nihms-1652066.pdf - HHS Public Access Author manuscript...

Age-related hearing loss and dementia
Alexander Chern, MD , Justin S. Golub, MD, MS
Department of Otolaryngology-Head & Neck Surgery, Columbia University Irving Medical Center,
180 Fort Washington Avenue, Harkness Pavilion, Room 865, New York, NY, 10032
Abstract
Dementia is a devastating disease and global health challenge that is highly prevalent worldwide.
A growing body of research has shown an independent association between age-related hearing
loss (ARHL) and dementia, identifying ARHL as a compelling potential target in preventive
strategies for dementia. However, a causal linkage between ARHL and dementia needs to be
investigated before making definitive clinical guidelines and treatment recommendations regarding
ARHL as a modifiable risk factor. In this review, we discuss the association between ARHL and
dementia, the importance of addressing this finding, as well as common mechanisms (e.g.,
microvascular disease) and causal mechanisms (e.g., depletion of cognitive reserve and social
isolation) that may explain the nature of this relationship. We also highlight future directions for
research, including randomized controlled trials, developing high-resolution microvascular
imaging, and further refining audiometric testing.
Introduction
Dementia is a debilitating disease and leading public health concern that affects
approximately 50 million people worldwide, a number that is projected to increase to 152
million in 2050. The economic burden of dementia to society is staggering, with an
estimated worldwide cost of $818 billion in 2015.
1
Given the limited efficacy of targeted
pharmacologic treatment modalities,
2
it is important to focus on reducing modifiable risk
factors through preventative measures; evidence shows that successful management of
modifiable risk factors can be effective in both delaying or preventing the disease and
reducing healthcare costs.
3
Moreover, a growing body of research has shown an association
between age-related hearing loss (ARHL) and dementia,
4–11
thus identifying ARHL as both
a potential modifiable risk factor and possible means to improve clinical outcomes in
patients with dementia. This review highlights the link between ARHL and dementia, as
well as why further investigation into this relationship is crucial.
What is age-related hearing loss?
Age-related hearing loss, otherwise known as presbycusis (from Greek presbys “old” and
akousis “hearing”), is the gradual, progressive hearing loss that occurs in individuals as they
grow older.
12
Though the term encompasses all conditions that lead to hearing loss in the
*
Corresponding author: Alexander Chern [email protected]
HHS Public Access
Author manuscript
Alzheimer Dis Assoc Disord . Author manuscript; available in PMC 2020 December 19.
Published in final edited form as:
Alzheimer Dis Assoc Disord . 2019 ; 33(3): 285–290. doi:10.1097/WAD.0000000000000325.