The relationship between subjective hearing impairment and mild behavioral impairment – A study of older adults without dementia in the COMPASS‐ND Study

Abstract As the number of older adults increases, increased prevalence of cognitive and sensory impairments pose growing public health challenges. Research on the relationship between hearing impairment and cognition, however, is minimal and has yielded mixed results, with some studies finding that hearing impairment is associated with cognitive decline, and others reporting that the association is weak or non-existent. Most of this research has been conducted outside of the U.S., and the few U.S.-based longitudinal studies have relied mostly on small, non-representative samples involving short follow-up periods. Further, despite known gendered patterns in cognitive and hearing impairments, no studies to date have examined whether the relationship between the two varies by gender. Our study addresses these weaknesses in the literature by utilizing nine waves of the Health and Retirement Study (1998-2014; n=14,169), a large, nationally representative, longitudinal study that facilitates examination of long-term interrelationships between hearing and cognitive impairments. In this study, we use autoregressive latent trajectory (ALT) methods to model: 1) the relationship between hearing impairment and cognitive decline, and 2) sex differences in the relationship. ALT models enable us to determine whether hearing impairment and cognitive impairment are associated, net of their common tendency simply to co-trend with age. Results indicate that hearing and cognitive impairments are strongly interrelated processes that trend together over time. Moreover, hearing impairment has an increasing impact on cognitive impairment across age while the effect of cognitive impairment on hearing impairment levels out over time. Sex differences in these patterns are discussed.

Download Full-text

HEARING IMPAIRMENT, DEPRESSION, AND THE ROLE OF SOCIAL ACTIVITY AMONG CHINESE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.595 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S166-S167

Author(s):

Shu Xu ◽

Haowei Wang ◽

Caitlin Connelly

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Hearing Impairment ◽

Social Engagement ◽

Depression Scale ◽

The United States ◽

Social Activities ◽

Chinese Older Adults ◽

Hearing Status ◽

The Relationship

Abstract Studies suggest that depression is closely linked to hearing impairment, which is highly prevalent among older adults in the United States. There is evidence that social engagement may be impacted by hearing impairment in older adults. However, there is relatively little research on these associations among Chinese older adults. This study examines the relationships between hearing impairment, social activities, and depressive symptoms among older adults in China. Using nationally representative data from the China Health and Retirement Longitudinal Study 2011, we conducted cross-sectional analysis on adults age 60 years and older (n=10,994). Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression scale and we considered self-reported hearing status (if participants wear a hearing aid and how they would rate their hearing), and social activities (i.e., volunteering, dancing, attending courses, etc.). Models were controlled for age, gender, education, and other covariates. Descriptive analysis showed that 9% of older adults experienced hearing impairment. Multiple linear regression analyses revealed that hearing impairment was positively associated with depressive symptoms among older Chinese adults (β=1.32, p<.001). Social activities were found to partially mediate the relationship between hearing status and depressive symptoms. Respondents with hearing impairment were less likely to engage in social activities (OR=.78, p<.01) and those who did not participate in social activities reported more depressive symptoms (β=1.28, p<.001). These findings suggest that Chinese older adults experiencing hearing loss are at greater risk of depression and that social activities play an important role in the relationship between hearing status and depression.

Download Full-text

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-020-01903-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Consecutive Series ◽

Sectional Study ◽

Behavioral Impairment ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia. Methods In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of > 8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status. Results At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49–37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p < 0.05). Conclusions Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

Download Full-text

Social Isolation and Loneliness: Moderators of the Relationship Between Sensory Impairment and Cognition

Innovation in Aging ◽

10.1093/geroni/igaa057.1534 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 474-474

Author(s):

Alison Huang ◽

George Rebok ◽

Bonnielin Swenor ◽

Jayant Pinto ◽

Linda Waite ◽

...

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Hearing Impairment ◽

Social Isolation ◽

Social Life ◽

Vision Impairment ◽

Sensory Impairment ◽

The Impact ◽

The Relationship

Abstract Hearing and vision impairment have been independently linked to accelerated cognitive decline in older adults, however there is limited evidence on the effect of dual sensory impairment (DSI) (both hearing and vision impairment) on cognition. Additionally, the impact of social isolation and loneliness, both correlates of DSI and independent risk factors for cognitive decline, on the DSI-cognition relationship has yet to be studied. Using data from the National Social Life, Health, and Aging Project (N=3,091), multivariable linear regression models were used to describe the cross-sectional relationship between self-reported functional sensory impairment (none, hearing only, vision only, DSI) and cognitive function, measured by the survey adapted Montreal Cognitive Assessment. We also included an interaction term in the model to investigate whether cognition is worse among older adults with sensory impairment who also are socially isolated or lonely. Participants in this sample are between 62-91 years with 15% reporting hearing impairment, 11% reporting vision impairment, and 7% reporting DSI. DSI was associated with significantly lower global cognitive function compared to no sensory impairment (-0.31 standard deviations (SD), 95% CI:-0.44 to-0.18), hearing impairment alone (-0.29 SD, 95% CI: -0.44 to -0.15), and vision impairment alone (-0.22 SD, 95% CI: -0.39 to -0.06). Furthermore, cognitive function was significantly worse among older adults with both DSI and smaller social networks (p-interaction <0.05). No differences in the DSI-cognition relationship were observed by level of loneliness. These findings add to the limited research on the relationship between DSI, social isolation and loneliness, and cognition.

Download Full-text

Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v1 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Behavioral Impairment ◽

Cross Sectional ◽

Cognitively Normal ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in cognitively normal older adults.Methods: This is a cross-sectional study. A consecutive series of 137 cognitively normal older adults in the Anti-Aging study, recruited from primary care clinics, were enrolled. Frailty was estimated using the original Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.6% of the older adults had frailty, 35.0% had prefrailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, p = 0.02). The frailty and MBI categories were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status are related to higher risk of cognitive impairment. MBI is significantly associated with an increased risk of having frailty before overt cognitive impairment. This association merits further study to identify strategies to the early detection, prevention and therapeutic intervention of frailty.

Download Full-text

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v4 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cross Sectional Study ◽

Consecutive Series ◽

Sectional Study ◽

Behavioral Impairment ◽

Cross Sectional ◽

Multivariable Logistic Regression ◽

Increased Risk ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia.Methods: In this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of >8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.

Download Full-text

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

10.21203/rs.3.rs-34750/v2 ◽

2020 ◽

Author(s):

Shaoyi Fan ◽

Ximin Liang ◽

Tianchan Yun ◽

Zhong Pei ◽

Bin Hu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Neuropsychiatric Symptoms ◽

Cross Sectional Study ◽

Sectional Study ◽

Multivariate Logistic Regression ◽

Behavioral Impairment ◽

Cross Sectional ◽

Increased Risk ◽

The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in non-dementia older adults.Methods: This is a cross-sectional study. A consecutive series of 137 non-dementia older adults in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02).Conclusions: MBI is significantly associated with an increased risk of having frailty before the presence of overt dementia. This association merits further study to identify strategies for the early detection, prevention and therapeutic intervention of frailty.

Download Full-text

The Relationship between Hearing Impairment and Cognitive Function in Middle-Aged and Older Adults: A Meta-Analysis

Communication Sciences & Disorders ◽

10.12963/csd.18492 ◽

2018 ◽

Vol 23 (2) ◽

pp. 378-391 ◽

Cited By ~ 4

Author(s):

Soo Jung Lee

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Hearing Impairment ◽

Meta Analysis ◽

Middle Aged ◽

The Relationship

Download Full-text

Neuroanatomical Moderators of the Impact of Mild Behavioral Impairment on Cognition

Innovation in Aging ◽

10.1093/geroni/igab046.2626 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 707-707

Author(s):

Hillary Rouse ◽

Brent Small

Keyword(s):

Older Adults ◽

Cortical Thickness ◽

Gray Matter ◽

Gray Matter Volume ◽

Behavioral Impairment ◽

Matter Volume ◽

Cortical Gray Matter ◽

And Performance ◽

The Impact ◽

The Relationship

Abstract Older adults with mild behavioral impairment (MBI), or the presence of late-life neuropsychiatric symptoms, have a unique cognitive phenotype. However, the neural correlates associated with MBI-related cognitive changes is not well understood. The goal of this study is to examine if specific regions of the brain moderate the relationship between the presence of MBI and performance on tasks of cognition. Data from the National Alzheimer’s Coordinating Center was utilized for this study. Participants (N=1,451) were included in our analyses if they were cognitively healthy or had mild cognitive impairment (MCI). Multiple domains of cognitive performance were evaluated. The neuroanatomical regions included hippocampus, caudal anterior cingulate (ACC), rostral ACC, entorhinal, and parahippocampal gray matter volume; and caudal ACC, rostral ACC, entorhinal, and parahippocampal mean cortical thickness. Hippocampal, entorhinal, and parahippocampal cortical gray matter volume moderated the relationship between MBI and performance on tasks of episodic memory. Left rostral ACC cortical gray matter volume and entorhinal and parahippocampal mean cortical thickness moderated the relationship between MBI and performance on language tasks. Hippocampi cortical gray matter volume also moderated the relationship between MBI and performance on processing speed tasks. Persons with smaller brain sizes in these areas were more negatively affected in these cognitive domains if they had MBI. These results suggest that the association between smaller brain volumes and cognition was stronger among persons with MBI. These findings suggest that older adults with MBI may perform worse on these tasks due to neurodegeneration that is present.

Download Full-text