 95% CI 1.08-4.92, p = 0.032). Hearing loss was associated with elevated but statistically nonsignificant estimates of adjusted HR (1.85, 95% CI 0.78-4.40) for incident MCI alone. Conclusions: Hearing loss is independently associated with prevalent dementia and incident MCI or dementia.

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Section: Discussionmentioning

confidence: 99%

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Heywood

Gao

Nyunt

et al. 2017

Dement Geriatr Cogn Disord

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“…Older age and microvascular pathology increase the risk of both dementia and peripheral hearing loss, and may therefore confound the association. Hearing loss may either add to the cognitive load of a vulnerable brain leading to changes in the brain (91), or lead to social disengagement or depression (92;93) and accelerated atrophy (94), all of which could contribute to accelerated cognitive decline (95).…”

Section: Hearingmentioning

confidence: 99%

Dementia prevention, intervention, and care

et al. 2017

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People with dementia are usually older, often have co-morbidities and may need help in coping with these illnesses. A third of older people now die with dementia and all professionals working in endof-life care need to make this a central part of their planning and communication. In this commission, we have detailed evidence-based approaches to dementia and its symptoms. Services should be available, scalable and give value. As there are limited resources, professionals and services need to use what works, not use what is ineffective, and be aware of the difference. Overall, there is good potential for prevention and, once someone develops dementia, for care to be high-quality, accessible, and give value to an under-served, growing population. Effective dementia prevention and care could transform the future for society and vastly improve living and dying for individuals with dementia and their families. Acting now on what we already know can make this difference happen. Key Messages 1 There are increasing numbers of people with dementia globally although incidence in some countries has decreased. 2 Be ambitious about prevention: We recommend energetically treating hypertension in middle aged and older people without dementia to reduce dementia incidence. Interventions for other risk factors, including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes and obesity; may have the potential of delaying or preventing a third of dementias. 3 Treat cognitive symptoms: To maximise cognition, people with Alzheimer's dementia or Dementia with Lewy Bodies should be offered Cholinesterase Inhibitors (ChEIs)at all stages, or memantine for severe dementia. ChEIs are not effective in Mild Cognitive Impairment. 4 Individualise dementia care: Good dementia care spans medical, social and supportive care, should be tailored to unique individual and cultural needs, preferences, priorities, and should incorporate support for the family carers 5 Care for family carers. Family carers are at high risk of depression. Effective interventions reduce the risk and treat the symptoms, include START (Strategies for Relatives) or REACH (Resources for Enhancing Alzheimer's Caregiver Health intervention) and should be made available. 6 Plan for the future. People with dementia and their families value discussions about the future and decisions about possible attorneys to make decisions. Clinicians should consider capacity to make different types of decisions at diagnosis. 7 Protect people with dementia. People with dementia and society require protection from possible risks of the condition, including self-neglect, vulnerability including to exploitation, managing money, driving or using weapons. Risk assessment and management at all stages of the disease is essential but it should be balanced against the persons' right to autonomy. 8 Manage neuropsychiatric symptoms. Management of the neuropsychiatric symptoms of dementia including agitation, low mood or psyc...

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“…They show that the better the cognitive performance, the better the results on auditory processing tests of the subjects (22) . Several studies mention the relationship between cognition and presbycusis (23,24,25) , including, authors ponder that if hearing loss actually has such a remarkable influence on cognitive decline and recommend that the hearing aids for the elderly should be strongly encouraged and fitted as soon as possible (26) . The difference in performance between the initial and final assessments indicated that older people with poorer performance on cognitive and memory tests were the ones who had greater improvement in their auditory abilities with hearing aids.…”

Section: The Results Obtained On Different Tests (Rgdt Dps -Right Eamentioning

confidence: 99%

Influência da cognição em habilidades auditivas de idosos pré e pós-adaptação de próteses auditivas

Lessa

Costa

2016

Audiol., Commun. Res.

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Purpose: To determine if auditory skills test results correlated with cognitive performance and evaluate their influence on hearing aid fittings in the elderly population. Methods: This study was carried out with 12 hearing-impaired individuals over 60 years of age. They were cognitively assessed with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery assessment. The instruments used to evaluate resolution and temporal ordering, as well as separation and binaural integration, were the Random Gap Detection Test, Duration Pattern Sequence and Pitch Pattern Sequence, and Dichotic Digits Tests. Their auditory abilities were evaluated before and three months after the hearing aid fittings. The data were statistically correlated to the data obtained from the cognitive assessments. Results: Ordering and temporal resolution were related to some cognitive assessments. The difference in some auditory abilities performance of temporal ordering and temporal resolution after the acclimatization period was inversely related to some cognitive assessments. Conclusion: In the elderly the better the performance on the auditory temporal skills, the better the cognitive test results. However, when analyzing the difference in performance between the auditory abilities before and after the hearing aid fittings, the patients with the worst cognitive performance showed the most improvement. This demonstrates that there is a possibility of neural plasticity stimulation, even in those with cognitive impairment. Keywords

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Hearing loss and cognitive decline in older adults: questions and answers

Cited by 54 publications

References 31 publications

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

Dementia prevention, intervention, and care

Influência da cognição em habilidades auditivas de idosos pré e pós-adaptação de próteses auditivas

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