The impact of hearing impairment and hearing aid use on progression to mild cognitive impairment in cognitively healthy adults: a longitudinal study of 5721 participants

2021 ◽  
Author(s):  
Magda Bucholc ◽  
Sarah Bauermeister ◽  
Daman Kaur ◽  
Paula McClean ◽  
Stephen Todd
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Hearing Aid Use ◽  
Increased Risk ◽  
The Impact

Abstract The increasing prevalence of dementia in older adults warrants attention to the identification of practices that can delay or reduce likelihood of progression to early forms of cognitive impairment, in particular, to mild cognitive impairment (MCI) which is often considered a transitional stage between healthy aging and dementia. In this study, we investigated the effect of hearing impairment and hearing aid usage on cognitive decline and progression to MCI in cognitively healthy individuals. We used data from a large referral-based cohort obtained from the National Alzheimer’s Coordinating Center. The baseline sample included 5721 cognitively normal subjects aged ≥ 40. We found that hearing impairment was associated with increased risk of progression to MCI (hazard ratio [HR] = 1.40, 95%CI, 1.16-1.68, false discovery rate [FDR] P < 0.001) and an accelerated rate of cognitive decline (P < 0.001). Among hearing-impaired participants, hearing aid users were less likely to develop MCI (HR, 0.33; 95% CI, 0.23-0.47; FDR P < 0.001) and experienced slower cognitive decline (P = 0.004) when compared to those not using hearing aids. We found no statistically significant differences in risk of conversion to MCI between individuals with normal hearing and hearing-impaired adults using hearing aids (HR, 1.23; 95% CI, 0.99-1.50; FDR P = 0.08). Our findings highlight the need for a randomized clinical trial that will allow us to investigate whether there is a causal relationship between hearing loss, hearing aid use, and conversion to MCI. Such knowledge could provide new and novel insights into prevention of cognitive impairment and dementia.

scholarly journals Association of the use of hearing aids with the conversion from mild cognitive impairment to dementia and progression of dementia: a longitudinal retrospective study

2020 ◽  
Author(s):  
Magda Bucholc ◽  
Paula L. McClean ◽  
Sarah Bauermeister ◽  
Stephen Todd ◽  
Xuemei Ding ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Sensitivity Analyses ◽  
Risk Of Death ◽  
Hearing Aid Use ◽  
Incident Dementia

AbstractINTRODUCTIONHearing aid usage has been linked to improvements in cognition, communication, and socialization, but the extent to which it can affect the incidence and progression of dementia is unknown. Such research is vital given the high prevalence of dementia and hearing impairment in older adults, and the fact that both conditions often coexist. In this study, we examined for the first time the effect of the use of hearing aids on the conversion from mild cognitive impairment (MCI) to dementia and progression of dementia.METHODSWe used a large referral-based cohort of 2114 hearing-impaired patients obtained from the National Alzheimer’s Coordinating Center. Survival analyses using multivariable Cox proportional hazards regression model and weighted Cox regression model with censored data were performed to assess the effect of hearing aid use on the risk of conversion from MCI to dementia and risk of death in hearing-impaired participants. Disease progression was assessed with CDR® Dementia Staging Instrument Sum of Boxes (CDRSB) scores. Three types of sensitivity analyses were performed to validate the robustness of the results.RESULTSMCI participants that used hearing aids were at significantly lower risk of developing all-cause dementia compared to those not using hearing aids (hazard ratio [HR] 0.73, 95%CI, 0.61-0.89; false discovery rate [FDR] P=0.004). The mean annual rate of change (standard deviation) in CDRSB scores for hearing aid users with MCI was 1.3 (1.45) points and significantly lower than for individuals not wearing hearing aids with a 1.7 (1.95) point increase in CDRSB per year (P=0.02). No association between hearing aid use and risk of death was observed. Our findings were robust subject to sensitivity analyses.DISCUSSIONAmong hearing-impaired adults, hearing aid use was independently associated with reduced dementia risk. The causality between hearing aid use and incident dementia should be further tested.HighlightsHigh prevalence of dementia and hearing impairment in older adultsHearing aid (HA) use associated with a lower risk of incident dementiaSlower cognitive decline in users than non-users of HA with mild cognitive impairmentThe relationship between hearing impairment and dementia should be further tested

scholarly journals Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer’s disease dementia: A qualitative study

2020 ◽  
Vol 8 ◽  
pp. 205031212090457
Author(s):  
Sarah Gregory ◽  
Jo Billings ◽  
Danielle Wilson ◽  
Gill Livingston ◽  
Anne GM Schilder ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Future Research ◽  
Structured Interviews ◽  
Hearing Aid Use ◽  
Age Range

Objectives: Hearing aid usage supports communication and independence; however, many do not use their hearing aids. This study explored the experiences of hearing aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using thematic analysis. Ten people (six males, age range 75–86 years old) with mild cognitive impairment or Alzheimer’s disease who had been fitted with hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to using hearing aids, (2) practical aspects of hearing aids, (3) benefits of hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the experience of using hearing aids. This population may benefit from targeted strategies to support use of hearing aids. The findings from this study can inform future research to optimise use of hearing aids in this population.

scholarly journals Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chi-Jung Tai ◽  
Tzyy-Guey Tseng ◽  
Yu-Han Hsiao ◽  
Tsu-Ann Kuo ◽  
Ching-Ya Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Propensity Score ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aid ◽  
Community Dwelling ◽  
Geriatric Syndromes ◽  
Hearing Aid Use

Abstract Background Previous studies have reported associations between hearing impairment (HI) and cognitive impairment, but the evidence is not conclusive while considering concurrent geriatric syndromes. Especially, evidence from previous studies rarely came from Asian studies. This study aimed to evaluate the independent effects of HI and hearing aid use on the incidence of cognitive impairment while considering most geriatric confounders. Methods This population-based, propensity-score matched cohort study used cohort from Waves IV–VII (1999–2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive impairment was identified based on Short Portable Mental Status Questionnaire (SPMSQ) scores. The hazard ratio (HR) was calculated using the Cox proportional hazard regression adjusting for age, sex, comorbidities, socioeconomic status, Center for Epidemiologic Studies Depression (CES-D) scores, the instrumental activities of daily living scale, mobility condition and quality of life. In addition, social support and participation were also considered as confounders in the analysis. To assess the robustness of our findings, we conducted a sensitivity analysis designed to access unmeasured confounding factors by calculating E-values. Results After 1:1 propensity-score matching, we included 709 participants in both the HI and non-HI groups with a mean age of 73.4 years and 39.4% of participants were female. The mean follow-up was 8.9 ± 3.9 years. The HI group had a higher incidence of cognitive impairment than the non-HI group (74.5% vs. 69.1%, respectively), with an adjusted HR of 1.16 (95% confidence interval [CI], 1.03–1.32) based on a 12-year follow up. The E-value was 1.45 for the estimate, which provided evidence for this study’s robustness. Although, a subgroup analysis showed that hearing aid use was associated with lower incidences of cognitive impairment (66.3% vs. 75.6%) when compared to non-users in the HI group, the adjusted HR of 0.82 (95% CI, 0.61–1.09) revealed no significant differences. Conclusions HI was an independent risk factor of incident cognitive impairment on top of concurrent geriatric syndromes. Early HI detection may thus be effective for preventing cognitive decline. Further studies are needed to evaluate the effect of hearing aid use on the prevention of cognitive decline.

scholarly journals Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

2020 ◽  
Author(s):  
Chi-Jung Tai ◽  
Tzyy-Guey Tseng ◽  
Yu-Han Hsiao ◽  
Tsu-Ann Kuo ◽  
Ching-Ya Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Propensity Score ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aid ◽  
Community Dwelling ◽  
Geriatric Syndromes ◽  
Hearing Aid Use

Abstract Background: Previous studies have reported associations between hearing impairment (HI) and cognitive impairment, but the evidence is not conclusive while considering concurrent geriatric syndromes. Especially, evidence from previous studies rarely came from Asian studies. This study aimed to evaluate the independent effects of HI and hearing aid use on the incidence of cognitive impairment while considering most geriatric confounders.Methods: This population-based, propensity-score matched cohort study used cohort from Waves IV­–VII (1999–2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive impairment was identified based on Short Portable Mental Status Questionnaire (SPMSQ) scores. The hazard ratio (HR) was calculated using the Cox proportional hazard regression adjusting for age, sex, comorbidities, socioeconomic status, Center for Epidemiologic Studies Depression (CES-D) scores, the instrumental activities of daily living scale, mobility condition and quality of life. In addition, social support and participation were also considered as confounders in the analysis. To assess the robustness of our findings, we conducted a sensitivity analysis designed to access unmeasured confounding factors by calculating E-values.Results: After 1:1 propensity-score matching, we included 709 participants in both the HI and non-HI groups with a mean age of 73.4 years and 39.4% of participants were female. The mean follow-up was 8.9±3.9 years. The HI group had a higher incidence of cognitive impairment than the non-HI group (74.5% vs. 69.1%, respectively), with an adjusted HR of 1.16 (95% confidence interval [CI], 1.03–1.32) based on a 12-year follow up. The E-value was 1.45 for the estimate, which provided evidence for this study’s robustness. Although, a subgroup analysis showed that hearing aid use was associated with lower incidences of cognitive impairment (66.3% vs. 75.6%) when compared to non-users in the HI group, the adjusted HR of 0.82 (95% CI, 0.61–1.09) revealed no significant differences.Conclusions: HI was an independent risk factor of incident cognitive impairment on top of concurrent geriatric syndromes. Early HI detection may thus be effective for preventing cognitive decline. Further studies are needed to evaluate the effect of hearing aid use on the prevention of cognitive decline.

scholarly journals Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

2020 ◽  
Author(s):  
Chi-Jung Tai ◽  
Tzyy-Guey Tseng ◽  
Yu-Han Hsiao ◽  
Tsu-Ann Kuo ◽  
Ching-Ya Huang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Propensity Score ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aid ◽  
Community Dwelling ◽  
Geriatric Syndromes ◽  
Hearing Aid Use

Abstract Background: Previous studies have reported associations between hearing impairment (HI) and cognitive impairment, but the evidence is not conclusive while considering concurrent geriatric syndromes. Especially, evidence from previous studies rarely came from Asian studies. This study aimed to evaluate the independent effects of HI and hearing aid use on the incidence of cognitive impairment while considering most geriatric confounders.Methods: This population-based, propensity-score matched cohort study used cohort from Waves IV­–VII (1999–2011) survey of the Taiwan Longitudinal Study on Aging (TLSA). Cognitive impairment was identified based on Short Portable Mental Status Questionnaire (SPMSQ) scores. The hazard ratio (HR) was calculated using the Cox proportional hazard regression adjusting for age, sex, comorbidities, socioeconomic status, Center for Epidemiologic Studies Depression (CES-D) scores, the instrumental activities of daily living scale, mobility condition and quality of life. In addition, social support and participation were also considered as confounders in the analysis. To assess the robustness of our findings, we conducted a sensitivity analysis designed to access unmeasured confounding factors by calculating E-values.Results: After 1:1 propensity-score matching, we included 709 participants in both the HI and non-HI groups with a mean age of 73.4 years and 39.4% of participants were female. The mean follow-up was 8.9±3.9 years. The HI group had a higher incidence of cognitive impairment than the non-HI group (74.5% vs. 69.1%, respectively), with an adjusted HR of 1.16 (95% confidence interval [CI], 1.03–1.32) based on a 12-year follow up. The E-value was 1.45 for the estimate, which provided evidence for this study’s robustness. Although, a subgroup analysis showed that hearing aid use was associated with lower incidences of cognitive impairment (66.3% vs. 75.6%) when compared to non-users in the HI group, the adjusted HR of 0.82 (95% CI, 0.61–1.09) revealed no significant differences.Conclusions: HI was an independent risk factor of incident cognitive impairment on top of concurrent geriatric syndromes. Early HI detection may thus be effective for preventing cognitive decline. Further studies are needed to evaluate the effect of hearing aid use on the prevention of cognitive decline.

scholarly journals Effects of hearing aid on improving cognition and depressive symptoms in elderly

2021 ◽  
Vol 7 (4) ◽  
pp. 639
Author(s):  
K. J. Arun Kumar ◽  
M. Vidyalakshmi
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Negative Impact ◽  
Hearing Aid ◽  
Financial Burden ◽  
Hearing Aid Use ◽  
The Mean ◽  
The Individual

<p class="abstract"><strong>Background: </strong>The prevalence of dementia among people aged over 60 years is between 5–7%, with the numbers of those affected globally predicted to double every 20 years between 2010 and 2050. While cognitive impairment and dementia have a negative impact on the individual, caregivers and society, the financial burden of cognitive decline and dementia are also a major source of concern. However, there is some cause for optimism in the form of potentially modifiable risk factors which can prevent or delay dementia. In this study we investigate the effect of hearing aid on improving cognition and depressive symptoms in elderly individuals with hearing impairment.</p><p class="abstract"><strong>Methods: </strong>Patients with hearing impairment were selected based on inclusion and exclusion criteria and prescribed with similar type of hearing aid. MMSE and GDS scores were obtained before fitting hearing aid and 3 months after fitting hearing aid.</p><p class="abstract"><strong>Results: </strong>A<strong> </strong>total number of 66 patients, 40 males (61%) and 26 females (39%) were included in the study. Before using hearing aids, the mean MMSE score was 18.98±5.37 (range 10–26), and it increased to 21.08±4.77 (range 12–27) after 3 months of hearing aid use (p&lt;0.005). The GDS analysis revealed a mean score of 6.85±2.81 (range 3–11) before using hearing aid and it decreased to 5.44±1.82 (range 3–8 after using the hearing aid (p&lt;0.005).</p><p class="abstract"><strong>Conclusions: </strong>Treating hearing loss with hearing aid may reduce burden associated with cognitive decline and depression.</p><p class="abstract"> </p>

Hearing Aid Amplification Reduces Communication Effort of People With Hearing Impairment and Their Conversation Partners

2020 ◽  
Vol 63 (4) ◽  
pp. 1299-1311 ◽  
Author(s):  
Timothy Beechey ◽  
Jörg M. Buchholz ◽  
Gitte Keidser
Keyword(s):  
Hearing Impairment ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Referential Communication ◽  
Hearing Impaired ◽  
Directional Hearing ◽  
Acoustic Environment ◽  
Communication Task ◽  
Acoustic Environments ◽  
The Impact

Objectives This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions. Design Fifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs. Each pair consisted of one young normal-hearing participant and one older hearing-impaired participant. Hearing-impaired participants received directional hearing aid amplification, according to their audiogram, via a master hearing aid with gain provided according to the NAL-NL2 fitting formula. Pairs of participants were required to take part in naturalistic conversations through the use of a referential communication task. Each pair took part in five conversations, each of 5-min duration. During each conversation, participants were exposed to one of five different realistic acoustic environments presented through highly open headphones. The ordering of acoustic environments across experimental blocks was pseudorandomized. Resulting recordings of conversational speech were analyzed to determine the magnitude of speech modifications, in terms of vocal level and spectrum, produced by normal-hearing talkers as a function of both acoustic environment and the degree of high-frequency average hearing impairment of their conversation partner. Results The magnitude of spectral modifications of speech produced by normal-hearing talkers during conversations with aided hearing-impaired interlocutors was smaller than the speech modifications observed during conversations between the same pairs of participants in the absence of hearing aid amplification. Conclusions The provision of hearing aid amplification reduces the effort required to maintain communication in adverse conditions. This reduction in effort provides benefit to hearing-impaired individuals and also to the conversation partners of hearing-impaired individuals. By considering the impact of amplification on both sides of dyadic conversations, this approach contributes to an increased understanding of the likely impact of hearing impairment on everyday communication.

scholarly journals Subjective cognitive decline: The first clinical manifestation of Alzheimer's disease?

2016 ◽  
Vol 10 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Adalberto Studart Neto ◽  
Ricardo Nitrini
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Manifestation ◽  
Neurodegenerative Disorder ◽  
Subjective Cognitive Decline ◽  
Subjective Memory ◽  
Increased Risk

ABSTRACT Background: Mild cognitive impairment is considered as the first clinical manifestation of Alzheimer's disease (AD), when the individual exhibits below performance on standardized neuropsychological tests. However, some subjects before having a lower performance on cognitive assessments already have a subjective memory complaint. Objective: A review about subjective cognitive decline, the association with AD biomarkers and risk of conversion to dementia. Methods: We performed a comprehensive non-systematic review on PubMed. The keywords used in the search were terms related to subjective cognitive decline. Results: Subjective cognitive decline is characterized by self-experience of deterioration in cognitive performance not detected objectively through formal neuropsychological testing. However, various terms and definitions have been used in the literature and the lack of a widely accepted concept hampers comparison of studies. Epidemiological data have shown that individuals with subjective cognitive decline are at increased risk of progression to AD dementia. In addition, there is evidence that this group has a higher prevalence of positive biomarkers for amyloidosis and neurodegeneration. However, Alzheimer's disease is not the only cause of subjective cognitive decline and various other conditions can be associated with subjective memory complaints, such as psychiatric disorders or normal aging. The features suggestive of a neurodegenerative disorder are: onset of decline within the last five years, age at onset above 60 years, associated concerns about decline and confirmation by an informant. Conclusion: These findings support the idea that subjective cognitive complaints may be an early clinical marker that precedes mild cognitive impairment due to Alzheimer's disease.

scholarly journals Survey of Hearing Aid Conditions for Hearing Impaired Persons While Driving

2020 ◽  
pp. 132-136
Author(s):  
Hiroshi Ikeda ◽  
Shigeyuki Minami
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Visual Information ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Safe Driving ◽  
Actual Usage ◽  
Hearing Ability ◽  
Acquired Hearing Loss ◽  
The Impact

Hearing impaired persons are required to drive with hearing aids to supplement their hearing ability, however, there has not been sufficient discussion regarding the impact of the use of a hearing aid on driving a vehicle. In order to investigate the actual usage and driving conditions of using hearing aids while driving a vehicle, this paper uses a questionnaire to survey (1) how easy it is to drive when wearing hearing aids, and (2) how often hearing aids are not worn while driving. Concerning the ease of driving when wearing a hearing aid, it was suggested that people with congenital hearing loss were more likely to rely on visual information, and those with acquired hearing loss continue to use their experience of hearing. When the level of disability is high, it is difficult to drive when using the hearing aid, and when the disability level is low, it is easier to drive. Regarding the frequency of driving without wearing hearing aids, about 60 % of respondents had such an experience. Those who often drive without hearing aids had experienced headaches due to noise from wearing hearing aids compared to those who wear hearing aids at all times. Hearing aids are necessary assistive devices for hearing impaired persons to obtain hearing information, and to provide a safe driving environment. Therefore, this paper addresses issues to maintain a comfortable driving environment while wearing a hearing aid.

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