title: Cognitive, health, and sociodemographic predictors of longitudinal decline in hearing acuity among older adults.
abstract: BACKGROUND
  We aimed to investigate predictors of change in pure-tone hearing thresholds in older adults.
  
  
  METHODS
  Data were drawn from a pooled sample from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project (N = 4,221, mean age = 73.6, range: 50-103 years). Pure-tone hearing thresholds were tested for frequencies between 0.5 and 8 kHz, on up to four occasions over a period of 11 years. Linear mixed models tested for predictors of change in hearing.
  
  
  RESULTS
  Hearing loss for high-range frequencies preceded decline in low-range frequencies. Men had higher baseline hearing thresholds, but women experienced faster rates of decline in hearing for mid- to high-range frequencies. The estimated rate of change for a 75-year-old adult was 0.91 decibel hearing level (dB HL) per year for pure-tone thresholds averaged over frequencies ranging between 0.5 and 4 kHz in the better ear. Baseline age (β = 0.03, p < .01), hypertension (β = 0.15, p < .01), and probable cognitive impairment (β = 0.40, p = .01) were independent predictors of annual rate of change in hearing thresholds. Incidence of probable cognitive impairment was also associated with higher hearing thresholds. Other known correlates for prevalence of hearing impairment, including low education, noise damage, diabetes, and history of stroke were independently associated with baseline levels of hearing but were not predictive of change in hearing thresholds.
  
  
  CONCLUSIONS
  Faster rates of decline in hearing are predicted by probable cognitive impairment and hypertension.
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Building 63, Eggleston Road, Canberra ACT 0200, Australia. kim.kiely@anu.edu.au
authors.forename: Kim M
authors.initials: KM
authors.lastname: Kiely
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Mary
authors.initials: M
authors.lastname: Luszcz
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001315:Australia / Q000453:epidemiology; D003071:Cognition; D005260:Female; D006304:Health Status; D006309:Hearing / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011304:Presbycusis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D012959:Socioeconomic Factors