title: Relationship of hearing loss and dementia: a prospective, population-based study.
abstract: OBJECTIVE
  To determine whether baseline hearing loss increases cognitive decline and risk for all-cause dementia in a population of elderly individuals.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Community-based, outpatient.
  
  
  METHODS
  Men and women aged 65 years or older without dementia at baseline.
  
  
  METHODS
  All subjects completed the Modified Mini-Mental Status Exam (3MS-R) at baseline and over 3 triennial follow-up visits. Hearing loss (HL) at baseline was based on observation of hearing difficulties during testing or interview. Incident dementia was determined by clinical assessment and expert consensus.
  
  
  METHODS
  Dementia and 3MS-R score.
  
  
  RESULTS
  At baseline, 4,463 subjects were without dementia, 836 of whom had HL. Of those with HL, 16.3% developed dementia, compared with 12.1% of those without HL (p < 0.001). Mean time to dementia was 10.3 years in the HL group versus 11.9 years for non-HL (log rank test p < 0.001). In Cox regression analyses controlling for sex, presence of APOE- [Latin Small Letter Open E]4 allele, education, and baseline age, and cardiovascular risk factors, HL was an independent predictor of developing dementia (hazard ratio = 1.27, p = 0.026 [95% CI, 1.03-1.56]). Linear mixed models controlling for similar covariates showed HL was associated with faster decline on the 3MS-R, at a rate of 0.26 points/year worse than those without HL.
  
  
  CONCLUSIONS
  Elderly individuals with HL have an increased rate of developing dementia and more rapid decline on 3MS-R scores than their nonhearing impaired counterparts. These findings suggest that hearing impairment may be a marker for cognitive dysfunction in adults age 65 years and older.
authors.affiliation: *Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City; †Center for Epidemiologic Studies, ‡Department of Family Consumer and Human Development, §Department of Psychology, Utah State University, Logan; and ∥Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, U.S.A.
authors.forename: Richard Klaus
authors.initials: RK
authors.lastname: Gurgel
authors.forename: Preston Daniel
authors.initials: PD
authors.lastname: Ward
authors.forename: Sarah
authors.initials: S
authors.lastname: Schwartz
authors.forename: Maria C
authors.initials: MC
authors.lastname: Norton
authors.forename: Norman L
authors.initials: NL
authors.lastname: Foster
authors.forename: JoAnn T
authors.initials: JT
authors.lastname: Tschanz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D034381:Hearing Loss / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012306:Risk