Relationship of hearing loss and dementia: a prospective, population-based study

Otol Neurotol. 2014 Jun;35(5):775-81. doi: 10.1097/MAO.0000000000000313.


Objective: To determine whether baseline hearing loss increases cognitive decline and risk for all-cause dementia in a population of elderly individuals.

Study design: Longitudinal cohort study.

Setting: Community-based, outpatient.

Patients: Men and women aged 65 years or older without dementia at baseline.

Intervention(s): All subjects completed the Modified Mini-Mental Status Exam (3MS-R) at baseline and over 3 triennial follow-up visits. Hearing loss (HL) at baseline was based on observation of hearing difficulties during testing or interview. Incident dementia was determined by clinical assessment and expert consensus.

Main outcome measure(s): Dementia and 3MS-R score.

Results: At baseline, 4,463 subjects were without dementia, 836 of whom had HL. Of those with HL, 16.3% developed dementia, compared with 12.1% of those without HL (p < 0.001). Mean time to dementia was 10.3 years in the HL group versus 11.9 years for non-HL (log rank test p < 0.001). In Cox regression analyses controlling for sex, presence of APOE- [Latin Small Letter Open E]4 allele, education, and baseline age, and cardiovascular risk factors, HL was an independent predictor of developing dementia (hazard ratio = 1.27, p = 0.026 [95% CI, 1.03-1.56]). Linear mixed models controlling for similar covariates showed HL was associated with faster decline on the 3MS-R, at a rate of 0.26 points/year worse than those without HL.

Conclusion: Elderly individuals with HL have an increased rate of developing dementia and more rapid decline on 3MS-R scores than their nonhearing impaired counterparts. These findings suggest that hearing impairment may be a marker for cognitive dysfunction in adults age 65 years and older.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Cognition Disorders / etiology*
  • Dementia / diagnosis
  • Dementia / epidemiology*
  • Dementia / etiology*
  • Female
  • Hearing Loss / complications*
  • Humans
  • Incidence
  • Male
  • Neuropsychological Tests
  • Prospective Studies
  • Risk