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Abstract
Objective: This study was undertaken to investigate the association of auditory threshold with cognitive decline and dementia.
Methods: The 1,057 surviving men of the Caerphilly cohort with audiometric data at baseline were followed for 17 years for cognitive outcomes. Pure-tone unaided audiometric threshold was assessed at 0.5, 1, 2, and 4 KHz at baseline and after 9 years. Incident dementia was assessed according to DSM-IV criteria, including standard criteria for vascular dementia and for Alzheimer disease. Cognitive decline was assessed by repeat administration of a cognitive test battery.
Results: Mean age-adjusted auditory threshold across both time points was associated with incident dementia and cognitive decline. After adjustment for premorbid cognitive function, the association with dementia was retained (odds ratio0.5 KHz = 2.67; 95% confidence interval, 1.38–5.18; p = 0.004). Stronger associations with cognitive decline were found for tests administered by interview than for those administered by computer.
Conclusions: This study has found an association of auditory threshold with dementia and cognitive decline over a 17-year period. The mechanisms underlying this association are unclear and may include a prodromal effect of dementia on auditory threshold, an effect of auditory threshold on cognitive assessment, an effect of auditory threshold on cognitive loss, or a shared etiologic pathway between both.
GLOSSARY
- AH4=
- Alice Heim test, part 1;
- CaPS=
- Caerphilly Prospective Study;
- CIND=
- cognitive impairment not dementia;
- dBA=
- unaided pure-tone binaural threshold;
- DSM-IV=
- Diagnostic and Statistical Manual of Mental Disorders, 4th edition;
- MMSE=
- Mini-Mental State Examination;
- NART=
- National Adult Reading Test;
- NINCDS-ADRDA=
- National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association;
- NINCDS-AIREN=
- National Institute of Neurological and Communicative Disorders and Stroke–Association Internationale pour la Recherche et l'Enseignement en Neurosciences;
- PTA=
- pure-tone average threshold.
Footnotes
Study funding: Supported by The Alzheimer's Society. The Caerphilly Study was initiated by the former MRC Epidemiology Unit (South Wales) and was funded by the Medical Research Council of the United Kingdom.
- Received March 7, 2012.
- Accepted May 22, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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