{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:22:06Z","timestamp":1790198526562,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014653","name":"NIHR Manchester Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014653","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VA Office of Academic Affiliations"},{"name":"Chief Scientist Office of the Scottish Government; VA Rehabilitation Research and Development","award":["9230C"],"award-info":[{"award-number":["9230C"]}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/S003576\/1"],"award-info":[{"award-number":["MR\/S003576\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00010\/4"],"award-info":[{"award-number":["MC_UU_00010\/4"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Health records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n\u2009=\u200972,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5\u20135\u00a0years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n\u2009=\u2009272,748) modelled the likelihood of being a persistent hearing-aid user at 3\u00a0years 2\u00a0months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The adjusted OR for incident dementia was 0.73 (95% CI 0.66\u20130.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43\u20130.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Substantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afac266","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T09:06:23Z","timestamp":1667293583000},"source":"Crossref","is-referenced-by-count":38,"title":["Dementia and hearing-aid use: a two-way street"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1544-1944","authenticated-orcid":false,"given":"Graham","family":"Naylor","sequence":"first","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Dillard","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology- Head & Neck Surgery, Medical University of South Carolina , Charleston, SC , USA"},{"name":"VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Orrell","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blossom C M","family":"Stephan","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Zobay","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham , UK"},{"name":"VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research , Portland, OR , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle H","family":"Saunders","sequence":"additional","affiliation":[{"name":"VA Rehabilitation R&D, National Center for Rehabilitative Auditory Research , Portland, OR , USA"},{"name":"Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester , Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"2022122616013404700_ref1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1001\/archneurol.2010.362","article-title":"Hearing loss and incident dementia","volume":"68","author":"Lin","year":"2011","journal-title":"Arch Neurol"},{"key":"2022122616013404700_ref2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet Commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"2022122616013404700_ref3","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.neuron.2020.08.003","article-title":"How can hearing loss cause dementia?","volume":"108","author":"Griffiths","year":"2020","journal-title":"Neuron"},{"key":"2022122616013404700_ref4","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1532-5415.2007.01499.x","article-title":"Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study","volume":"56","author":"P\u00e9r\u00e8s","year":"2008","journal-title":"J Am Geriatr Soc"},{"key":"2022122616013404700_ref5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1037\/0882-7974.12.1.12","article-title":"Emergence of a powerful connection between sensory and cognitive functions across the adult life span: a new window to the study of cognitive aging?","volume":"12","author":"Baltes","year":"1997","journal-title":"Psychol Aging"},{"key":"2022122616013404700_ref6","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1097\/AUD.0000000000001174","article-title":"Hearing assessment and rehabilitation for people living with dementia","volume":"43","author":"Dawes","year":"2022","journal-title":"Ear Hear"},{"key":"2022122616013404700_ref7","doi-asserted-by":"crossref","first-page":"838","DOI":"10.3109\/14992027.2015.1059503","article-title":"Hearing-aid use and long-term health outcomes: hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality","volume":"54","author":"Dawes","year":"2015","journal-title":"Int J Audiol"},{"key":"2022122616013404700_ref8","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1093\/gerona\/glx250","article-title":"Death, depression, disability, and dementia associated with self-reported hearing problems: a 25-year study","volume":"73","author":"Amieva","year":"2018","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2022122616013404700_ref9","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1001\/jamaoto.2018.1656","article-title":"Association of cognition and age-related hearing impairment in the English longitudinal study of ageing","volume":"144","author":"Ray","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2022122616013404700_ref10","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1111\/jgs.15363","article-title":"Longitudinal relationship between hearing aid use and cognitive function in older Americans","volume":"66","author":"Maharani","year":"2018","journal-title":"J Am Geriatr Soc"},{"key":"2022122616013404700_ref11","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.1111\/jgs.16109","article-title":"Can hearing aids delay time to diagnosis of dementia, depression, or falls in older adults?","volume":"67","author":"Mahmoudi","year":"2019","journal-title":"J Am Geriatr Soc"},{"key":"2022122616013404700_ref12","doi-asserted-by":"crossref","first-page":"254","DOI":"10.3390\/jcm9010254","article-title":"The effect of hearing aid use on cognition in older adults: can we delay decline or even improve cognitive function?","volume":"9","author":"Sarant","year":"2020","journal-title":"J Clin Med"},{"key":"2022122616013404700_ref13","doi-asserted-by":"crossref","first-page":"e12122","DOI":"10.1002\/trc2.12122","article-title":"Association of the use of hearing aids with the conversion from mild cognitive impairment to dementia and progression of dementia: a longitudinal retrospective study","volume":"7","author":"Bucholc","year":"2021","journal-title":"Alzheimers Dement (N Y)"},{"key":"2022122616013404700_ref14","doi-asserted-by":"crossref","first-page":"e12248","DOI":"10.1002\/trc2.12248","article-title":"The impact of hearing impairment and hearing aid use on progression to mild cognitive impairment in cognitively healthy adults: an observational cohort study","volume":"8","author":"Bucholc","year":"2022","journal-title":"Alzheimers Dement (N Y)"},{"key":"2022122616013404700_ref15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.18063\/ijps.v8i1.1308","article-title":"Self-reported hearing loss, hearing aid use, and cognitive function among US older adults","volume":"8","author":"West","year":"2022","journal-title":"Int J Popul Stud"},{"key":"2022122616013404700_ref16","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1097\/AUD.0000000000001249","article-title":"Dementia in a hearing-impaired population according to hearing aid use: a Nationwide Population-Based Study in Korea","volume":"43","author":"Byun","year":"2022","journal-title":"Ear Hear"},{"key":"2022122616013404700_ref17","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S1525-8610(04)70018-3","article-title":"Hearing aid use in nursing homes, part 2: barriers to effective utilization of hearing aids","volume":"5","author":"Cohen-Mansfield","year":"2004","journal-title":"J Am Med Dir Assoc"},{"key":"2022122616013404700_ref18","doi-asserted-by":"crossref","first-page":"205031212090457","DOI":"10.1177\/2050312120904572","article-title":"Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer\u2019s disease dementia: a qualitative study","volume":"8","author":"Gregory","year":"2020","journal-title":"SAGE Open Med"},{"key":"2022122616013404700_ref19","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1097\/AUD.0000000000000980","article-title":"Electronic health records as a platform for audiological research: data validity, patient characteristics, and hearing-aid use persistence among 731,213 US veterans","volume":"42","author":"Saunders","year":"2021","journal-title":"Ear Hear"},{"key":"2022122616013404700_ref20","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/AUD.0000000000001032","article-title":"A measure of long-term hearing-aid use persistence based on battery re-ordering data","volume":"42","author":"Zobay","year":"2021","journal-title":"Ear Hear"},{"key":"2022122616013404700_ref21","volume-title":"HCUP Chronic Condition Indicator","author":"Healthcare Cost and Utilization Project (HCUP)","year":"2016"},{"key":"2022122616013404700_ref22","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/1084713810385712","article-title":"Factors influencing help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: a review of the literature","volume":"14","author":"Knudsen","year":"2010","journal-title":"Trends Amplif"},{"key":"2022122616013404700_ref23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/14992020802572627","article-title":"Survey on hearing aid use and satisfaction in Switzerland and their determinants","volume":"48","author":"Bertoli","year":"2009","journal-title":"Int J Audiol"},{"key":"2022122616013404700_ref24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/epirev\/mxu013","article-title":"Epidemiologic approaches to veterans' health","volume":"37","author":"Gaziano","year":"2015","journal-title":"Epidemiol Rev"},{"key":"2022122616013404700_ref25","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1097\/AUD.0000000000000695","article-title":"Correlates of hearing aid use in UK adults: self-reported hearing difficulties, social participation, living situation, health, and demographics","volume":"40","author":"Sawyer","year":"2019","journal-title":"Ear Hear"},{"key":"2022122616013404700_ref26","doi-asserted-by":"crossref","first-page":"642","DOI":"10.3766\/jaaa.21.10.4","article-title":"Use of hearing aids and assistive listening devices in an older Australian population","volume":"21","author":"Hartley","year":"2010","journal-title":"J Am Acad Audiol"},{"key":"2022122616013404700_ref27","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.2105\/AJPH.2010.300078","article-title":"Determinants of hearing aid acquisition in older adults","volume":"101","author":"Fischer","year":"2011","journal-title":"Am J Public Health"},{"key":"2022122616013404700_ref28","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/S0277-9536(00)00392-0","article-title":"In their own words: a model of healthy aging","volume":"53","author":"Bryant","year":"2001","journal-title":"Soc Sci Med"},{"key":"2022122616013404700_ref29","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.3109\/14992027.2013.832420","article-title":"Identifying the barriers and facilitators to optimal hearing aid self-efficacy","volume":"53","author":"Meyer","year":"2014","journal-title":"Int J Audiol"},{"key":"2022122616013404700_ref30","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1002\/gps.3946","article-title":"Survival in dementia and predictors of mortality: a review","volume":"28","author":"Todd","year":"2013","journal-title":"Int J Geriatr Psychiatry"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/51\/12\/afac266\/48135685\/afac266.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/51\/12\/afac266\/48135685\/afac266.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T17:11:48Z","timestamp":1701277908000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afac266\/6931852"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afac266","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.10.25.21265439","asserted-by":"object"}]},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12]]},"published":{"date-parts":[[2022,12]]},"article-number":"afac266"}}