Hearing Loss Linked to Higher Risk of Subjective Cognitive Decline in Men

By Marilynn Larkin

NEW YORK (Reuters Health) - Hearing loss is associated with a "substantially higher risk" of subsequent subjective cognitive function decline in men, researchers say.

"Clinicians should be aware that hearing loss could potentially influence performance on certain cognitive measures," Dr. Sharon Curhan of Brigham and Women's Hospital in Boston said in an email to Reuters Health. "Therefore, hearing ability should be taken into account when conducting a cognitive assessment."

"Cognitive assessments that do not rely on auditory ability may be useful," she added.

Dr. Curhan and colleagues studied 10,107 mostly white men (mean age, about 68) using data from the Health Professionals Follow-Up Study. (https://bit.ly/2DmRDrT) Participants self-reported in 2006 whether they had a hearing problem and if so, its severity: mild, moderate, severe - no hearing aid, and severe - hearing aid.

Subjective cognitive decline was scored in 2008, 2012 and 2016 using a six-point scale, with one point assigned for each cognitive concern. A decline was defined as a new report of at least one concern during follow-up.

As reported online January 29 in Alzheimer's and Dementia, after 52,752 person-years of follow-up, there were 2,771 cases of subjective cognitive decline.

Hearing loss was associated with higher risk of decline. Compared with men with no hearing loss, the multivariable-adjusted relative risk of cognitive decline was 1.30 among men with mild hearing loss, 1.42 among those with moderate hearing loss, and 1.54 among those with severe hearing loss who did not use hearing aids.

Among men with severe hearing loss who used hearing aids, the magnitude of the elevated risk was somewhat attenuated (aRR, 1.37) but did not differ significantly from the risk of those with severe hearing loss who did not use hearing aids.

"If those with hearing loss are at higher risk of cognitive decline," Dr. Curhan said, "identifying hearing loss, raising awareness about (its) implications on daily activities, work life, social engagement, social isolation, depression, and the added cognitive load and fatigue associated with difficulty hearing in challenging listening situations - then managing hearing loss with lifestyle and environmental adaptations, hearing rehabilitation and hearing aids could possibly be an early-stage intervention that could help prevent or slow the progression of cognitive decline."

Next steps include longitudinal studies of the relationship between hearing loss and cognition in women and in younger populations, she noted.

"We also plan to investigate the association between changes in measured audiometric hearing thresholds and cognition among participants in the CHEARS (Conservation of Hearing Study) Audiometry Assessment Arm," she concluded. (https://bit.ly/2Dph63V)

Dr. Keith Fargo, Director of Scientific Programs and Outreach at the Alzheimer's Association, told Reuters Health by email, "This study adds to the accumulating evidence that untreated hearing loss is a risk factor for cognitive decline."

"Importantly," he added, "this study only shows an association between hearing loss and cognitive impairment, not cause and effect. More research is needed to determine if there is a causal relationship."

"As the evidence on this topic grows, clinicians need to be aware in order to give proper guidance to their patients," he said. "For example, they may be more likely to inform their patients that properly treating their hearing loss may help protect their cognition as they age."

SOURCE: https://bit.ly/2Dk6C5V

Alzheimers Dement 2019.

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