title: Hearing Impairment and Incident Dementia and Cognitive Decline in Older Adults: The Health ABC Study.
abstract: BACKGROUND
  Age-related peripheral hearing impairment (HI) is prevalent, treatable, and may be a risk factor for dementia in older adults. In prospective analysis, we quantified the association of HI with incident dementia and with domain-specific cognitive decline in memory, perceptual speed, and processing speed.
  
  
  METHODS
  Data were from the Health, Aging and Body Composition (Health ABC) study, a biracial cohort of well-functioning adults aged 70-79 years. Dementia was defined using a prespecified algorithm incorporating medication use, hospital records, and neurocognitive test scores. A pure-tone average in decibels hearing level (dBHL) was calculated in the better hearing ear using thresholds from 0.5 to 4kHz, and HI was defined as normal hearing (≤25 dBHL), mild (26-40 dBHL), and moderate/severe (>40 dBHL). Associations between HI and incident dementia and between HI and cognitive change were modeled using Cox proportional hazards models and linear mixed models, respectively.
  
  
  RESULTS
  Three-hundred eighty seven (20%) participants had moderate/severe HI, and 716 (38%) had mild HI. After adjustment for demographic and cardiovascular factors, moderate/severe audiometric HI (vs. normal hearing) was associated with increased risk of incident dementia over 9 years (hazard ratio: 1.55, 95% confidence interval [CI]: 1.10, 2.19). Other than poorer baseline memory performance (difference of -0.24 SDs, 95% CI: -0.44, -0.04), no associations were observed between HI and rates of domain-specific cognitive change during 7 years of follow-up.
  
  
  CONCLUSIONS
  HI is associated with increased risk of developing dementia in older adults. Randomized trials are needed to determine whether treatment of hearing loss could postpone dementia onset in older adults.
authors.affiliation: Department of Epidemiology, and.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Deal
authors.affiliation: Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Josh
authors.initials: J
authors.lastname: Betz
authors.affiliation: Departments of Psychiatry and Neurology, and.|Department of Epidemiology and Biostatistics, University of California, San Francisco.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland.
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.affiliation: Department of Epidemiology and Biostatistics, State University of New York Downstate Medical Center, Brooklyn.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Purchase-Helzner
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.affiliation: Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pennsylvania.|Department of Communication Science & Disorders, University of Pittsburgh School of Health and Rehabilitation Sciences, Pennsylvania.
authors.forename: Sheila
authors.initials: S
authors.lastname: Pratt
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania.
authors.forename: Nandini
authors.initials: N
authors.lastname: Govil
authors.affiliation: Intramural Research Program, National Institute on Aging, Bethesda, Maryland.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.affiliation: Departments of Otolaryngology-Head & Neck Surgery and Epidemiology, Johns Hopkins School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland.|Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Lin
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D015577:Geriatric Assessment; D034381:Hearing Loss / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Cognition; Cognitive aging; Epidemiology; Sensory