The Impact of Self-Reported Hearing Difficulties on Memory Collaboration in Older Adults

Hearing loss, cognition, and risk of neurocognitive disorder: evidence from a longitudinal cohort study of older adult Australians

Addressing midlife hearing loss could prevent up to 9% of new cases of dementia, the highest of any potentially modifiable risk factor identified in the 2017 commissioned report in The Lancet. In Australia, hearing loss is the second-most common chronic health condition in older people, affecting 74% of people aged over 70. Estimates indicate that people with severe hearing loss are up to 5-times more likely to develop dementia, but these estimates vary between studies due to methodological limitations. Using data from the Sydney Memory and Aging Study, in which 1,037 Australian men and women aged between 70 and 90 years were enrolled and completed biennial assessments from 2005-2017, investigations between hearing loss and baseline cognitive performance as well as longitudinal risk of neurocognitive disorder were undertaken. Individuals who reported moderate-to-severe hearing difficulties had poorer cognitive performances in the domains of Attention/Processing Speed and Visuospatial Ability, and on an overall index of Global Cognition, and had a 1.5-times greater risk for the neurocognitive disorder during 6-years' follow-up. Hearing loss independently predicted risk for MCI but not dementia. The presence of hearing loss is an important consideration for neuropsychological case formulation in older adults with cognitive impairment. Hearing loss may increase cognitive load, resulting in observable cognitive impairment on neuropsychological testing. Individuals with hearing loss who demonstrate impairment in non-amnestic domains may experience benefits from the provision of hearing devices; This study provides support for a randomized control trial of hearing devices for improvement of cognitive function in this group.

Subjective hearing handicap is associated with processing speed and visuospatial performance in older adults without severe hearing handicap

OBJECTIVE

Age-related hearing loss is a common disorder with significant consequences for quality of life. This study assessed the Hearing Handicap Inventory for the Elderly (HHIE) and cognition (Mini Mental State Exam; MMSE, Logical Memory; LM, Symbol Search; SS, Stroop Test; ST, and Mental Rotation; MR) to investigate which cognitive domains are most strongly involved with hearing self-assessment in older adults.

METHODS

The HHIE and cognitive measures were administered to 196 older adults (average age = 67.7 ± 4.3 years, male 56, female 140) without cognitive impairment and without severe hearing handicap. We conducted permutation tests of multiple regression analysis of the standardized scores on the HHIE and cognitive tests.

RESULTS

HHIE showed a significant negative correlation between processing speed performance on the SS (standardized β = -0.095, adjusted p = 0.04) and visuospatial performance on the MR (standardized β = -0.145, adjusted p = 0.04), and no correlation between the scores of the HHIE and either episodic memory performance on the LM (standardized β = 0.060, adjusted p = 0.22) or executive function performance on the ST (standardized β = 0.053, adjusted p = 0.32).

CONCLUSION

People reporting higher hearing handicaps should watch for poor cognitive function in processing speed and visuospatial abilities. These results imply that higher HHIE can have adverse effects on age-related cognitive decline.