PMID- 31725853
OWN - NLM
STAT- MEDLINE
DCOM- 20210112
LR  - 20240210
IS  - 2168-619X (Electronic)
IS  - 2168-6181 (Print)
IS  - 2168-6181 (Linking)
VI  - 146
IP  - 1
DP  - 2020 Jan 1
TI  - Association of Subclinical Hearing Loss With Cognitive Performance.
PG  - 57-67
LID - 10.1001/jamaoto.2019.3375 [doi]
AB  - IMPORTANCE: Age-related hearing loss (HL) is a common and treatable condition 
      that has been associated with cognitive impairment. The level of hearing at which 
      this association begins has not been studied to date. OBJECTIVE: To investigate 
      whether the association between hearing and cognition is present among 
      individuals traditionally classified as having normal hearing. DESIGN, SETTING, 
      AND PARTICIPANTS: Cross-sectional study of 2 US epidemiologic studies (Hispanic 
      Community Health Study [HCHS], 2008-2011, and National Health and Nutrition 
      Examination Study [NHANES], 1999-2000, 2001-2002, and 2011-2012 cycles). The 
      dates of analysis were November 2018 to August 2019. Multivariable generalized 
      additive model (GAM) regression and linear regression were used to assess the 
      association between HL (exposure) and cognition (outcome). Participants included 
      6451 individuals aged 50 years or older from the general Hispanic population 
      (HCHS [n = 5190]) and the general civilian, noninstitutionalized US population 
      (NHANES [n = 1261]). EXPOSURES: Audiometric HL (4-frequency pure-tone average). 
      MAIN OUTCOMES AND MEASURES: Neurocognitive performance measured by the Digit 
      Symbol Substitution Test (DSST) (score range, 0-113), Word Frequency Test (range, 
      0-49), Spanish-English Verbal Learning Test (SEVLT) 3 trials (range, 5-40), SEVLT 
      recall (range, 0-15), and Six-Item Screener (range, 0-6); higher scores indicated 
      better cognitive performance. RESULTS: Among 6451 individuals, the mean (SD) age 
      was 59.4 (6.1) years, and 3841 (59.5%) were women. The GAM regression showed a 
      significant inverse association between hearing and cognition across the entire 
      spectrum of hearing after adjusting for demographics and cardiovascular disease. 
      In separate multivariable linear regressions stratified by the classic binary 
      definition of HL, decreased hearing was independently associated with decreased 
      cognition in adults with normal hearing (pure-tone average </=25 dB) across all 
      cognitive tests in the HCHS. For example in this group, a 10-dB decrease in 
      hearing was associated with a clinically meaningful 1.97-point (95% CI, 
      1.18-2.75) decrease in score on the DSST. When using a stricter HL cut point (15 
      dB), an association was also present in NHANES. The associations between hearing 
      and cognition were stronger or equivalent in individuals with normal hearing than 
      among those with HL. For example, there was a 2.28-point (95% CI, 1.56-3.00) 
      combined cohort DSST score decrease per 10-dB decrease among individuals with 
      normal hearing vs a 0.97-point (95% CI, 0.20-1.75) decrease among those with HL, 
      with a significant interaction term between continuous and binary hearing. 
      CONCLUSIONS AND RELEVANCE: An independent association was observed between 
      cognition and subclinical HL. The association between hearing and cognition may 
      be present earlier in HL than previously understood. Studies investigating 
      whether treating HL can prevent impaired cognition and dementia should consider a 
      lower threshold for defining HL than the current 25-dB threshold.
FAU - Golub, Justin S
AU  - Golub JS
AD  - Department of Otolaryngology-Head and Neck Surgery, Vagelos College of Physicians 
      and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, 
      Columbia University, New York.
FAU - Brickman, Adam M
AU  - Brickman AM
AD  - Department of Neurology, Taub Institute for Research in Alzheimer's Disease and 
      the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians 
      and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, 
      Columbia University, New York.
FAU - Ciarleglio, Adam J
AU  - Ciarleglio AJ
AD  - Department of Biostatistics and Bioinformatics, Milken Institute School of Public 
      Health, George Washington University, Washington, DC.
FAU - Schupf, Nicole
AU  - Schupf N
AD  - Department of Neurology, Taub Institute for Research in Alzheimer's Disease and 
      the Aging Brain, and Gertrude H. Sergievsky Center, Vagelos College of Physicians 
      and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, 
      Columbia University, New York.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University, 
      New York, New York.
FAU - Luchsinger, Jose A
AU  - Luchsinger JA
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University, 
      New York, New York.
AD  - Department of Medicine, Vagelos College of Physicians and Surgeons, New 
      York-Presbyterian/Columbia University Irving Medical Center, Columbia University, 
      New York.
LA  - eng
GR  - K23 AG057832/AG/NIA NIH HHS/United States
GR  - K24 AG045334/AG/NIA NIH HHS/United States
GR  - L30 AG060513/AG/NIA NIH HHS/United States
GR  - R01 AG062624/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Video-Audio Media
PL  - United States
TA  - JAMA Otolaryngol Head Neck Surg
JT  - JAMA otolaryngology-- head & neck surgery
JID - 101589542
SB  - IM
CIN - JAMA Otolaryngol Head Neck Surg. 2020 Jan 1;146(1):67-68. PMID: 31725835
MH  - Age Factors
MH  - Aged
MH  - Cognitive Dysfunction/epidemiology/*etiology
MH  - Cross-Sectional Studies
MH  - Female
MH  - Hearing Loss/*complications/epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neuropsychological Tests
MH  - Nutrition Surveys
MH  - United States/epidemiology
PMC - PMC6865840
COIS- Conflict of Interest Disclosures: Dr Golub reported receiving travel expenses for 
      industry-sponsored events from Cochlear, Advanced Bionics, and Oticon Medical; 
      consulting fees from Oticon Medical, Auditory Insight, Optinose, and Decibel 
      Therapeutics; and honoraria from Abbott; and reported that his department 
      received unrestricted educational grants from Storz, Stryker, Acclarent, 3NT, and 
      Decibel Therapeutics. Dr Luchsinger reported being editor in chief of Alzheimer 
      Disease & Associated Disorders and receiving a stipend from its publisher and 
      reported being a paid consultant for vTv Therapeutics. No other disclosures were 
      reported.
EDAT- 2019/11/15 06:00
MHDA- 2021/01/13 06:00
PMCR- 2020/11/14
CRDT- 2019/11/15 06:00
PHST- 2019/11/15 06:00 [pubmed]
PHST- 2021/01/13 06:00 [medline]
PHST- 2019/11/15 06:00 [entrez]
PHST- 2020/11/14 00:00 [pmc-release]
AID - 2755646 [pii]
AID - ooi190075 [pii]
AID - 10.1001/jamaoto.2019.3375 [doi]
PST - ppublish
SO  - JAMA Otolaryngol Head Neck Surg. 2020 Jan 1;146(1):57-67. doi: 
      10.1001/jamaoto.2019.3375.