Dementia and hearing-aid use: a two-way street
2021
Objectives: Hearing-aid use may reduce risk of dementia, but cognitive impairment
makes hearing-aid use more challenging. These two causal pathways may both
manifest as an association between reduced hearing-aid use and incident dementia. This
study examined the effects of each pathway separately, through a unique combination
of longitudinal data regarding hearing, general health, dementia diagnoses and
continuity of HA use.
Methods: Longitudinal 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 logistic regression to model the likelihood of a dementia diagnosis at 3
year 6 months (3y6m) to 5 years post hearing-aid fitting for patients previously free of
dementia and mild cognitive impairment (MCI). Analysis 2 (n=350,918) modelled the
likelihood of being a persistent hearing aid user at 3y2m after fitting, contrasting subgroups
with differing levels of cognitive function at the time of fitting. Models
controlled for relevant predictors available in the dataset.
Results: In analysis 1, the adjusted OR for incident dementia was 0.73 (ci 0.66-0.81)
for persistent (vs. non persistent) hearing-aid users. In analysis 2, the adjusted OR for
hearing-aid use persistence was 0.46 (ci 0.43-0.48) in those with pre-existing dementia
(vs. those remaining free of MCI and dementia).
Conclusion: The results indicate substantial effects from both causal pathways.
Research studying protective effects of hearing-aid use against dementia needs to
account for this. Clinically, hearing devices and hearing care processes must be
accessible and usable for all, regardless of their level of cognitive function.
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