Aging
The effect of hearing aid use on incidence of dementia among older adults Matas Griskaitis* Matas Griskaitis Griskaitis Griskaitis NYU Grossmann School of Medicine
An estimated 22.2% of the U.S. population has hearing loss, which is associated with cognitive decline and increased dementia risk. Prior studies suggest that hearing aid (HA) use may reduce cognitive decline, and target trial emulation analyses have proposed a protective causal effect on dementia incidence. However, effect estimates may be biased due to model misspecification. To address this, we used the causal roadmap and applied a doubly robust targeted maximum likelihood estimation (TMLE) approach combined with a SuperLearner package to estimate the causal effect of HA use on 2-year dementia incidence among hearing-impaired adults aged ≥65 years.
We used data from the nationally representative National Health and Aging Trends Study, restricting to Medicare beneficiaries aged ≥65 years with objectively measured hearing impairment at wave 11 and no dementia at baseline. Baseline self-reported HA use was compared with non-use after adjustment for baseline confounders. TMLE with SuperLearner was used to estimate marginal risk differences, accounting for censoring. Among 2,148 participants (555 HA users and 1,593 non-users), the 2-year risk difference for incident dementia was − 1.2% (95% CI: -5.3% – 2.9%, p = 0.565). Age-stratified analyses showed no statistically significant effects. A sensitivity analysis using an alternative hearing impairment threshold yielded similar null results.
In this representative sample of older adults, HA use was not associated with a statistically significant reduction in dementia incidence within two years. Longer follow-up and repeated exposure assessment may be required to better evaluate the potential preventive role of hearing aid use on dementia risk.