Do you really think your incompetent doctor in everything stroke related will know and prevent this for you?
With your risk of dementia post stroke your doctor and hospital (If competent) need to create this protocol and have dementia prevention protocols on hand.
1. A documented 33% dementia chance post-stroke from an Australian study? May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.`
3. A 20% chance in this research. July 2013.
4. Dementia Risk Doubled in Patients Following Stroke September 2018
Do you prefer your doctor and hospital incompetence NOT KNOWING? OR NOT DOING?
Hearing Loss May Play a Bigger Role in Dementia Than Previously Thought
Nearly 1 in 3 dementia cases linked with audiometric hearing loss, study suggests
Key Takeaways
- Up to 32% of dementia cases may be attributable to audiometric hearing loss, U.S. data suggested.
- Population attributable fractions were similar for both mild and moderate or greater hearing loss.
- Self-reported hearing loss was not associated with increased dementia risk.
Hearing loss may play a bigger role in dementia than previously thought, data from a U.S. cohort study suggested.
In a sample of nearly 3,000 older adults, up to 32% (95% CI 11.0%-46.5%) of incident dementia over 8 years could be attributable to any degree of audiometric hearing loss, reported Jason Smith, PhD, of Johns Hopkins Bloomberg School of Public Health in Baltimore, and co-authors.
Population attributable fractions (PAFs) were similar by hearing loss severity. For mild hearing loss, the PAF was 16.2% (95% CI 4.2%-24.2%). For moderate or greater hearing loss, it was 16.6% (95% CI 3.9%-24.3%), Smith and colleagues wrote in JAMA Otolaryngology-Head & Neck Surgery.
PAFs were larger in people ages 75 and older (30.5%), women (30.8%), and white participants (27.8%) compared with those younger than age 75, male, and Black. Self-reported hearing loss was not associated with increased dementia risk.
The sample came from the Atherosclerosis Risk in Communities (ARIC) neurocognitive study and included people who identified as either Black or white from four U.S. sites.
The findings mean that "up to 32% of population-level dementia risk could potentially be delayed or prevented if we completely treated hearing loss, assuming there is a causal association between hearing loss and dementia," Smith told MedPage Today. "It implies there could be broad benefits for dementia prevention with interventions for this risk factor even in later life."
The PAF is the maximum proportion of dementia that could be attributed to hearing loss in a population of both exposed and unexposed individuals. It accounts for both the relative risk and prevalence of hearing loss.
The PAF of 32% in this study was substantially higher than other estimates. The 2020 Lancet Commission on Dementia Prevention reported a global PAF of 8.2% for hearing loss, for example.
One reason for the wide variance "is that we measured audiometric hearing loss," Smith told MedPage Today. "Some prior PAF research has measured hearing loss using self-report. Self-report underestimates hearing loss prevalence in older adults -- it is likely capturing a separate, distinct construct -- and, by extension, could underestimate the PAF associated with hearing loss," he explained.
"Pure-tone audiometry is more sensitive than self-report in capturing clinically significant hearing loss in older adults," Smith added. Earlier research from the National Health and Aging Trends Study suggested that up to 17% of U.S. dementia cases could be attributable to moderate or greater audiometric hearing loss, for example.
PAFs assume a causal relationship and because this study used observational data, it doesn't provide evidence on whether hearing impairment causes dementia, noted Thomas Littlejohns, PhD, of the University of Oxford in England, on the U.K. Science Media Center website.
"For example, we can't tell from these results whether hearing problems are related to dementia through other factors common to aging or whether hearing problems are a consequence, rather than a cause, of dementia." Littlejohns wrote. "The latter is a particular problem in observational data, as dementia develops over many years and it is possible that hearing problems emerge in the early stages of dementia (similar to memory problems) before a clinical diagnosis is made."
The ACHIEVE trial recently tested the effect of a hearing intervention over 3 years in cognitively healthy older adults with hearing loss, including 238 participants from the ARIC study and 739 older adults recruited from the community. In the ARIC group, treating hearing loss reduced the rate of 3-year cognitive decline by 48% compared with controls. No effect was seen in the community sample.
In the current analysis, Smith and colleagues evaluated 2,946 ARIC participants in Maryland, North Carolina, Mississippi, and Minnesota who were dementia-free at baseline and had up to 8 years of follow-up.
Mean age was about 75 years; 59.4% were female, 21.6% were Black, and 78.4% were white. Overall, 1,947 participants (66.1%) had audiometric hearing loss and 1,097 people (37.2%) had self-reported hearing loss.
Incident all-cause dementia was identified using a standardized algorithm. Models used to estimate hazard ratios of incident dementia were adjusted for age, sex, race, education, APOE4 status, hypertension, diabetes, body mass index, smoking status, stroke history, and hearing aid use.
Because self-reported hearing loss was not tied to dementia risk, its PAF could not be determined, the researchers noted.
The analysis had several limitations, they acknowledged. The data came from a community-based cohort of self-identified Black and white adults and the generalizability of prevalence estimates to the wider U.S. population could be limited. By design, ARIC oversampled adults who self-identified as Black for greater representation.
The study also could not account for the potential cumulative effects of hearing loss on dementia risk, Smith and colleagues said.
Disclosures
The Atherosclerosis Risk in Communities (ARIC) study is supported by the NIH.
Smith reported relationships with the National Institute on Aging and the Cochlear Center Epidemiology Scholarship for Sensory Loss in Aging.
Co-authors reported relationships with the NIH and the Johns Hopkins Cochlear Center for Hearing and Public Health one reported being a member of the Scientific Advisory Board, Neosensory, from 2021 to 2023.
Littlejohns had no conflicts of interest.
Primary Source
JAMA Otolaryngology -- Head & Neck Surgery
Source Reference: Ishak E, et al "Population attributable fraction of incident dementia associated with hearing loss" JAMA Otolaryngol Head Neck Surg 2025; DOI: 10.1001/jamaoto.2025.0192.
No comments:
Post a Comment