Association of Brain Atrophy with Subjective and Objective Hearing Assessments in Older Adults

To investigate associations between objective and subjective hearing assessments, cognitive function, and brain atrophy in older adults, which are currently insufficiently understood.

Cross-sectional observational cohort study.

709 community-dwelling older adults in Japan aged ≥65 years who underwent a functional health examination between August 2021 and March 2023.

Hearing impairment was assessed objectively (via audiometric testing) and subjectively (via self-reported questionnaires). Associations between objective and subjective hearing assessments and brain atrophy were examined using binary logistic regression analysis. Hippocampal atrophy was the primary outcome measure.

Among 709 participants [median age: 73 years (IQR 69-78 years); 428 women (60.8%)], 51.5% had neither objective nor subjective hearing impairment, 5.1% reported subjective impairment without objective impairment, 27.2% had objective impairment without subjective impairment, and 16.2% exhibited objective and subjective impairments. Objective hearing impairment was significantly associated with hippocampal atrophy (β = -0.088, P = .019, adjusted R² = 0.23). Participants with objective and subjective hearing impairment had significantly higher odds of hippocampal atrophy than those without impairments (adjusted odds ratio 1.91, 95% CI 1.01-3.61).

These findings emphasize the importance of objective and subjective hearing assessments in older adults to identify hearing deficits and individuals at risk of neurodegeneration and cognitive decline. Incorporating hearing assessments into routine geriatric health evaluations may facilitate early interventions to mitigate brain atrophy and promote cognitive health.