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- Title
Examining the Combined Estimated Effects of Hearing Loss and Depressive Symptoms on Risk of Cognitive Decline and Incident Dementia.
- Authors
Powell, Danielle S; Brenowitz, Willa D; Yaffe, Kristine; Armstrong, Nicole M; Reed, Nicholas S; Lin, Frank R; Gross, Alden L; Deal, Jennifer A
- Abstract
Objectives Late-life depression is a comorbidity that may co-occur in older adults with hearing loss—each has prevalent and independent modifiable risk factors for dementia. Methods Using data from 1,820 Health, Aging and Body Composition study participants (74 ± 2.8 years, 38% Black race), we compared the hearing loss–dementia/cognitive decline relationship between those with normal hearing/mild hearing loss and those with moderate or greater hearing loss. Using linear mixed-effects and Cox proportional hazard models, we investigated if the associations between hearing loss and cognitive decline or dementia (Modified Mini-Mental State [3MS] Examination and Digit Symbol Substitution Test [DSST]) differed by the presence or absence of depressive symptoms. Depressive symptoms were defined as Center for Epidemiologic Study—Depression scale 10 ≥10 at one or more visits from Years 1–5. Algorithmic incident dementia was defined using medication use, hospitalizations, and cognitive test scores. Audiometric hearing loss was measured at Year 5 and categorized as normal/mild versus moderate or greater hearing loss. Results Having both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS Examination (β = −0.30; 95% confidence interval [CI]: −0.78, −0.19) and DSST (β = −0.35; 95% CI: −0.67, −0.03) over 10 years of follow-up. Having both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio [HR]: 2.91; 95% CI: 1.59, 5.33 vs. HR: 1.54; 95% CI: 1.10, 2.15 hearing loss only and HR: 2.35; 95% CI: 1.56, 3.53 depressive symptoms only) of incident dementia in multivariable-adjusted Cox proportional hazards models. Discussion Comorbid conditions among hearing-impaired older adults should be considered and may aid in dementia prevention and management strategies.
- Subjects
PENNSYLVANIA; TENNESSEE; COGNITION disorder risk factors; DEMENTIA risk factors; CONFIDENCE intervals; RISK assessment; COMPARATIVE studies; SEVERITY of illness index; NEUROPSYCHOLOGICAL tests; PSYCHOLOGICAL tests; HEARING disorders; MENTAL depression; CENTER for Epidemiologic Studies Depression Scale; DEMENTIA; HOSPITAL care; AUDIOMETRY; DESCRIPTIVE statistics; COMORBIDITY; PROPORTIONAL hazards models; ALGORITHMS; LONGITUDINAL method; DISEASE complications; OLD age
- Publication
Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 2022, Vol 77, Issue 5, p839
- ISSN
1079-5014
- Publication type
Article
- DOI
10.1093/geronb/gbab194