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Longitudinal Changes in Hearing and Visual Impairments and Risk of Dementia in Older Adults in the United States.

TitleLongitudinal Changes in Hearing and Visual Impairments and Risk of Dementia in Older Adults in the United States.
Publication TypeJournal Article
Year of Publication2022
AuthorsHwang, PH, Longstreth, WT, Thielke, SM, Francis, CE, Carone, M, Kuller, LH, Fitzpatrick, AL
JournalJAMA Netw Open
Volume5
Issue5
Paginatione2210734
Date Published2022 05 02
ISSN2574-3805
KeywordsAged, Alzheimer Disease, Cohort Studies, Female, Hearing, Hearing Loss, Humans, Male, Medicare, Prospective Studies, United States, Vision Disorders
Abstract<p><b>Importance: </b>Hearing and vision problems are individually associated with increased dementia risk, but the impact of having concurrent hearing and vision deficits, ie, dual sensory impairment (DSI), on risk of dementia, including its major subtypes Alzheimer disease (AD) and vascular dementia (VaD), is not well known.</p><p><b>Objective: </b>To evaluate whether DSI is associated with incident dementia in older adults.</p><p><b>Design, Setting, and Participants: </b>This prospective cohort study from the Cardiovascular Health Study (CHS) was conducted between 1992 and 1999, with as many as 8 years of follow-up. The multicenter, population-based sample was recruited from Medicare eligibility files in 4 US communities with academic medical centers. Of 5888 participants aged 65 years and older in CHS, 3602 underwent cranial magnetic resonance imaging and completed the modified Mini-Mental State Examination in 1992 to 1994 as part of the CHS Cognition Study. A total of 227 participants were excluded due to prevalent dementia, leaving a total of 3375 participants without dementia at study baseline. The study hypothesis was that DSI would be associated with increased risk of dementia compared with no sensory impairment. The association between the duration of DSI with risk of dementia was also evaluated. Data analysis was conducted from November 2019 to February 2020.</p><p><b>Exposures: </b>Hearing and vision impairments were collected via self-report at baseline and as many as 5 follow-up visits.</p><p><b>Main Outcomes and Measures: </b>All-cause dementia, AD, and VaD, classified by a multidisciplinary committee using standardized criteria.</p><p><b>Results: </b>A total of 2927 participants with information on hearing and vision at all available study visits were included in the analysis (mean [SD] age, 74.6 [4.8] years; 1704 [58.2%] women; 455 [15.5%] African American or Black; 2472 [85.5%] White). Compared with no sensory impairment, DSI was associated with increased risk of all-cause dementia (hazard ratio [HR], 2.60; 95% CI, 1.66-2.06; P < .001), AD (HR, 3.67; 95% CI, 2.04-6.60; P < .001) but not VaD (HR, 2.03; 95% CI, 1.00-4.09; P = .05).</p><p><b>Conclusions and Relevance: </b>In this cohort study, DSI was associated with increased risk of dementia, particularly AD. Evaluation of hearing and vision in older adults may help to identify those at high risk of developing dementia.</p>
DOI10.1001/jamanetworkopen.2022.10734
Alternate JournalJAMA Netw Open
PubMed ID35511175
PubMed Central IDPMC9073563
Grant ListHHSN268201200036C / HL / NHLBI NIH HHS / United States
HHSN268200800007C / HL / NHLBI NIH HHS / United States
HHSN268201800001C / HL / NHLBI NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
U01 HL130114 / HL / NHLBI NIH HHS / United States
ePub date: 
22/05