PT - JOURNAL ARTICLE AU - Gallacher, John AU - Ilubaera, Victor AU - Ben-Shlomo, Yoav AU - Bayer, Antony AU - Fish, Mark AU - Babisch, Wolfgang AU - Elwood, Peter TI - Auditory threshold, phonologic demand, and incident dementia AID - 10.1212/WNL.0b013e31826e263d DP - 2012 Oct 09 TA - Neurology PG - 1583--1590 VI - 79 IP - 15 4099 - http://n.neurology.org/content/79/15/1583.short 4100 - http://n.neurology.org/content/79/15/1583.full SO - Neurology2012 Oct 09; 79 AB - 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. 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.