medwireNews: Treating audiometric hearing loss could lower the risk for dementia for a large number of older adults, particularly White adults, women, and those older than 75 years of age, suggests a population-based study published in JAMA Otolaryngology–Head & Neck Surgery.
“Public health interventions targeting clinically significant audiometric hearing loss might have broad benefits for dementia prevention,” suggest Jason Smith (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA) and team.
As part of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), carried out in four USA states between 2011 and 2019, the researchers investigated the population attributable fraction (PAF) of incident dementia associated with hearing loss in 2946 participants aged 66 to 90 years who did not have dementia at baseline and underwent a hearing assessment at their sixth ARIC-NCS visit in 2016–2017. The participants had a mean age of 74.9 years, 59% were women, 78% were White, and 22% were Black.
A total of 1947 (66.1%) participants had clinically significant hearing loss (measured audiometrically), of whom 39.0% had mild hearing loss (26–40 dB) and 27.0% had moderate or greater hearing loss (>40 dB), while 1097 (37.2%) had self-reported hearing loss (mean 42.9 dB), ascertained by the Hearing Handicap Inventory for the Elderly questionnaire. Of those with self-reported hearing loss, 90.7% also had objective hearing loss measured audiometrically.
During a median follow-up of 6.6 years, 239 (8.0%) of the participants developed incident dementia, diagnosed according to a standardized algorithm incorporating a longitudinal neuropsychological battery and cognitive data, supplemental cognitive data, and hospitalizations and death certificate codes.
Based on this, Smith and team calculated the PAF of 8-year incident dementia from any degree of hearing loss to be a significant 32%. They note that this is higher than previous US estimates of 2–19%.
PAFs from mild and moderate or greater hearing loss were similar, at 16.2% and 16.6%, respectively. However, there were no dementia cases attributable to self-reported hearing loss alone, meaning a PAF could not be calculated.
“Although self-report is easier to capture on a larger scale, this likely measures a construct of hearing distinct from peripheral hearing acuity (eg, a perceived or functional impact of [hearing loss]),” the investigators observe. “Future work quantifying PAFs in older adults should prioritize objective measures of [hearing loss] for estimating [hearing loss] prevalence.”
The team also found a greater proportion of dementia from any level of hearing loss in participants 75 years or older compared with people younger than 75 years old, at 30.5% versus 22.0%, mainly due to larger PAFs from moderate or greater hearing loss in the older group. This was also the reason for a higher rate of dementia attributable to any hearing loss in women compared with men (30.8 vs 24.0%), and in White versus Black participants (27.8 vs 22.9%).
Smith and team say that “the preventive potential from addressing [hearing loss] in later life in the US could be sizeable.”
They conclude: “The ability to control important upstream risk factors for [hearing loss] (noise exposure, infection, ototoxic medications), as well as the capacity for hearing treatment and rehabilitation through technological interventions, such as hearing aids and cochlear implants, provides a compelling public health message about the importance of accessing affordable and acceptable hearing health care for maintaining auditory health across the course of life.”
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JAMA Otolaryngol Head Neck Surg 2025; doi:10.1001/jamaoto.2025.0192
