Studiendatenbank

Although the phenomena underlying cognitive decline and dementia are complex, there is growing evidence suggesting that degraded sensory inputs caused by age-related hearing loss may play a central role in accelerating cognitive decline in older individuals. Further supporting this notion is evidence that hearing augmentation with hearing aids can mitigate hearing loss-related cognitive impairments. Despite this evidence, few studies have attempted to investigate hearing aid efficacy with a focus on cognitive outcome measures. In this preliminary study, we sought to determine if certain demographic and audiological factors are linked to individual differences regarding observed cognitive changes following hearing aid use. We show that several factors can explain large portions of the variance observed in cognitive score changes following short-term hearing aid use in first-time users, suggesting that it might be possible to develop predictive algorithms to determine individualized estimates of the cognitive benefit of hearing aid use. Future studies with larger sample sizes are warranted, in particular, to explore a wider array of cognitive functions, investigate a greater range of potential predictors, and better quantify their relative contribution to outcome measure estimates.

<h4>Background</h4>Individuals with untreated hearing loss often experience cognitive decline as a result of increased cognitive load and reduced sensory stimulation. Despite the well-established link between untreated hearing loss and cognitive decline in older adults, its impact on cognition in young and middle-aged adults has not been systematically examined. Given the Lancet Commission's identification of midlife hearing loss as the leading modifiable risk factor for dementia, early identification of cognitive decline is essential. This review explored the cognitive impact of untreated hearing loss in adults.<h4>Method</h4>A comprehensive search was conducted in PubMed, Scopus, Web of Science, and EMBASE to include studies comparing cognitive function between adults with normal hearing and those with untreated hearing loss aged 18-65 years. The methodological quality of the included studies was examined via the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Pooled mean differences and heterogeneity were analysed for each domain.<h4>Results</h4>Seven studies included in the qualitative synthesis had "moderate" to "strong" methodological quality. The cognitive domains assessed in these studies were global cognitive function, memory, attention, and executive function. Of these, six were eligible for meta-analysis, which revealed a small but statistically significant decline in overall cognitive performance and memory and executiv

Hearing loss in midlife is an important and potentially modifiable risk factor for the development of dementia. Research examining the association between dementia and hearing loss has expanded rapidly; however, evidence for the mechanisms linking the two conditions is inconclusive, limiting the development of targeted interventions. This review provides a critical overview of current evidence on dementia risk in relation to hearing loss, proposed mechanisms underpinning this association, and emerging evidence on the effectiveness of hearing interventions in modifying trajectories of cognitive decline, dementia risk, and disease progression. Alongside its role as a risk factor, hearing loss commonly co-occurs with dementia, highlighting the need for integrated approaches to care that address the considerable impact of these co-morbid conditions on individuals and communities. Finally, we emphasise the importance of including diverse populations in future research to improve generalisability of findings and help advance equity in dementia prevention and care.

Age-related hearing loss (ARHL) is one of the most common causes of disability in older adults. It is also frequently associated with neurological and neurodegenerative disorders, including dementia, as well as with stress, anxiety, depression, and social isolation. These observations suggest that ARHL should be considered not merely as a sensory dysfunction, but rather as a complex disease involving extra-auditory domains. Namely, identifying shared pathogenic determinants between hearing loss and neurodegenerative diseases remains a significant challenge. Increasing research in this field has highlighted common molecular mechanisms underlying age-related hearing and cognitive vulnerability, as well as potential overlapping neuronal networks involved in both cognitive and auditory neurodegeneration. In this review, we first outline the clinical features, risk factors, and molecular pathways involved in ARHL. We then examine the molecular mechanisms underlying ARHL at both peripheral (cochlea) and central level (auditory cortex), and subsequently discuss the cognitive comorbidities of ARHL, with a particular focus on cognitive impairment and affective disorders. From a translational point of view, exploring the extra-auditory consequences of ARHL will be crucial, as it will enable the identification of risk factors for both auditory and cognitive vulnerability and support the development of effective therapeutic interventions.

<b>Background/Objectives:</b> Few studies have examined the relationship between hearing aid use and physical activity levels, yielding inconsistent results. The aim of this study was to determine the possible association between hearing aid use and physical activity levels in a representative sample of older adults with hearing loss and a clinical indication for hearing aid use in Chile. <b>Methods</b>: We conducted a cross-sectional analysis of data from a nationally representative health survey employing geographically stratified, multistage probability sampling. Participants were aged ≥60, had medical indication for hearing aid use, demonstrated normal cognitive function, and reported no motor disability. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ). We also collected data on self-perceived hearing status, specialist recommendations for hearing aid use, and adherence among device owners. Multivariate ordinal regression models evaluated the association between hearing aid use and physical activity, accounting for the survey's complex sampling design. <b>Results:</b> The sample comprised 356 individuals, representing 599,912 older adults after applying survey weights. Overall, 50.5% reported owning a hearing aid; of these, 46.8% always used their device, and 19.1% never used it. Compared with consistent users, participants who used their hearing aid "sometimes" or "rarely" had significantly lower odds of higher physical activity lev

Hearing impairment is a growing public health challenge among older adults in India, with low uptake of hearing aids despite potential benefits for communication, social participation, and health-related quality of life (HRQoL). This study evaluated the cost-utility of hearing aid provision for older adults (≥60 years) with hearing impairment in India to inform policy and financing decisions. A cost-utility analysis compared hearing aid use with no hearing aid over a 3-year decision tree and a 15-year Markov model. Data were collected in 2023 from 636 participants (276 users, 360 non-users). HRQoL was measured using EQ-5D-5L and converted to QALYs with the India value set. Costs were based on the government ceiling price for digital behind-the-ear hearing aids (₹8,000 per ear), modelled for unilateral and bilateral use. ICERs and budget impact were estimated. Mean EQ-5D-5L utility was higher among hearing aid users than non-users (0.832 vs. 0.601), with corresponding QALYs of 5.824 vs. 4.207 (incremental gain 1.617 QALYs). In the 3-year decision tree, ICERs were ₹5,419/QALY (one-year) and ₹10,359/QALY (two-year). In the discounted 15-year Markov model, ICERs were ₹3,076/QALY (one-year) and ₹5,971/QALY (two-year). Budget impact was ₹1,230 crore over 3 years (₹410 crore annually) for the modelled scale-up among older adults. Hearing-aid provision for older adults with hearing impairment in India is highly cost-effective in short- and long-term modelling. Prioritising access wit

<h4>Objective</h4>We investigated potential racial disparities in the effects of audiometric hearing loss and its treatment on dementia and mortality among 3,602 older adults aged 68-89 years, 22% of whom were self-identified Black race.<h4>Methods</h4>Adjudicated all-cause dementia was determined using neurocognitive test data, proxy reports, and surveillance of hospital records and death certificates. Audiometric hearing loss, defined as the better-ear averaged pure-tone threshold (0.5-4 kHz), was categorized using clinical cutpoints. Multivariable-adjusted Cox proportional hazards models included hearing loss-race interaction terms.<h4>Results</h4>Dementia risk associated with moderate-to-severe hearing loss did not differ by race [Black participants: hazard ratio (HR): 1.66; 95% confidence interval (CI): 1.05, 2.61; White participants: HR: 1.71; 95% CI: 1.16, 2.51; <i>P</i>-interaction = 0.92]. However, moderate-to-severe hearing loss was associated with a 2.3-fold increase in mortality among Black participants only (95% CI: 1.17, 4.60).<h4>Conclusions</h4>Our findings emphasize the importance of including minoritized populations in hearing treatment research to build an evidence base for policy development and clinical decision-making. Hearing loss affects the health of both Black and White Americans. Racial disparities in hearing healthcare should be addressed to advance health equity for all older adults.

<h4>Background</h4>Over-the-counter (OTC) hearing aids were introduced to improve the affordability and accessibility of hearing health care for adults with perceived mild-to-moderate hearing loss. While these devices have demonstrated effectiveness in cognitively healthy older adults-particularly in the domains of audibility, self-reported hearing ability, and speech recognition in quiet-their use and outcomes in people with dementia remain underexplored. This issue warrants further attention, as people with dementia often experience co-occurring hearing loss and may rely on OTC hearing aids to overcome cost and access barriers to prescription amplification. However, given the cognitive and functional challenges of dementia, it is unclear whether and how OTC hearing aids can support the hearing care needs of these individuals.<h4>Objective</h4>To explore interest-holder perspectives on the feasibility and acceptability of OTC hearing aids for community-dwelling older adults with dementia, identifying key facilitators and barriers that influence their use in this population.<h4>Methods</h4>Semistructured interviews were conducted with 45 participants across three interest-holder groups (15 per group): (1) community-dwelling older adults with dementia and hearing loss, (2) family caregivers of community-dwelling older adults with dementia and hearing loss, and (3) geriatric direct care professionals. Interviews were conducted and recorded via secure Zoom (Zoom Communications)

<b>Background:</b> Hearing loss is one of the most common yet often overlooked sensory deficits worldwide, with consequences extending well beyond auditory function. Mounting evidence highlights the complex interrelationships among hearing loss, cognitive decline, and psychosocial well-being. Neural mechanisms underlying this association include increased cognitive load, cortical reorganisation, and social isolation, which mediate the impact of auditory deprivation on the brain and mental health. Furthermore, hearing impairment is consistently associated with a higher risk of depression and anxiety, particularly when the duration of untreated deafness is prolonged. <b>Methods:</b> This narrative review summarises recent longitudinal and neuroimaging studies investigating the effects of hearing loss and the timing of intervention with hearing aids. The review focuses on evidence addressing cognitive, psychological, and neural outcomes in relation to early versus delayed amplification. <b>Results:</b> Across multiple studies, early adoption of hearing aids within a limited timeframe after diagnosis is linked to better cognitive performance, lower depressive symptom scores, and more preserved neural network integrity. Experimental evidence supports the existence of sensitive periods for auditory intervention, during which brain plasticity allows for optimal reorganisation and recovery of function. Conversely, delayed amplification may lead to irreversible cortical changes and pe

<b>Background</b>: Age-related hearing loss (ARHL) is the most common sensory disorder in older adults and has been identified as a potentially modifiable risk factor for cognitive decline and dementia. Increasing evidence suggests that auditory dysfunction may contribute to adverse cognitive trajectories through multiple interacting pathways. This narrative review examines the mechanisms underlying the association between ARHL and cognitive decline, evaluates the impact of hearing rehabilitation, and discusses future research priorities. <b>Methods</b>: A narrative synthesis of epidemiological, neurobiological, and interventional studies was conducted, with emphasis on longitudinal cohort studies, neuroimaging research, and clinical investigations of hearing aids (HAs) and cochlear implants (CIs). <b>Results</b>: ARHL is consistently associated with accelerated cognitive decline and increased dementia risk. Proposed mechanisms include sensory deprivation-related cortical reorganization, increased cognitive load during effortful listening, shared neuropathological processes, and social disengagement. Neuroimaging studies demonstrate structural and functional alterations in auditory and associative brain regions in individuals with hearing loss. Emerging evidence suggests that HA and CI may improve cognitive performance and potentially attenuate decline, although long-term randomized data remain limited. <b>Conclusions</b>: Current evidence supports ARHL as a clinically releva

<h4>Objective</h4>This study examined the associations between hearing loss (HL) and other modifiable dementia risk factors in adults aged 50 years or older living in Tasmania and explored the effects of corrected versus uncorrected HL on these factors.<h4>Methods</h4>A cross-sectional study design using an online survey categorised participants as No-HL, HL-corrected or HL-uncorrected. Logistic regression estimated the odds of being in higher dementia risk categories.<h4>Results</h4>The HL-corrected group was more likely to be in the low-risk alcohol group (OR = 0.567, 95% CI: 0.468-0.687), 28% less likely for high cholesterol (OR = 0.722, 95% CI: 0.571-0.913) and 26% less likely for diabetes (OR = 0.743, 95% CI: 0.582-0.948). They also had lower odds than the HL-uncorrected group for alcohol risk (OR = 0.652, 95% CI: 0.508-0.837).<h4>Conclusions</h4>Corrected HL is associated with reduced odds of higher-risk categories for diabetes, alcohol use and high cholesterol.

<h4>Background</h4>Age-related hearing loss (ARHL) or presbycusis is a bilateral sensorineural hearing impairment associated with aging of the structures of the inner ear and auditory pathways and is the most common cause of acquired hearing loss in older adults. Presbycusis is a disabling condition that affects communication and quality of life, and has been associated with poorer cognitive performance. This study aimed to examine the association between ARHL, cognitive screening performance, and hearing-related quality of life in older adults.<h4>Methods</h4>This single-center prospective observational study with cross-sectional analysis included 60 participants aged 60 years and older: 40 patients with presbycusis and 20 control participants with normal hearing or mild hearing loss. Hearing threshold was examined using pure-tone audiometry and expressed as the Pure Tone Average (PTA). Cognitive function was screened using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and quality of life was evaluated using the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) questionnaire.<h4>Results</h4>On cognitive screening, most patients with age-related hearing loss scored in the range suggestive of cognitive impairment, and 90% reported reduced hearing-related quality of life. Statistically significant correlations were observed between PTA and both MoCA and MMSE scores, suggesting that hearing threshold is strongly associated

<b>Background</b>: There might be a significant association between hearing loss (HL) and cognitive performance or postural imbalance, but how they relate to each other remains unknown. The aim of this study is to gain an understanding of these relationships. <b>Methods</b>: An observational prospective study with subjects ≥ 55 years old divided into groups: normal hearing (group A), untreated HL > 20 decibel hearing level (dBHL) (group B), and patients with treated HL > 20 dBHL (group C). At the initial visit and follow-up, participants underwent tests and questionnaires evaluating hearing, balance, and cognition. Statistical analyses-including relative risk, Spearman's Rho correlation, interaction, and adjusted models-were performed using Stata 17; a <i>p</i>-value < 0.05 was considered statistically significant. <b>Results</b>: In total, 714 subjects were initially recruited: 210 in group A, 302 in group B, and 202 in group C. A mean follow-up time of 3.6 years was completed by 101 individuals. Compared with the normal-hearing group, hearing loss increased the probability of unsteadiness by 1.4-fold in group B and 4.1-fold in group C. Poorer performance on the Timed Up and Go (TUG) test was predicted by lower scores on both cognitive executive function tests, with correlations of -0.4 and 0.34 (<i>p</i> < 0.001). Regarding confounding factors, statistically significant differences were found for age and education in cognitive performance; age in the TUG results; and sex, c

<b>Background/Objectives:</b> Hearing loss and dementia are highly prevalent conditions in older adults and represent a growing public health challenge. Over the past decade, a substantial body of epidemiological evidence has demonstrated a consistent association between age-related hearing loss and cognitive dysfunction, including incident dementia. However, the nature of this relationship remains incompletely understood. <b>Methods:</b> This narrative review provides a structured overview of current evidence, focusing on epidemiological findings, mechanistic pathways, and clinical implications. Hearing loss has been associated with both accelerated cognitive decline and increased dementia risk, with a clear severity-impact relationship. <b>Results:</b> Several interacting mechanisms have been proposed, including increased cognitive load, structural and functional brain changes, social isolation, and shared vascular and metabolic risk factors. Emerging concepts such as the "auditory brain" and central auditory dysfunction further suggest that hearing impairment may also represent an early manifestation of neurodegenerative processes. Intervention studies have yielded mixed results. While hearing rehabilitation improves communication and quality of life, randomized evidence has not consistently demonstrated a reduction in cognitive decline in the general population, but potential benefits may exist in higher-risk subgroups. Increasing attention has been directed toward the ro

<h4>Purpose</h4>Hearing loss (HL) has been increasingly recognized as a potential risk factor for cognitive decline and dementia. However, findings from existing meta-analyses remain heterogeneous. This umbrella review aimed to comprehensively synthesize current meta-analytic evidence on the association between adult hearing loss and cognitive outcomes.<h4>Methods</h4>PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception to 9 January 2026. Systematic reviews with meta-analyses examining the relationship between hearing loss and cognitive outcomes in adults were included. Methodological quality was assessed using AMSTAR-2. Evidence credibility was evaluated using the Ioannidis classification framework, and certainty of evidence was assessed using the GRADE approach. Overlap among primary studies across meta-analyses was quantified using the corrected covered area (CCA).<h4>Results</h4>Nine meta-analyses were included. Hearing loss was significantly associated with increased risk of cognitive impairment (OR = 1.34, 95% CI: 1.17-1.53) and dementia (OR = 1.43, 95% CI: 1.21-1.68). In older adults, the associations were slightly stronger. Hearing loss was also associated with higher risk of Alzheimer's disease (OR = 1.66, 95% CI: 1.33-2.07). Evidence credibility was classified as highly suggestive for cognitive impairment and dementia.<h4>Conclusion</h4>Adult hearing loss is significantly associated with increased risks of cognitive im

<h4>Objective</h4>To evaluate the cognition and the depressive symptoms of elderly individuals with hearing impairment before and after the use of Hearing Aids (HA), in order to determine whether auditory rehabilitation can influence cognition and mood.<h4>Methods</h4>This is a prospective longitudinal study including elderly participants (>60 years) treated at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo (USP), who had indication for the use of hearing aids for auditory rehabilitation. Prior to HA fitting, tests were applied to assess cognition (Mini-Mental State Exam, verbal fluency test, and clock drawing test), mood (Geriatric Depression Scale), and restriction in daily life activities due to hearing loss (HHIE). These tests were repeated at 6- and 12-months after HA fitting.<h4>Results</h4>The study included 56 elderly individuals with a mean age of 73.9-years (±6.9). After 6-months of HA use, a significant increase was observed in the MMSE score ‒ from 23.4 (±4.8) to 24.8 (±4.5) (p = 0.016) ‒ and in the clock test score ‒ from 5.7 (±3.7) to 7.0 (±3.0) (p = 0.016). Participants without initial cognitive decline showed no significant differences. Among those re-evaluated after 12-months, the MMSE score increased from 25.6 (±3.0) to 28.2 (±1.7) (p = 0.001). Verbal fluency improved from 11.0 (±2.7) to 14.3 (±4.2) (p = 0.0013), and the clock test from 7.5 (±2.1) to 8.5 (±1.3) (p = 0.0387). In the subgroup without initial cognitive