Bucholc Magda, McClean Paula L, Bauermeister Sarah, Todd Stephen, Ding Xuemei, Ye Qinyong, Wang Desheng, Huang Wei, Maguire Liam P
Cognitive Analytics Research Lab School of Computing, Engineering & Intelligent Systems Ulster University Derry UK.
Northern Ireland Centre for Stratified Medicine Biomedical Sciences Research Institute Clinical Translational Research and Innovation Centre (C-TRIC) Ulster University Derry UK.
Alzheimers Dement (N Y). 2021 Feb 14;7(1):e12122. doi: 10.1002/trc2.12122. eCollection 2021.
Hearing aid usage has been linked to improvements in cognition, communication, and socialization, but the extent to which it can affect the incidence and progression of dementia is unknown. Such research is vital given the high prevalence of dementia and hearing impairment in older adults, and the fact that both conditions often coexist. In this study, we examined for the first time the effect of the use of hearing aids on the conversion from mild cognitive impairment (MCI) to dementia and progression of dementia.
We used a large referral-based cohort of 2114 hearing-impaired patients obtained from the National Alzheimer's Coordinating Center. Survival analyses using multivariable Cox proportional hazards regression model and weighted Cox regression model with censored data were performed to assess the effect of hearing aid use on the risk of conversion from MCI to dementia and risk of death in hearing-impaired participants. Disease progression was assessed with Clinical Dementia Rating Sum of Boxes (CDR-SB) scores. Three types of sensitivity analyses were performed to validate the robustness of the results.
MCI participants that used hearing aids were at significantly lower risk of developing all-cause dementia compared to those not using hearing aids (hazard ratio [HR] 0.73, 95% confidence interval [CI], 0.61 to 0.89; false discovery rate [FDR] = 0.004). The mean annual rate of change (standard deviation) in CDR-SB scores for hearing aid users with MCI was 1.3 (1.45) points and significantly lower than for individuals not wearing hearing aids with a 1.7 (1.95) point increase in CDR-SB per year (= 0.02). No association between hearing aid use and risk of death was observed. Our findings were robust subject to sensitivity analyses.
Among hearing-impaired adults, hearing aid use was independently associated with reduced dementia risk. The causality between hearing aid use and incident dementia should be further tested.
助听器的使用与认知、沟通和社交能力的改善有关，但它对痴呆症发病率和进展的影响程度尚不清楚。鉴于老年人中痴呆症和听力障碍的高患病率，以及这两种情况经常共存的事实，此类研究至关重要。在本研究中，我们首次研究了使用助听器对从轻度认知障碍（MCI）转变为痴呆症以及痴呆症进展的影响。
我们使用了从国家阿尔茨海默病协调中心获得的基于转诊的2114名听力受损患者的大型队列。使用多变量Cox比例风险回归模型和带有删失数据的加权Cox回归模型进行生存分析，以评估使用助听器对听力受损参与者从MCI转变为痴呆症的风险和死亡风险的影响。用临床痴呆评定量表总和（CDR-SB）评分评估疾病进展。进行了三种类型的敏感性分析以验证结果的稳健性。
与未使用助听器的MCI参与者相比，使用助听器的MCI参与者发生全因痴呆症的风险显著更低（风险比[HR] 0.73，95%置信区间[CI]，0.61至0.89；错误发现率[FDR] = 0.004）。患有MCI的助听器使用者的CDR-SB评分的年均变化率（标准差）为1.3（1.45）分，明显低于未佩戴助听器的个体，后者的CDR-SB每年增加1.7（1.95）分（P = 0.02）。未观察到使用助听器与死亡风险之间的关联。我们的研究结果在敏感性分析中是稳健的。
在听力受损的成年人中，使用助听器与降低痴呆症风险独立相关。助听器使用与新发痴呆症之间的因果关系应进一步检验。
