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Using linear mixed-effects and Cox proportional hazard models, we investigated if the associations between hearing loss and cognitive decline or dementia (Modified Mini-Mental State [3MS] Examination and Digit Symbol Substitution Test [DSST]) differed by the presence or absence of depressive symptoms. Depressive symptoms were defined as Center for Epidemiologic Study\u2014Depression scale 10 \u226510 at one or more visits from Years 1\u20135. Algorithmic incident dementia was defined using medication use, hospitalizations, and cognitive test scores. Audiometric hearing loss was measured at Year 5 and categorized as normal\/mild versus moderate or greater hearing loss.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Having both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS Examination (\u03b2 = \u22120.30; 95% confidence interval [CI]: \u22120.78, \u22120.19) and DSST (\u03b2 = \u22120.35; 95% CI: \u22120.67, \u22120.03) over 10 years of follow-up. Having both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio [HR]: 2.91; 95% CI: 1.59, 5.33 vs. HR: 1.54; 95% CI: 1.10, 2.15 hearing loss only and HR: 2.35; 95% CI: 1.56, 3.53 depressive symptoms only) of incident dementia in multivariable-adjusted Cox proportional hazards models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Comorbid conditions among hearing-impaired older adults should be considered and may aid in dementia prevention and management strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geronb\/gbab194","type":"journal-article","created":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T03:22:21Z","timestamp":1634181741000},"page":"839-849","source":"Crossref","is-referenced-by-count":34,"title":["Examining the Combined Estimated Effects of Hearing Loss and Depressive Symptoms on Risk of Cognitive Decline and Incident Dementia"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3447-4450","authenticated-orcid":false,"given":"Danielle S","family":"Powell","sequence":"first","affiliation":[{"name":"Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA"},{"name":"Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willa D","family":"Brenowitz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Neurology, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2479-1076","authenticated-orcid":false,"given":"Nicole M","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas S","family":"Reed","sequence":"additional","affiliation":[{"name":"Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank R","family":"Lin","sequence":"additional","affiliation":[{"name":"Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA"},{"name":"Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alden L","family":"Gross","sequence":"additional","affiliation":[{"name":"Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Deal","sequence":"additional","affiliation":[{"name":"Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 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