Adult-onset hearing loss and incident cognitive impairment and dementia – A systematic review and meta-analysis of cohort studies

We comprehensively summarized the cohort evidence to date on adult-onset hearing loss as risk factor for incident cognitive impairment and dementia, and examined the evidence for dose-response, risk for various dementia subtypes, and other moderators. Previous meta-analyses were less comprehensive. We included cohort studies with participants without dementia and with hearing assessments at baseline, minimum 2 years follow-up and incident cognitive outcomes. We used random-effect models and subgroup and meta-regression on moderator analyses. We identified fifty studies (N=1,548,754). Hearing loss (yes/no) was associated with incident dementia risk (HR=1.35 [95% CI = 1.26 – 1.45), mild cognitive impairment (MCI HR=1.29 [95% CI = 1.11 – 1.50]), cognitive decline not specified as MCI or dementia (HR=1.29 [95% CI = 1.17 – 1.42]), and Alzheimer's disease dementia (ADD, HR=1.56 [95% CI = 1.30 – 1.87]), but not with vascular dementia (HR, 1.30 [95% CI = 0.83 – 2.05]). Each 10-decibel worsening of hearing was associated with a 16% increase in dementia risk (95% CI = 1.07 – 1.27). The effect of hearing loss did not vary across potential moderators. Cohort studies consistently support that adult-onset hearing loss increases the risk of incident cognitive decline, dementia, MCI, and ADD.