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Age-related hearing impairment—a risk factor and frailty marker for dementia and AD

Nature Reviews Neurology volume 11, pages 166–175 (2015)Cite this article

Subjects

Key Points

  • Age-related hearing impairment (ARHI, also known as presbycusis) is the most common hearing disorder and a major cause of chronic disability in older age

  • ARHI has an adverse effect on general health and quality of life; epidemiological studies have linked ARHI to incident cognitive impairment, accelerated cognitive decline and Alzheimer disease (AD)

  • ARHI can cause difficulty in speech comprehension, thereby compromising communication skills and potentially leading to social isolation and loneliness

  • Difficulty in verbal communication can exacerbate depletion of cognitive reserve, which might causally link ARHI to cognitive decline

  • At present, control of modifiable risk factors for dementia and AD remains the most realistic preventive strategy for these disorders

  • ARHI is a potentially a reversible risk factor for dementia and AD; timely diagnosis combined with hearing aids and cognitive training might delay or prevent cognitive deterioration

Abstract

Age-related hearing impairment (ARHI, also known as presbycusis) is potentially a reversible risk factor for dementia and Alzheimer disease (AD). Social isolation, loneliness, poor verbal communication, and cognitive reserve depletion might causally link ARHI with cognitive impairment. ARHI is an important frailty marker, and several factors related to physical frailty could be associated with cognitive impairment. Such factors include inflammatory markers and vascular factors, which might also directly contribute to ARHI. Randomized controlled trials of potential interventions, and larger population-based studies, could facilitate further understanding of the interplay between cognitive impairment, ARHI and frailty in older age. Deficits in both peripheral hearing and central auditory processing (CAP) can contribute to ARHI. Impairments in peripheral hearing and CAP have been linked to accelerated cognitive decline, incident cognitive impairment and AD; moreover, CAP dysfunction is common in mild cognitive impairment (MCI) and AD. Assessment of CAP dysfunction in people with ARHI might, therefore, aid identification of older individuals with increased risk of MCI and AD.

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Figure 1: Hearing impairment, frailty and cognitive decline.

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Acknowledgements

F.P., V.S. and G.L. have received funding from Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale (PRIN) 2009 Grant 2009E4RM4Z.

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Authors and Affiliations

  1. Department of Basic Medicine, Neurodegenerative Disease Unit, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Policlinico, Piazza Giulio Cesare, 11, Bari, Italy

    Francesco Panza & Giancarlo Logroscino

  2. Interdisciplinary Medicine Department, Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Policlinico, Piazza Giulio Cesare, 11, Bari, Italy

    Vincenzo Solfrizzi

  3. Department of Clinical Research in Neurology, University of Bari Aldo Moro, “Pia Fondazione Cardinale G. Panico”, Via San Pio, 4, Tricase, Lecce, Italy

    Francesco Panza & Giancarlo Logroscino

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All authors researched the data for the article, provided substantial contributions to discussions of its content, wrote the article, and undertook review and/or editing of the manuscript before submission.

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Correspondence to Francesco Panza.

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Panza, F., Solfrizzi, V. & Logroscino, G. Age-related hearing impairment—a risk factor and frailty marker for dementia and AD. Nat Rev Neurol 11, 166–175 (2015). https://doi.org/10.1038/nrneurol.2015.12

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