https://immattersacp.org/weekly/archives/2022/12/13/4.htm

Devices to restore hearing may avert cognitive decline, improve cognitive test scores

Physicians should strongly encourage their patients with hearing loss to use restorative devices such as hearing aids and cochlear implants, according to the authors of a new meta-analysis that found significant cognitive benefits with the devices.


Hearing restorative devices were associated with a 19% decrease in hazards of long-term cognitive decline and a 3% improvement in cognitive test scores, a systematic review and meta-analysis found.

Researchers reviewed randomized clinical trials or observational studies relating to the effect of hearing interventions, defined as hearing aids or cochlear implants, on cognitive function, cognitive decline, cognitive impairment, and dementia in patients with hearing loss. There were 137,484 participants in 31 studies (25 observational studies, six trials), of which 19 (15 observational studies, four trials) were included in quantitative analyses. Results were published online Dec. 5 by JAMA Neurology.

Meta-analysis of eight studies with 126,903 participants and follow-up duration ranging from 2 to 25 years found significantly lower risk of cognitive decline among patients who used hearing aids versus those with uncorrected hearing loss (hazard ratio, 0.81; 95% CI, 0.76 to 0.87). Meta-analysis of 11 studies with 568 participants on hearing restoration and short-term cognitive test score changes found a 3% improvement in scores after the use of hearing aids or cochlear implants (ratio of means, 1.03; 95% CI, 1.02 to 1.04).

The cognitive benefit of hearing restorative devices should be further investigated in randomized trials, the authors wrote. “This study adds to the growing evidence base and serves as an impetus for clinicians treating patients with hearing loss to persuade them to adopt hearing restorative devices, to mitigate their risk of cognitive decline such as dementia.”

An accompanying editorial said the meta-analysis provides convincing evidence that hearing restorative devices are associated with a considerable reduction in risk of cognitive decline. “While we await the completion of additional studies to test if hearing loss may cause cognitive decline/dementia—and if hearing restorative devices could mitigate that possible pathway—we recommend physicians consider hearing evaluation as part of a standard dementia workup,” it said.