Multiple Sensory Impairment Is Associated With Increased Risk of Dementia Among Black and White Older Adults

Abstract

Background: Few studies have examined impairment in multiple senses (multisensory impairment) and risk of dementia in comparison to having a single or no sensory impairment. Methods: We studied 1,810 black and white nondemented participants from Health, Aging, and Body Composition (Health ABC) Study aged 70-79 years at enrollment. Sensory impairment was determined at our study baseline (Year 3-5 of Health ABC) using established cut points for vision (Bailey-Lovie visual acuity and Pelli-Robson contrast sensitivity test), hearing (audiometric testing), smell (12-item Cross-Cultural Smell Identification Test), and touch (peripheral nerve function tests). Incident dementia over 10 years of follow-up was based on hospitalization records, dementia medications, or at least 1.5 SD decline in Modified Mini-Mental State Examination score (race-specific). Cox proportional hazard models with adjustment for demographics, health behaviors, and health conditions evaluated the relationship between risk of dementia and increasing number of sensory impairments. Results: Sensory impairments were common: 28% had visual impairment, 35% had hearing loss, 22% had poor smell, 12% had touch insensitivity; 26% had more than two impairments, and 5.6% had more than three sensory impairments. Number of impairments was associated with risk of dementia in a graded fashion (p < .001). Compared to no sensory impairments, the adjusted hazard ratio was 1.49 (95% CI: 1.12, 1.98) for one sensory impairment, 1.91 (95% CI: 1.39, 2.63) for two sensory impairments, and 2.85 (95% CI: 1.88, 4.30) for more than three sensory impairments. Conclusions: Multisensory impairment was strongly associated with increased risk of dementia. Although, the nature of this relationship needs further investigation, sensory function assessment in multiple domains may help identify patients at high risk of dementia.

Hearing Impairment and Cognitive Decline in Older, Community-Dwelling Adults

“…The link between hearing impairment and cognitive impairment may be due to a common underlying cause such as vascular disease (3,34) or neurodegenerative diseases such as Alzheimer's disease. However, control for prevalent cardiovascular disease, cardiovascular risk factors, and genetic risk for Alzheimer's disease did not change the observed associations.…”

“…With the aging of the population and high costs associated with caring for cognitively impaired older adults, identification of risk factors for cognitive decline in aging is becoming increasingly important. Hearing impairment, which affects 60%-68% of U.S. adults older than 70 years (1), is recognized as a risk factor for age-related cognitive impairment, disability, and dementia (2)(3)(4)(5). A recent systematic review and meta-analysis indicated that age-related hearing loss was associated with twofold or greater pooled odds of cognitive impairment and dementia in cross-sectional studies (6).…”

Performance on the standard and hearing‐impaired Montreal Cognitive Assessment in cochlear implant users

“…[4][5][6][7][8] The administration of cognitive screening tools, including the MoCA, has become a notable area of research as associations have been found between sensory impairments (eg, loss of vision and hearing loss [HL]) and cognitive deficits. [9][10][11][12] For example, HL has been associated with impairments across several cognitive domains (eg, immediate and delayed recall, processing speed, and semantic memory) and dementia. 12 Though these relationships range from weak to moderate, 12,13 the contributions of HL are similar in magnitude to other modifiable risk factors of dementia (eg, obesity, diabetes, and hypertension).…”

“…The administration of cognitive screening tools, including the MoCA, has become a notable area of research as associations have been found between sensory impairments (eg, loss of vision and hearing loss [HL]) and cognitive deficits . For example, HL has been associated with impairments across several cognitive domains (eg, immediate and delayed recall, processing speed, and semantic memory) and dementia .…”

Risk Factors for Incident Dementia Among Older Cubans

“…Hearing loss and vision loss have been associated with dementia in HIC (38)(39)(40)(41)(42), but evidence for these associations in Latin America or other LMIC is lacking. The current results suggest that eye problems, but not hearing problems, are associated with an increased risk of dementia in Cuban older adults, but only in the older age group.…”