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 Among people who'd been diagnosed with hearing loss, those who used
hearing aids were up to 18% less likely to be diagnosed with
dementia, depression or fall-related injuries over the next three
years, compared to people not using the devices, researchers report
in the Journal of the American Geriatrics Society.
More than 27 million older Americans live with hearing loss. But
only 12.3% of those with a formal diagnosis get hearing aids, the
authors note.
"Prevalence of hearing loss is estimated to increase as our
population grows older, and we know there are strong associations
between uncorrected hearing loss and conditions such as Alzheimer's
disease or dementia," lead author Dr. Elham Mahmoudi of the
University of Michigan in Ann Arbor told Reuters Health by email.
Past research has linked prolonged sensory deprivation - such as
loss of hearing - with social isolation and cognitive decline, the
study team notes. Hearing loss has also been tied to depression,
anxiety and balance trouble with increased risk of falls.
Using insurance claims data, Mahmoudi's team studied 114,862 people
age 66 and older with hearing loss.
"For each patient, data was collected over four years - one year
before they were diagnosed with hearing loss, and three years
after," Mahmoudi said. "This was done to ensure the patient had not
been diagnosed with Alzheimer's disease or dementia, depression or
anxiety, and injuries from falls in the year before their
diagnosis."
Only 12.3% of the study subjects used hearing aids, the authors
found. Hearing aid use was more common among men (13.3%) than women
(11.3%), and among non-Hispanic whites (13.6%) compared to black
(9.8%) or Hispanic (6.5%) people.
The gender and race differences are significant, the authors note,
because the cognitive conditions being studied are more common among
women than men, and among African-Americans compared to whites.
Hearing aid use was highest in north-central states at almost 37%,
and lowest, at 6%, in the mountain states.
While everyone in the study had health insurance, hearing aids are
typically not covered or only partly covered, and the cost falls on
the individual, the study team points out. On average, hearing aids
cost between $2,000 and $7,000.
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"We not only need to advocate for insurance coverage for hearing
aids, but also educate the public about the risks of uncorrected
hearing loss," Mahmoudi said.
The aging U.S. population makes this study significant, noted Dr.
Linda McEvoy of the University of California, San Diego, who wasn't
involved in the research.
The study lacked data on patients' education levels, socioeconomic
status or lifestyle that could influence the risks for dementia and
other study outcomes. This, McEvoy said, is an important limitation.
"If hearing aid users in the current study have higher levels of
education than non-users, then some of the protective associations
of using the aid may be the effect of education, not the hearing
aids," McEvoy said in an email.
The study wasn't designed to determine how hearing aids might reduce
risk for physical and mental decline, and randomized clinical trials
to test if hearing aids have this protective effect are needed, the
study team notes.
Until then, Mahmoudi believes, it would help to make hearing aids
more affordable.
"Beyond the costs, low prevalence of hearing aid use has been linked
to complexity of the hearing-care system in the U.S., stigma, and
poor perceived benefit and need," she said. "People also do not have
a single point of contact."
Although hearing aids are expensive, she noted, "the costs of the
conditions they could prevent or delay are substantially more
expensive."
McEvoy agrees.
"The costs of caring for cognitively-impaired older adults are high.
If hearing loss contributes to that risk, then hearing aids may be
an easily implemented solution to reduce some of that burden on our
healthcare system."
SOURCE: https://bit.ly/2oCcqnD Journal of the American Geriatrics
Society, online September 4, 2019.
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