Association of Hearing Acuity and Cognitive Function Among a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional Study

Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study

OBJECTIVE

Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship.

METHOD

The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: β) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies.

RESULTS

5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: β = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: β = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant.

CONCLUSION

The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.

Probability Distributions for Associations Between Cognitive Screening and Pure-tone Thresholds in Older Adults

OBJECTIVES

Lower general cognitive function is frequently reported in older adults with elevated pure-tone thresholds. Here, we examined reason(s) for this association, including whether this relationship is dependent on the frequency range or extent of hearing loss and cognitive screening performance.

DESIGN

Linear regression was used to examine associations between better-ear pure-tone thresholds and Mini-Mental Status Exam (MMSE) performance in a cross-sectional sample of relatively healthy older adults (N = 508; 68% women, 60-89+ years; M age = 72). Quantile regression was also used to identify the ranges of 0.5 and 4.0 kHz thresholds and MMSE scores where these variables exhibited significant associations.

RESULTS

MMSE scores and pure-tone thresholds exhibited small but significant associations, particularly for better-ear 0.5 kHz thresholds. This hearing threshold and cognitive screening association was present among participants with better hearing, including the oldest older adults. There was limited evidence for mediating health condition effects on this association. An item analysis of the MMSE revealed that the MMSE and pure-tone threshold associations were largely due to the delayed recall item of the MMSE.

CONCLUSIONS

Together, the small effect results are consistent with the extant literature and suggest that there are multiple reasons for modest pure-tone threshold and cognitive screening performance associations.

The Relationship of Age-Related Hearing Loss with Cognitive Decline and Dementia in a Sinitic Language-Speaking Adult Population: A Systematic Review and Meta-Analysis

Background and Objectives

Substantial evidence supports the association between untreated hearing loss, cognitive decline, and dementia in the non-tonal language-speaking population. Whether a similar association between hearing loss and cognitive decline and dementia exists in Sinitic tonal language-speaking people is yet to be elucidated. We aimed to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline, and dementia in older adults who speak a Sinitic tonal language.

Research Design and Methods

This systematic review considered peer-reviewed articles that employed objective or subjective hearing measurement and cognitive function, cognitive impairment, or diagnosis of dementia. All articles written in English and Chinese and published before March 2022 were included. Databases including Embase, MEDLINE, Web of Science, PsycINFO and Google Scholar, SinoMed, and CBM were utilized using MeSH terms and keywords.

Results

Thirty-five articles met our inclusion criteria. Of these, 29 unique studies with an estimated 372,154 participants were included in the meta-analyses. Among all included studies, the effect size of cognitive function with hearing loss, the regression coefficient was -0.26 (95% confidence interval [CI], -0.45 to -0.07). Among cross-sectional and cohort studies, a significant association was found between hearing loss and cognitive impairment and dementia, with odds ratios of 1.85 (95% CI, 1.59-2.17) and 1.89 (95% CI, 1.50-2.38), respectively.

Discussion and Implications

Most of the studies included in this systematic review observed a significant association between hearing loss and cognitive impairment and dementia. There was no significant difference to the findings in non-tonal language populations.

Relationship of age-related hearing loss with cognitive decline and dementia in Sinitic tonal language-speaking populations: protocol for a systematic review and meta-analysis

INTRODUCTION

Existing research on the potential association between age-related hearing loss (ARHL) and cognitive decline and dementia in tonal language-speaking populations is limited and inconsistent. There is psychophysiological evidence suggesting a tonal language background may be linked to enhanced general cognitive functions. We aim to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline and dementia in older adults who speak a Sinitic tonal language, the most commonly spoken tonal language.

METHODS AND ANALYSIS

This systematic review will consider peer-reviewed articles that employ objective or subjective hearing measurement and cognitive impairment or diagnosis of dementia. All relevant research publications in English or Chinese and published up to March 2022 will be considered for inclusion. Embase, MEDLINE, Web of Science, PsycINFO Google Scholar, SinoMed and Chinese Biomedical Database will be used, using both medical subject heading terms and keywords. The quality of evidence of an association between ARHL and cognitive impairment and/or dementia will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A random-effects meta-analysis will be carried out with the Comprehensive Meta-Analysis software.

ETHICS AND DISSEMINATION

Ethical approval will not be required for this systematic review. The results will be disseminated through peer-reviewed publications and conferences.

PROSPERO REGISTRATION NUMBER

CRD42021235310.