scholarly journals Co-occurring Hearing Loss and Cognitive Decline in Older Adults: A Dual Group-Based Trajectory Modeling Approach

2021 ◽  
Vol 13 ◽  
Author(s):  
Yvonne Tran ◽  
Diana Tang ◽  
Charles Lo ◽  
Catherine McMahon ◽  
Paul Mitchell ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Hearing Aid ◽  
Neurological Complications ◽  
Age Group ◽  
Severe Hearing Loss ◽  
Trajectory Modeling ◽  
Dual Trajectories

Hearing loss and cognitive impairments are both highly prevalent neurological complications for older adults. While there is growing evidence to suggest that these two conditions are interrelated, little research has been conducted that directly examines the progression and developmental trajectories of these complications contemporaneously. The aim of the study is to identify the distinct trajectory profiles for hearing loss and cognitive function in an older population over a 10-year period. Through dual trajectory modeling, the interrelationship, co-occurring movements, and overlaps between these two complications were examined. We also investigated the influence of hearing aid ownership on cognitive function trajectories. We utilized longitudinal data from 1,445 participants in the Blue Mountains Hearing Study (aged 55+ years) involving repeated measures from a population-based survey with audiometric hearing assessments. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). The group-based trajectory modeling (GBTM) identified three trajectory profiles for both hearing loss and cognitive function in two older age groups (55–69 years and 70+ years). The outputs from the dual trajectories models showed the conditional probability for “no hearing loss” trajectories to be around 90% more likely to have “high-normal” cognitive function, demonstrating co-occurring overlap. In contrast, for “moderate to severe hearing loss” trajectories, the conditional probability drops to 65% and 79% for the 55–69 age group and 70+ age group respectively. There was also an increasing probability for “cognitive decline” conditional on the severity of hearing loss with 6.7%, 7.5%, and 8.7% for no hearing loss, mild hearing loss, and moderate to severe hearing loss trajectory groups. While we did not find any statistically significant difference in the influence of hearing aid use in the cognitive function trajectories, there was a consistent greater representation of non-hearing aid users in the trajectories with poorer cognitive function. This study found GBTM to identify trajectories that were in agreement with our current understanding of hearing loss and cognitive impairment in older adults. This study also adds to the existing evidence-base as dual trajectories demonstrated co-occurrence in developmental changes in these two common neurological complications for the older population.

scholarly journals Self-Reported Hearing Loss in Older Adults Is Associated With Higher Emergency Department Visits and Medical Costs

2019 ◽  
Vol 56 ◽  
pp. 004695801989690
Author(s):  
Timothy S. Wells ◽  
Lizi Wu ◽  
Gandhi R. Bhattarai ◽  
Lorraine D. Nickels ◽  
Steven R. Rush ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Hearing Loss ◽  
Health Care Utilization ◽  
Hearing Aid ◽  
Medical Costs ◽  
Care Utilization ◽  
Severe Hearing Loss ◽  
Hearing Aid Use

Hearing loss is common among older adults. Thus, it was of interest to explore differences in health care utilization and costs associated with hearing loss and hearing aid use. Hearing loss and hearing aid use were assessed through self-reports and included 5 categories: no hearing loss, aided mild, unaided mild, aided severe, and unaided severe hearing loss. Health care utilization and costs were obtained from medical claims. Those with aided mild or severe hearing loss were significantly more likely to have an emergency department visit. Conversely, those with aided severe hearing loss were about 15% less likely to be hospitalized. Individuals with unaided severe hearing loss had the highest annual medical costs ($14349) compared with those with no hearing loss ($12118, P < .001). In this study, those with unaided severe hearing loss had the highest medical costs. Further studies should attempt to better understand the relationship between hearing loss, hearing aid use, and medical costs.

scholarly journals Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities

2020 ◽  
Author(s):  
Jiamin Gao ◽  
Nicole M. Armstrong ◽  
Jennifer A. Deal ◽  
Frank R. Lin ◽  
Ping He
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Fixed Effects ◽  
Leisure Activities ◽  
Leisure Activity ◽  
Cognitive Change ◽  
Activity Engagement

Abstract Background Hearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess whether having hearing loss were associated with cognitive decline and engagement in leisure activities modified this association among Chinese elderly. Methods Using data from the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011-2014, 9,710 individuals aged 65 years old or above with self-reported measures of hearing status and global cognition, as measured by the Modified Mini Mental Examination (MMSE), were included in this study. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and by sex. Results People with self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference on the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive function decline with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognition. Actively participating in leisure activities modified the relationship between hearing loss and cognitive decline in males, while leisure activity engagement did not modify any associations among females. Conclusion Hearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.

scholarly journals The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function?

2020 ◽  
Vol 9 (1) ◽  
pp. 254 ◽  
Author(s):  
Julia Sarant ◽  
David Harris ◽  
Peter Busby ◽  
Paul Maruff ◽  
Adrian Schembri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Hearing Loss ◽  
Executive Function ◽  
Speech Perception ◽  
Cognitive Function ◽  
Hearing Aid ◽  
Visual Learning ◽  
Hearing Aid Use

Hearing loss is a modifiable risk factor for dementia in older adults. Whether hearing aid use can delay the onset of cognitive decline is unknown. Participants in this study (aged 62–82 years) were assessed before and 18 months after hearing aid fitting on hearing, cognitive function, speech perception, quality of life, physical activity, loneliness, isolation, mood, and medical health. At baseline, multiple linear regression showed hearing loss and age predicted significantly poorer executive function performance, while tertiary education predicted significantly higher executive function and visual learning performance. At 18 months after hearing aid fitting, speech perception in quiet, self-reported listening disability and quality of life had significantly improved. Group mean scores across the cognitive test battery showed no significant decline, and executive function significantly improved. Reliable Change Index scores also showed either clinically significant improvement or stability in executive function for 97.3% of participants, and for females for working memory, visual attention and visual learning. Relative stability and clinically and statistically significant improvement in cognition were seen in this participant group after 18 months of hearing aid use, suggesting that treatment of hearing loss with hearing aids may delay cognitive decline. Given the small sample size, further follow up is required.

scholarly journals Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities

2020 ◽  
Author(s):  
Jiamin Gao ◽  
Nicole M. Armstrong ◽  
Jennifer A. Deal ◽  
Frank R. Lin ◽  
Ping He
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Fixed Effects ◽  
Leisure Activities ◽  
Leisure Activity ◽  
Cognitive Change ◽  
Activity Engagement

Abstract BackgroundHearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess whether having hearing loss were associated with cognitive decline and engagement in leisure activities modified this association among Chinese elderly.MethodsUsing data from the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011-2014, 9,710 individuals aged 65 years old or above with self-reported measures of hearing status and global cognition, as measured by the Modified Mini Mental Examination (MMSE), were included in this study. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and by sex.ResultsPeople with self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference on the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive function decline with 8% [-1.22, -0.39] increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognition. Actively participating in leisure activities modified the relationship between hearing loss and cognitive decline in males, while leisure activity engagement did not modify any associations among females.ConclusionHearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.

scholarly journals Do Communication Patterns Affect the Association between Cognitive Impairment and Hearing Loss among Older Adults in Vietnam?

2021 ◽  
Vol 18 (4) ◽  
pp. 1603
Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Vision Loss ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Communication Devices ◽  
Community Dwelling Older Adults

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.

scholarly journals Social isolation, rather than loneliness, is associated with cognitive decline in older adults: the China Health and Retirement Longitudinal Study

2021 ◽  
pp. 1-8
Author(s):  
Bin Yu ◽  
Andrew Steptoe ◽  
Yongjie Chen ◽  
Xiaohua Jia
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Cognitive Decline ◽  
Social Isolation ◽  
Mental Status ◽  
Chinese Older Adults ◽  
Confounding Variables

Abstract Background Social isolation and loneliness have each been associated with cognitive decline, but most previous research is limited to Western populations. This study examined the relationships of social isolation and loneliness on cognitive function among Chinese older adults. Methods This study used two waves of data (2011 and 2015) from the China Health and Retirement Longitudinal Study and analyses were restricted to those respondents aged 50 and older. Social isolation, loneliness, and cognitive function were measured at baseline. Follow-up measures on cognitive function were obtained for 7761 participants (mean age = 60.97, s.d. = 7.31; male, 50.8%). Lagged dependent variable models adjusted for confounding factors were used to evaluate the association between baseline isolation, loneliness, and cognitive function at follow-up. Results Loneliness was significantly associated with the cognitive decline at follow-up (episodic memory: β = −0.03, p < 0.01; mental status: β = −0.03, p < 0.01) in the partially adjusted models. These associations became insignificant after additional confounding variables (chronic diseases, health behaviors, disabilities, and depressive symptoms) were taken into account (all p > 0.05). By contrast, social isolation was significantly associated with decreases in all cognitive function measures at follow-up (episodic memory: β = −0.05, p < 0.001; mental status: β = −0.03, p < 0.01) even after controlling for loneliness and all confounding variables. Conclusions Social isolation is associated with cognitive decline in Chinese older adults, and the relationships are independent of loneliness. These findings expand our knowledge about the links between social relationships and the cognitive function in non-Western populations.

scholarly journals Hearing Aid Acquisition in Chinese Older Adults With Hearing Loss

2018 ◽  
Vol 108 (2) ◽  
pp. 241-247 ◽  
Author(s):  
Ping He ◽  
Xu Wen ◽  
Xiangyang Hu ◽  
Rui Gong ◽  
Yanan Luo ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Aid ◽  
Chinese Older Adults

Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia

2018 ◽  
Vol 127 (11) ◽  
pp. 798-805 ◽  
Author(s):  
Siti Zamratol Mai Sarah Mukari ◽  
Wan Fazlina Wan Hashim
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Help Seeking ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Hearing Level ◽  
Low Sensitivity ◽  
Single Question

Introduction: The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. Methods: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. Results: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. Conclusion: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

Hearing Loss, Control, and Demographic Factors Influencing Hearing Aid Use Among Older Adults

1998 ◽  
Vol 41 (3) ◽  
pp. 527-537 ◽  
Author(s):  
Dean C. Garstecki ◽  
Susan F. Erler
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Psychological Control ◽  
Hearing Aid ◽  
Demographic Factors ◽  
Ego Strength ◽  
Hearing Sensitivity ◽  
Hearing Aid Use ◽  
Hearing Handicap

Preference for non-use of hearing aids among older adults who are candidates for amplification remains to be explained. Clinical studies have examined the contribution of consumer attitudes, behaviors, and life circumstances to this phenomenon. The present study extends the interests of earlier investigators in that it examines psychological control tendencies in combination with hearing loss and demographic variables among older adults who elected to accept (adherents) or ignore (nonadherents) advice from hearing professionals to acquire and use hearing aids. One hundred thirty-one individuals participated by completing measures of hearing, hearing handicap, psychological control, depression, and ego strength. Participants were asked to provide demographic information and personal opinions regarding hearing aid use. Adherence group and gender differences were noted on measures of hearing sensitivity, psychological control, and demographic factors. Female adherents demonstrated greater hearing loss and poorer word recognition ability but less hearing handicap, higher internal locus of control, higher ego strength, and fewer depressive tendencies than female nonadherents. They reported demographic advantages. Female adherents assumed responsibility for effective communication. Although male adherents and nonadherents did not differ significantly demographically, male adherents were more accepting of their hearing loss, took responsibility for communication problems, and found hearing aids less stigmatizing. Implications for clinical practice and future clinical investigations are identified and discussed. Results are expected to be of interest to clinicians, clinical investigators, and health care policymakers.

Mortality Following Trajectories of Mobility Limitations: The Modifying Impact of Social Factors

2018 ◽  
Vol 32 (3-4) ◽  
pp. 134-142
Author(s):  
Terese Sara Høj Jørgensen ◽  
Volkert Siersma ◽  
Rikke Lund ◽  
Charlotte Juul Nilsson
Keyword(s):  
Older Adults ◽  
Social Factors ◽  
Regression Models ◽  
Age Group ◽  
Mobility Limitations ◽  
Hazard Regression ◽  
Trajectory Modeling ◽  
High Level ◽  
Method Group

Objective: How are trajectories of mobility limitations (MLs) among older adults associated with mortality? Do social factors modify these associations? Method: Group-based trajectory modeling was used to identify four trajectories of MLs over a period of 4.5 years among 3,055 older Danes. Mortality analyses were conducted using additive hazard regression models. Results: Compared to older adults without MLs, older adults with high level of MLs who experienced further increase in MLs were associated with the most additional deaths followed by older adults with no MLs at baseline who later experienced limitations and older adults with a medium ML level at baseline who later experienced further increase in limitations. Men and 80-year olds experienced more additional deaths following adverse ML trajectories than women and 75-year olds. Discussion: Trajectories that led to higher ML levels were associated with most additional deaths especially among men and in the oldest age group.

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