Dementia and hearing-aid use: a two-way street

Naylor, Graham; Dillard, Lauren; Orrell, Martin; Stephan, Blossom C M; Zobay, Oliver; Saunders, Gabrielle H

Abstract

Objectives
Hearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths.

Methods
Health records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n = 72,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5–5 years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n = 272,748) modelled the likelihood of being a persistent hearing-aid user at 3 years 2 months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors.

Results
The adjusted OR for incident dementia was 0.73 (95% CI 0.66–0.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43–0.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia).

Conclusion
Substantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status.

Citation

Naylor, G., Dillard, L., Orrell, M., Stephan, B. C. M., Zobay, O., & Saunders, G. H. (2022). Dementia and hearing-aid use: a two-way street. Age and Ageing, 51(12), Article afac266. https://doi.org/10.1093/ageing/afac266

• Journal Article Type: Article
• Acceptance Date: Sep 14, 2022
• Online Publication Date: Dec 19, 2022
• Publication Date: 2022-12
• Deposit Date: Jan 4, 2023
• Publicly Available Date: Jan 5, 2023
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 12
• Article Number: afac266
• DOI: https://doi.org/10.1093/ageing/afac266
• Keywords: Geriatrics and Gerontology, Aging, General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/15436557
• Publisher URL: https://academic.oup.com/ageing/article/51/12/afac266/6931852