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Public Health
Francis B Kolo1, Sophia Lu2, Alexa S Beiser3,4
1Glenn Biggs Institute, San Antonio, TX, USA.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 23, 2025
Summary
Midlife hearing loss is linked to accelerated brain aging, reduced executive function, and nearly double the risk of dementia. Addressing hearing loss may be key to preventing cognitive decline.
Area of Science:
- Neuroscience
- Gerontology
- Epidemiology
Background:
- Age-related hearing loss (HL) is a modifiable risk factor for cognitive impairment and dementia.
- Understanding the relationship between hearing thresholds and brain health is crucial for dementia prevention strategies.
Purpose of the Study:
- To investigate the association between pure tone average (PTA) hearing thresholds and measures of brain aging, vascular injury, and cognitive function.
- To determine if midlife hearing loss predicts the risk of developing dementia over time.
Main Methods:
- Utilized data from 1656 Framingham Heart Study participants (mean age 58) free of stroke and dementia.
- Calculated PTA thresholds and defined hearing loss categories; employed multivariate regression and Cox proportional hazards models.
- Assessed brain MRI, cognitive function, and incident dementia over 4-8 years, adjusting for covariates like age, sex, education, and APOE-4 status.
Main Results:
- Mild hearing loss correlated with smaller brain volumes (equivalent to 1.75 years of aging) and executive function decline.
- Higher PTA was associated with increased white matter hyperintensity volume.
- Slight or greater hearing loss (>16 dB) increased dementia risk by 71%, particularly in APOE-4 carriers.
Conclusions:
- Midlife hearing loss is associated with accelerated brain aging, cognitive decline, and increased dementia risk.
- These findings suggest hearing loss may play a causal or biomarker role in dementia development.
- Interventions targeting midlife hearing loss could be a strategy for dementia prevention.
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