Central auditory dysfunction, cognitive dysfunction, and dementia in older people.
OBJECTIVE
To determine in older people the relation between auditory dysfunction and cognitive dysfunction, and if central auditory test abnormalities predict the onset of clinical dementia or cognitive decline.


METHODS
Prospective population-based cohort study.


METHODS
Framingham Heart Study outpatient biennial examinations 18 and 21.


METHODS
Members of the Framingham Heart Study cohort with normal findings from cognitive screening tests at biennial examination 18.


METHODS
Peripheral audiometric thresholds and word recognition in quiet; Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM); Mini-Mental State Examination; and detailed neuropsychological testing of subjects with abnormal findings from the Mini-Mental State Examination. Relative risk of dementia was determined using age-adjusted Cox proportional hazards regression models.


RESULTS
Hearing loss significantly lowered performance on the verbal parts of the Mini-Mental State Examination. The relative risk of subsequent clinical dementia or cognitive decline was 6 in subjects with very poor scores (< 50%) in one ear on the SSI-ICM (P = .02); the relative risk was 12.5 if the poor scores were present in both ears (P = .001).


CONCLUSIONS
Central auditory dysfunction precedes senile dementia in a significant number of cases and may be an early marker for senile dementia. Hearing tests should be included in the evaluation of persons older than 60 years and in those suspected of having cognitive dysfunction.
Gates
G A
GA
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, USA.
Cobb
J L
JL
Linn
R T
RT
Rees
T
T
Wolf
P A
PA
D'Agostino
R B
RB
D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D003072:Cognition Disorders / Q000150:complications*; D015986:Confounding Factors, Epidemiologic; D003704:Dementia / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006313:Hearing Loss, Central / Q000150:complications*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors