Hearing aids can reduce the risk of dementia in hearing-impaired people

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Hearing aids can reduce the risk of dementia in hearing-impaired people

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Hearing aids can reduce the risk of dementia in hearing-impaired people.

Keep your hearing and prevent dementia! The 12-year follow-up data of more than 430,000 people shows that hearing aids can reduce the risk of dementia in hearing-impaired people.

Dementia and hearing loss are common diseases among the elderly.

On the one hand, it is estimated that by 2050, the number of dementia patients affected by cognitive impairment will reach 150 million worldwide [1]. On the other hand, currently globally, 10%, 30%, and 70-90% of people aged 40-69, people over 65, and people over 85 suffer from hearing loss (≥20 dB) [2-4].

There is growing evidence of an association between the two disorders, with up to 8.2% of dementia cases being preventable by preventing hearing loss [5,6]. Therefore, as a measure to remedy hearing loss, hearing aids are considered as a potential way to reduce the risk of dementia . However, the results of existing studies are inconsistent, and whether the use of hearing aids can improve cognitive function and slow down cognitive decline is not yet clear.

Recently, “The Lancet Public Health” published data from a large research cohort supporting the protection against dementia by wearing hearing aids [6].

Researchers from Qilu Medical College of Shandong University analyzed the 12.1-year follow-up data of more than 430,000 people and found that hearing loss is associated with a 42% increase in the risk of dementia, but if hearing aids are used, the risk level is the same as without hearing loss people are similar .

From the perspective of reason, hearing aids may help people stay away from dementia by improving the loneliness, isolation, and depression caused by hearing loss, but these effects are very weak. It is speculated that there are other factors mediating the use of hearing aids and dementia. Correlations between risks.

Screenshot of paper homepage

Dementia is a syndrome of acquired persistent intellectual impairment. In addition to Alzheimer’s disease (AD), other common causes and types include vascular dementia (VaD), dementia with Lewy bodies (DLB), Parkinson’s disease dementia ( PDD), frontotemporal lobar degeneration (FTLD), and other central nervous system diseases or dementia caused by systemic, metabolic, or toxic diseases [7].

According to 2020 statistics, nearly 40% of all-cause dementia cases worldwide can be attributed to modifiable risk factors. Therefore, starting from these risk factors has become a key strategy to guard against dementia [1].

A total of 437,704 participants from UK Biobank were included in the study , mean age at baseline was 56 years, and 53.7% were women .

During a mean follow-up of 12.1 years, 74.5% of participants had normal hearing and 25.6% developed hearing loss. Among those with hearing loss, 11.7% used hearing aids.

The researchers observed that the prevalence of hearing loss increased with age and was more common in men. People with obesity, cardiovascular disease, loneliness, and depression have a higher prevalence of hearing loss and use of hearing aids.

In a multivariate analysis adjusted for age, education, income, sex, and race, people with hearing loss who did not use hearing aids had a 42% increased risk of all-cause dementia compared with people without hearing loss (HR 1.42;95 %CI 1.28–1.57) , there was no increased risk for people with hearing loss but using hearing aids (HR 1.04; 95%CI 0.98–1.10) .

Specifically, for people who do not use hearing aids + hearing loss, 29.08% of the risk of all-cause dementia can be attributed to this (ie, the attributable risk ratio, AR%=29.08%) .

After stratified analysis, results were found to be similar for male and female groups. However, among women, the factor of hearing loss and not using hearing aids accounted for a higher proportion of attributable risk of all-cause dementia and specific types of dementia such as Alzheimer’s disease and vascular dementia than men (35.90 % vs 25.93%; 28.06% vs 22.88%; 43.82% vs 31.03%) .

Association between hearing aid use status and risk of all-cause dementia

In addition, because of evidence that long-term hearing loss can cause feelings of loneliness, social isolation, and depression, the researchers also examined whether hearing aids affect dementia risk by improving these indirect factors.

It turned out that these factors did play a certain mediating effect, but things were not that simple. Analysis of mediator variables found that the association between hearing aid use and dementia was 1.52% moderated by improved social isolation, 2.28% by improved loneliness, and 7.14% by improved depressed mood .

The mediating effect of hearing aid use on dementia-related loneliness, social isolation and depressed mood

That said, there are other factors that play an integral role between hearing aids and dementia risk.

Combining the existing research results, the researchers speculate that, in addition to the indirect way of affecting social connections, hearing aids may help people with hearing loss stay away from dementia in two more direct ways .

First , in the case of hearing loss, the acquired acoustic information is chaotic when it reaches the brain, which requires the brain to mobilize more cognitive resources to process and decipher the information, so it is used for events such as memory or executive function. Reduced resources, which eventually lead to cognitive impairment;

Second , hearing loss may cause auditory deprivation, that is, the auditory center is not fully stimulated, leading to atrophy and decline of the auditory-related brain structure and function, and then cognitive impairment.

Rescuing hearing loss by wearing hearing aids reasonably may solve these troubles for the brain, thereby avoiding the increased risk of dementia caused by hearing loss.

Of course, this is an association study, and we have not yet been able to confirm a causal relationship between hearing aid use and reduced risk of dementia.

It has been suggested that the brain needs to adapt to the slightly distorted sound produced by hearing aids. If it is difficult to accept and cannot be used persistently, it may indicate that the brain has already undergone pathological changes.

In other words, one possibility is not excluded that the brains of people who are accustomed to wearing hearing aids are relatively healthy [8].

However, sensitivity analyzes with lags of 5 and 10 years consistently showed that reverse causality was less likely.

Taken together, the results of this study underscore the urgent need to increase awareness of hearing loss and the need for hearing aids when appropriate, both from the perspective of improving quality of life and preventing the onset of dementia .

references:

[1]Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396: 413–46.

[2]Chadha S, Kamenov K, Cieza A. The world report on hearing, 2021. Bull World Health Organ 2021; 99: 242A

[3]Amieva H, Ouvrard C, Giulioli C, Meillon C, Rullier L, Dartigues JF. Self-reported hearing loss, hearing aids, and cognitive decline in elderly adults: a 25-year study. J Am Geriatr Soc 2015; 63 : 2099–104.

[4] The Lancet Global Health. Amplifying the global issue of hearing loss. Lancet Glob Health 2022; 10: e1360.

[5]Loughrey DG, Kelly ME, Kelley GA, Brennan S, Lawlor BA. Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2018; 144: 115–26.

[6] https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00048-8/fulltext

[7] Chinese Journal of Medicine, 2020, 100(17): 1294-1298. DOI: 10.3760/cma.j.cn112137-20191223-02804

[8] https://www.sciencemediacentre.org/expert-reaction-to-observational-study-looking-at-hearing-aid-use-and-risk-of-dementia/

Hearing aids can reduce the risk of dementia in hearing-impaired people

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