A pilot randomized controlled trial of hearing aids to improve mood and cognition in older adults

Brewster, Katharine K.; Pavlicová, Martina; Stein, Alexandra; Chen, Mei; Chen, Chen; Brown, Patrick J.; Roose, Steven P.; Kim, Ana H.; Golub, Justin S.; Brickman, Adam M.; Galatioto, Josephine; Kuhlmey, Megan; Rutherford, Bret R.

doi:10.1002/gps.5311

Cited by 30 publications

(45 citation statements)

References 30 publications

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“…Table 1 outlines the characteristics of the included studies. The 17 included studies span from 1990 to 2020, 4 of which are RCTs [29][30][31][32], and the other 13 are prospective cohort studies. The study sample sizes ranged from 6 to 2040 participants, totalling 3526 participants in this systematic review.…”

Section: Study Design Characteristicsmentioning

confidence: 99%

“…With six of the studies using a follow-up of 6 months [30,31,33,36,41,43]. In nine studies the control group consisted of hearing-impaired participants without hearing aid treatment [29,[31][32][33][34][35][36][37][38]. The other eight studies compared the effect of the intervention results to baseline results [30,[39][40][41][42][43][44][45].…”

Section: Study Design Characteristicsmentioning

confidence: 99%

“…The other eight studies compared the effect of the intervention results to baseline results [30,[39][40][41][42][43][44][45]. The studies by Deal et al [30] and Brewster et al [32] are primarily feasibility studies and secondarily assessed the cognitive outcomes over a period of 6 months and 12 weeks respectively. In the study of Deal et al [30] the comparator group participated in the "successful aging intervention", an interactive health education program which did not meet the inclusion criteria for this review.…”

Section: Study Design Characteristicsmentioning

confidence: 99%

“…The risk of bias assessments for the RCTs and the prospective cohort studies are shown in Tables 2 and 3 respectively. Three RCTs are judged to have some concerns [30][31][32] and one as high risk for bias [29]. In all studies, participants were randomised using appropriate random sequence methods, however one trial had baseline imbalances with a significantly younger intervention group and therefore was rated with some concerns [32].…”

Section: Assessment Of Risk Of Bias and Representativenessmentioning

confidence: 99%

“…Three RCTs are judged to have some concerns [30][31][32] and one as high risk for bias [29]. In all studies, participants were randomised using appropriate random sequence methods, however one trial had baseline imbalances with a significantly younger intervention group and therefore was rated with some concerns [32]. We judged the deviations from the intended intervention to be high in one study [29], with some concerns in two studies [30,31].…”

Section: Assessment Of Risk Of Bias and Representativenessmentioning

confidence: 99%

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The effect of hearing aids on cognitive function: A systematic review

et al. 2021

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Rationale Dementia currently affects 50 million people globally with this expected to triple by 2050. Even though hearing loss is associated with cognitive decline, the underlying mechanisms are not fully understood. Considering hearing loss is the largest modifiable risk factor for developing dementia, it is essential to study the effect of hearing aids on cognitive function. Objective To systematically review the existing literature to examine the evidence for using hearing aids intervention as a treatment for deteriorating cognitive function. Design A search of PubMed, Cochrane Library, Embase and grey literature was conducted revealing 3060 unique records between 1990–2020. Two reviewers independently selected longitudinal studies observing the effects of hearing aids on cognitive function in persons without dementia at onset of the study. Due to the heterogeneity of the data, a meta-analysis could not be performed. Outcomes are described in a summary of findings table and portrayed diagrammatically. Results We identified 17 unique studies, spanning 30 years of research and 3526 participants. The included studies made use of 50 different cognitive function tests. These tests were grouped into separate cognitive domains according to the DSM-V classification for further analysis. The most beneficial impact of hearing aids seems to be in the cognitive domain of executive function, with six studies showing improvement, two studies being inconclusive and three studies not demonstrating a significant effect. Three of five studies demonstrated significant improvement when screening for brief mental status. The least beneficial impact is seen in domain of complex attention, with eight studies showing no significant effects, compared with one demonstrating improvement with intervention. Conclusions Based on this systematic review, we conclude that there is controversy about the effects of hearing aids on cognition. Additional research through randomized clinical trials with standardized cognitive assessment and longer follow-up is warranted to further elucidate this relationship.

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Section: Study Design Characteristicsmentioning

confidence: 99%

Section: Study Design Characteristicsmentioning

confidence: 99%

Section: Study Design Characteristicsmentioning

confidence: 99%

Section: Assessment Of Risk Of Bias and Representativenessmentioning

confidence: 99%

Section: Assessment Of Risk Of Bias and Representativenessmentioning

confidence: 99%

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The effect of hearing aids on cognitive function: A systematic review

et al. 2021

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Association of Hearing Aids and Cochlear Implants With Cognitive Decline and Dementia

et al. 2023

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ImportanceHearing loss is associated with cognitive decline. However, it is unclear if hearing restorative devices may have a beneficial effect on cognition.ObjectiveTo evaluate the associations of hearing aids and cochlear implants with cognitive decline and dementia.Data SourcesPubMed, Embase, and Cochrane databases for studies published from inception to July 23, 2021.Study SelectionRandomized clinical trials or observational studies published as full-length articles in peer-reviewed journals relating to the effect of hearing interventions on cognitive function, cognitive decline, cognitive impairment, and dementia in patients with hearing loss.Data Extraction and SynthesisThe review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) reporting guidelines. Two authors independently searched the PubMed, Embase, and Cochrane databases for studies relating to the effect of hearing interventions on cognitive decline and dementia in patients with hearing loss.Main Outcomes and MeasuresMaximally adjusted hazard ratios (HRs) were used for dichotomous outcomes and ratio of means for continuous outcomes. Sources of heterogeneity were investigated using sensitivity and subgroup analyses, and publication bias was assessed using visual inspection, the Egger test, and trim and fill.ResultsA total of 3243 studies were screened; 31 studies (25 observational studies, 6 trials) with 137 484 participants were included, of which 19 (15 observational studies, 4 trials) were included in quantitative analyses. Meta-analysis of 8 studies, which had 126 903 participants, had a follow-up duration ranging from 2 to 25 years, and studied long-term associations between hearing aid use and cognitive decline, showed significantly lower hazards of any cognitive decline among hearing aid users compared with participants with uncorrected hearing loss (HR, 0.81; 95% CI, 0.76-0.87; I2 = 0%). Additionally, meta-analysis of 11 studies with 568 participants studying the association between hearing restoration and short-term cognitive test score changes revealed a 3% improvement in short-term cognitive test scores after the use of hearing aids (ratio of means, 1.03; 95% CI, 1.02-1.04, I2 = 0%).Conclusions and RelevanceIn this meta-analysis, the usage of hearing restorative devices by participants with hearing loss was associated with a 19% decrease in hazards of long-term cognitive decline. Furthermore, usage of these devices was significantly associated with a 3% improvement in cognitive test scores that assessed general cognition in the short term. A cognitive benefit of hearing restorative devices should be further investigated in randomized trials.

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A precision medicine tool to understand who responds best to hearing aids in late‐life depression

Brewster

Zilcha‐Mano

Wallace

et al. 2022

Int J Geriat Psychiatry

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Objectives Accumulating evidence suggests that hearing loss (HL) treatment may benefit depressive symptoms among older adults with Major Depressive Disorder (MDD), but the specific individual characteristics of those who stand to improve most are unknown. Methods N = 37 patients ≥60 years with HL and MDD received either active or sham hearing aids in this 12‐week double‐blind randomized controlled trial. A combined moderator approach was utilized in the analysis in order to examine multiple different pretreatment individual characteristics to determine the specific qualities that predicted the best depressive symptom response to hearing aids. Pretreatment characteristics included: Hearing Handicap Inventory for the Elderly (HHIE‐S), pure tone average (PTA), speech reception threshold (SRT), Short Physical Performance Battery (SPPB), cognition (Repeatable Battery for the Assessment of Neuropsychological Status). Results The analysis revealed a combined moderator, predicting greater improvement with active versus sham hearing aids, that had a larger effect size than any individual moderator (combined effect size [ES] = 0.49 [95% CI: 0.36, 0.76]). Individuals with worse hearing‐related disability (HHIE‐S: individual ES = −0.16), speech recognition (SRT: individual ES = −0.14), physical performance (SPPB: individual ES = 0.41), and language functioning (individual ES = 0.19) but with relatively less severe audiometric thresholds (PTA: individual ES = 0.17) experienced greater depressive symptom improvement with active hearing aids. Conclusions Older adults with relatively worse HL‐related, physical, and cognitive functioning may stand to benefit most from hearing aids. Given the large number of older adults experiencing HL and MDD, a non‐invasive and scalable means of targeting those most likely to respond to interventions would be valuable.

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A pilot randomized controlled trial of hearing aids to improve mood and cognition in older adults

Cited by 30 publications

References 30 publications

The effect of hearing aids on cognitive function: A systematic review

The effect of hearing aids on cognitive function: A systematic review

Association of Hearing Aids and Cochlear Implants With Cognitive Decline and Dementia

A precision medicine tool to understand who responds best to hearing aids in late‐life depression

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