Hearing-Loss Treatment May Help Preserve Social Connection in Older People

PN Alert is Switching Platforms The APA Annual Meeting starts tomorrow in Los Angeles! During the meeting, we will be pausing Psychiatric News Alerts as we transition to our new host platform—Hubspot. Alerts will resume on Thursday, May 22. In the meantime, follow PN’s coverage of the Annual Meeting on our X (Twitter), LinkedIn and Instagram accounts.

Older adults with hearing loss who receive treatment may retain greater social connections over time than those who do not receive treatment, according to a study in JAMA Internal Medicine.

Nicholas S. Reed, Au.D., Ph.D., of New York University, and colleagues examined data from 977 adults (mean age of 76.3) with untreated hearing loss and no substantial cognitive impairment. Participants were randomized to two groups: One group received a hearing intervention consisting of four sessions with a certified study audiologist, hearing aids, counseling, and education, with booster visits every six months. The control group received health education consisting of four sessions with a certified educator on chronic disease and disability prevention, including goal-setting, activities, stretching, and counseling. The researchers measured the participants’ social connections and loneliness at baseline, six months, and one, two, and three years.

At baseline, the mean social network size was 22.6 in the intervention group and 22.3 in the control group. After three years, the mean social network size declined to 21.3 in the intervention group and 19.8 in the control group. Adults in the intervention group also retained more social network diversity (number of relationship roles such as parent, child, or neighbor) after three years.

The intervention group’s mean loneliness scores (assessed via the UCLA Loneliness Scale) improved from 32.8 at baseline to 32.3 at three years, whereas the control group’s scores worsened from 32.7 at baseline to 33.5 at three years.

“Given the high prevalence of hearing loss among older adults and already established delivery models, hearing intervention represents a public health target for population-level reductions in social isolation and loneliness,” the researchers wrote, noting that hearing interventions are scalable and low-risk efforts. “Additional efforts to incorporate coverage for hearing care and audiological support services … into Medicare benefits may further help improve access and affordability of hearing care for older adults.”

For related information, see the Psychiatric News article “Special Report: Lifting the Veil on Loneliness and Alienation.”

(Image: Getty Images/iStock/Jacob Wackerhausen)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on X, LinkedIn and Instagram!

Dementia Cases Projected to Double: Here’s Who’s at Highest Risk

More than 40% of older adults in the United States today may develop dementia by the age of 95, with higher risk in women, Black adults, and carriers of the apolipoprotein ε4 (APOE ε4) gene variant, according to the results of a study issued yesterday by Nature Medicine.

Researchers projected a near-doubling of new annual dementia cases over the next four decades—from about 514,000 in 2020 to about 1 million in 2060—a trend largely driven by the sizable baby boom generation reaching older ages.

“Previous studies suggest that 11-14% of men and 19-23% of women in the United States will develop dementia during their lives,” wrote Michael Fang, Ph.D., M.H.S., at Johns Hopkins Bloomberg School of Public Health, and colleagues. “However, these estimates were based on older data with limited dementia ascertainment, potentially resulting in underestimation. Racial disparities in the lifetime risk of dementia are also poorly characterized, as population-based analyses have typically been limited to Non-Hispanic White populations.”

Fang and colleagues used data from 15,043 diverse participants of a long-running community study (median follow-up of 23 years) to estimate the lifetime risk of dementia from ages 55 to 95; all included participants were dementia-free at age 55. During the study follow-up, 3,252 participants developed dementia, 5,803 died without dementia, and 2,131 left the study.

The researchers applied the data from the study to U.S. census projections to evaluate the potential number of incident dementia cases from 2020 to 2060. They reported the following:

• The lifetime risk of dementia after age 55 years was 42%.
• The cumulative incidence of dementia remained low up to age 75 (4%), then increased progressively faster.
• The median age of dementia diagnosis was 81 years.
• Lifetime risks were higher in women versus men (48% vs. 35%) and Black adults versus White adults (44% vs. 41%).
• Adults with two copies of the APOE ε4 alle had a substantially higher lifetime risk of dementia (59%) compared with those with one copy (48%) and those with no copies (39%), with differences seen beginning at about 70 years of age.

“Our results suggest that the current lifetime risk of dementia may be substantially higher than previously thought, emphasizing the importance of prevention throughout the life course,” Fang and colleagues wrote. “Policies focused on optimizing cardiovascular health and preserving hearing may be particularly important. Accumulating data from clinical trials have linked healthy lifestyle behaviors, the absence of vascular risk factors, and hearing rehabilitation with improved cognitive outcomes.”

For related information, see the Psychiatric News article “New Medication, Staging Criteria Signal a Potential Shift in Alzheimer’s Care.”

(Image: Getty Images/iStock/Jacob Wackerhausen)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on X!

Follow Psychiatric News on LinkedIn!

Hearing Loss Linked to Cognitive Decline; Hearing Aids Do Not Appear to Change Risk

Mild or disabling hearing loss (HL) among adults ages 45 to 69 may be associated with cognitive impairment, according to a report in JAMA Open Network. Further, wearing a hearing aid does not appear to significantly change the risk for cognitive impairment.

Baptiste Grenier, M.D., of the Universite Paris Cite, and colleagues noted that the prevalence of cognitive impairment is increasing, with up to 150 million individuals worldwide expected to be living with dementia by 2050. “Given the major burden of cognitive decline and the absence of curative treatment, identifying modifiable risk factors is of importance,” they wrote.

Grenier and colleagues analyzed data on 62,072 older participants (average age 57.4 years; 52% female) in the French CONSTANCES cohort, a population-based epidemiological cohort that recruited more than 200,000 randomly selected adults ages 18 to 69 from the French National Insurance Fund between January 1, 2012, and December 31, 2020.

Overall, 49% of participants (n = 30,624) had normal hearing, 38% (n= 23,768) had mild HL, 10% (n = 6,012) had disabling HL without use of a hearing aid, and 3% (n = 1,668) used a hearing aid; hearing status was objectively assessed with audiometric testing.

Upon enrollment, all participants ages 45 and older also underwent an extensive cognitive evaluation from trained neuropsychologists. The researchers computed a global cognitive score for the participants based on three of the tests:

• Digit Symbol Substitution Test of attention, psychomotor speed, and reasoning
• Free and Cued Selective Reminding Test of episodic verbal memory
• Trail Making Test of shifting abilities and executive function

Across all ages, 27% of individuals with mild HL and 37% of those with disabling HL had global cognitive scores indicative of impairment, compared with 16% among those with normal hearing. The authors found no statistical difference in cognitive impairment risk between all individuals with disabling HL who used a hearing aid and those who did not. A secondary analysis suggested that hearing aids may reduce the risk of cognitive impairment in individuals with disabling hearing loss and depression.

The authors said that HL may cause cognitive decline because of social isolation, prolonged deprivation of auditory input, and/or shared neurodegenerative processes in the brain associated with hearing loss and cognitive deterioration. HL is also associated with loss of brain volume in critical sections of the brain.

Prescription of hearing aids for patients with disabling HL “should be guided by their established benefits on quality of life and social isolation, but not to mitigate cognitive decline for which further research is needed,” the authors wrote.

For related information, see the Psychiatric News article “Late Life Anxiety Linked to Cognitive Decline.”

(Image: Getty Images/iStock/bymuratdeniz)

---

Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.

Follow Psychiatric News on X!

Follow Psychiatric News on LinkedIn!

Hearing Aids May Reduce Risk of Depression, Anxiety, Dementia in Older Adults

Older adults who use hearing aids may be less likely to develop depression, anxiety, and dementia for at least three years after a hearing loss diagnosis compared with those who do not begin using hearing aids, according to a study published Wednesday in the Journal of the American Geriatrics Society. In addition, these individuals appear less likely to get injured in a fall.

“By providing enhanced hearing input, HAs [hearing aids] may facilitate greater social engagement, lower levels of effort to recognize sounds and speech, lower levels of depression or anxiety symptoms, higher levels of physical balance, and greater feelings of independence and self-efficacy,” wrote Elham Mahmoudi, Ph.D., and colleagues at the University of Michigan.

Mahmoudi and colleagues examined insurance claims data from 114,862 adults aged 66 and older who received a hearing loss diagnosis between 2008 and 2013. All the adults included in the analysis remained on the same coverage—a Medicare managed care plan that includes partial coverage for hearing aids—for at least three years after receiving the diagnosis of hearing loss.

The analysis showed that about 11% of women and 13% of men diagnosed with hearing loss began using hearing aids. Over the next three years, the adults who used hearing aids had an 18% reduced risk of being diagnosed with Alzheimer’s/dementia, 11% reduced risk of being diagnosed with anxiety or depression, and a 13% reduced risk of having an injurious fall compared with adults without hearing aids.

“Although [hearing aids] are expensive, the medical costs of many conditions that could be prevented or delayed by using [hearing aids] are substantially more expensive,” the authors concluded. “Any delay in diagnosis of [Alzheimer’s] or dementia could not only lead to large cost savings, but also improve the health and well-being of older adults.”

To read more about this topic, see the American Journal of Psychiatry article “Sensation and Psychiatry: Linking Age-Related Hearing Loss to Late-Life Depression and Cognitive Decline.”

(image: iStock/VioletaStoimenova)

Follow Psychiatric News on Twitter!

And check out the new Psychiatric News Brief on Alexa-enabled devices.