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Association of Cardiovascular Comorbidities With Hearing Loss in the Older Old
Kapil Wattamwar1, Z Jason Qian2, Jenna Otter3
1Yale School of Medicine, New Haven, Connecticut.
Insights
Cardiovascular disease risk factors are linked to worse hearing and faster hearing decline in adults over 80. This association was stronger in men, with coronary artery disease showing the most significant impact on hearing.
Area of Science:
- Gerontology
- Cardiology
- Audiology
Background:
- The population aged over 80 is rapidly growing, with a high prevalence of cardiovascular comorbidities.
- The relationship between cardiovascular disease (CVD) and hearing loss in this demographic is not well understood.
Purpose of the Study:
- To examine the association between CVD risk factors and auditory function in individuals over 80 years old.
Main Methods:
- Analysis of audiological data and medical records from 433 patients (aged 80-106) between 2001-2014.
- Comparison of hearing loss (low and high frequency) and hearing deterioration rates between patients with CVD risk factors and disease-free individuals.
Main Results:
- Individuals with at least one cardiovascular comorbidity exhibited significantly worse low-frequency hearing (42.4 vs 36.9 dB HL).
- Patients with CVD or related risk factors experienced accelerated hearing loss (1.90 vs 1.18 dB HL/year).
- Coronary artery disease showed the strongest association with hearing loss across all frequencies and impaired word recognition, with a more pronounced effect in men.
Conclusions:
- Cardiovascular risk factors and diseases are associated with poorer hearing and accelerated hearing deterioration in the elderly population (>80).
- Hearing loss in women showed a weaker association with CVD, potentially due to estrogen's cardioprotective effects.
- Further research is needed to determine the link between CVD severity, management, and hearing outcomes.
Importance:
In the United States, the population of individuals older than 80 years is expected to double in the next 40 years. Cardiovascular comorbidities are prevalent in this older old population, and their relationship with hearing loss has not been well characterized.
Objective:
To investigate the association of cardiovascular disease (CVD)-related risk factors with auditory function among the older old (>80 years).
Design, Setting, And Participants:
Audiological data and medical records from 2001 through 2014 of 433 patients aged 80 to 106 years at an academic medical center were analyzed in 2017.
Main Outcomes And Measures:
The degree of low- and high-frequency hearing loss of participants with coronary artery disease, diabetes, hypertension, history of cerebrovascular accident, and smoking status was compared with that of disease-free individuals. Rate of hearing loss was also determined.
Results:
Among the 433 patients (67% female; mean [SD] age, 89 [5.8] years), the presence of at least 1 cardiovascular morbidity was associated with elevated mean (SD) low-frequency pure-tone average (LFPTA) of 42.4 (1.6) vs 36.9 (3.5) decibels hearing loss (dB HL), a difference of 5.47 (95% CI, 4.15-9.49) dB HL. Among the 96 patients with 2 audiograms performed at age 80 years or older from which the rate of hearing loss could be calculated, 32 patients had CVD or related risk factors and 64 were healthy controls. Those with at least 1 disease had accelerated hearing loss. Patients with cardiovascular morbidity experienced a faster mean (SD) decline in LFPTA of 1.90 (0.27) vs 1.18 (0.42) dB HL/y, a difference of 0.72 (95% CI, 0.08-1.36) dB HL/y. Of the conditions studied, coronary artery disease had the highest association with audiometric thresholds and was associated with hearing loss at all frequencies tested and with poor word recognition score. Hearing loss was more strongly associated with CVD risk factors in men than in women.
Conclusions And Relevance:
In this study of the older old, cardiovascular risk factors and disease were associated with worse hearing and a greater rate of hearing deterioration. Hearing loss in women was less associated with the presence of CVD, possibly owing to the cardioprotective effects of estrogen. The association of hearing with CVD severity and management remains to be determined.
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