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

Abstract

Background Hearing aid usage has been linked to improvements in cognition, communication, and socialization, but the extent to which it can affect the onset and progression of dementia is unknown. This study leveraged the National Alzheimer's Coordinating Center Uniform Data Set to longitudinally examine the association between the use of hearing aids and risk of progression from Mild Cognitive Impairment (MCI) to dementia as well as progression of dementia in hearing-impaired adults. Methods The sample included 977 participants aged >50 with MCI or all-cause dementia enrolled between 2005 and 2018. Participants were classified into four groups according to the definition of the duration of disease stage: Group 1, 450 participants with MCI at baseline that developed dementia during follow up; Group 2, 314 participants diagnosed with dementia at baseline and subsequently died during follow-up; Group 3, 126 healthy participants who were later diagnosed with MCI and then dementia at follow-up; Group 4, 87 participants with MCI at baseline who later converted to dementia and subsequently died during follow-up. Groups 3 and 4 were used to better capture the duration of MCI-to-dementia and dementia-to-death periods. Kaplan-Meier survival functions and survival analyses using Cox proportional hazards regression models were performed to assess the effect of hearing aid use on risk of MCI-to-dementia conversion and mortality risk in dementia participants. Sensitivity analyses were performed to control for confounding. Results Hearing aid users with MCI showed a reduced risk of developing dementia both in Group 1 (hazard ratio [HR] 0.56, 95%CI, 0.45-0.69; false discovery rate [FDR] p <.0001) and Group 3 (HR,0.42; 95%CI, 0.27-0.66; FDR p <.001). The mean progression rate in CDRSB was significantly higher for those who did not use hearing aids (p =.04). Hearing aid usage was also found to influence the progression of dementia. Hearing-aid users with dementia had a lower risk of death, both in Group 2 (HR,0.75; 95%CI, 0.60-0.95; FDR p =.038) and Group 4 (HR,0.53; 95%CI, 0.33-0.89; FDR p =.04). Our findings were robust subject to multiple sensitivity analyses. Conclusions Among hearing-impaired adults, hearing aid usage was significantly associated with reduced dementia risk and slower disease progression.

Pure-tone audiometry and dichotic listening in primary progressive aphasia and Alzheimer’s disease

“…There is now a plethora of evidence suggesting that hearing loss and dementia are linked. Peripheral hearing impairment measured with pure-tone audiometry has been identified as a major risk factor for dementia in mid-life (Lin et al, 2011;Livingston et al, 2020) and recent evidence suggests that peripheral amplification may improve quality of life and hearing abilities in people with dementia (Leroi et al, 2020), and may alter cognitive trajectories in older adults at increased risk of cognitive decline (Bucholc et al, 2021(Bucholc et al, , 2022Lin et al, 2023;Maharani et al, 2018;Yeo et al, 2023). Several potential mechanisms have been proposed that may account for this association (Griffiths et al, 2020;.…”

ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults

“…Missing data in these cases is reported to underestimate the HL-cognition relationship by 30% (Deal et al, 2021). Other significant methodological issues include small sample size, self-report or no measurement of HL and/or device use, lack of measurement of intervention benefits, and lack of a control/comparative sample (Amieva et al, 2015;Deal et al, 2015;Mahmoudi et al, 2019;Bucholc et al, 2021). Most studies had short follow-up periods of only 6-12 months, so the long-term effects of HA use on cognition are unknown.…”