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Hearing loss (HL) is the third leading chronic health condition among older adults. Most studies investigating HL and cognition have been performed in high-income countries. Risk factors for dementia (eg. hypertension, midlife hearing loss, obesity and physical inactivity) are more common in low-income and middle-income countries (LMIC) or developing countries; therefore, there is greater potential for dementia prevention in these settings than in high-income countries. Here we have a cross-sectional analysis of Longitudinal Study of Adult Health (ELSA-Brasil) to see if HL is associated with cognitive decline in Brazil (LMIC). The mean age of the sample (51 years old) was lower than the mean age in previous studies (that range 56 to 77 years). The presence of HL in the better ear was considered. It was observed that cognitive performance in tests decreased with age. The group with HL had worse scores than the group without HL. These findings were not statistically significant. Only objectively-measured HL showed a significant association with lower verbal fluency. In conclusion, it was found that HL defined by the audiometry had a statistically significant association with poor verbal fluency performance, mainly in older individuals. The study is limited as ELSA-Brasil is composed of active or retired civil servants, who are more affluent and have more access to health services than the Brazilian population. The relationships between HL, cognitive function, and ageing are complex and the interactions among them involve different pathways, which still need to be clarified. It appears that there is the same association in LMIC as there is in high-income countries. As HL is a potentially modifiable risk factor for cognitive impairment, a better understanding of the link between the HL and cognition could help reduce the rates of dementia. Although there is still no strong evidence of the long-term effects of interventions for HL to improve cognitive function, auditory plasticity caused by the use of hearing aids has been demonstrated in adults and may improve cognitive function.

Hearing Loss and Cognitive Function: Baseline Findings From the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil.
Samelli A, Santos I, Deal J, et al.
EAR AND HEARING
2022;43(5):1416-25.
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CONTRIBUTOR
Clair Saxby

University Hospital Plymouth, UK.

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