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Review
. 2021 Feb;42(1):10-25.
doi: 10.1055/s-0041-1725997. Epub 2021 Apr 15.

Age-Related Hearing Loss and the Development of Cognitive Impairment and Late-Life Depression: A Scoping Overview

Rahul K Sharma  1   2 , Alexander Chern  1 , Justin S Golub  1
Affiliations
Review

Age-Related Hearing Loss and the Development of Cognitive Impairment and Late-Life Depression: A Scoping Overview

Rahul K Sharma et al. Semin Hear. 2021 Feb.

Abstract

Age-related hearing loss (ARHL) has been connected to both cognitive decline and late-life depression. Several mechanisms have been offered to explain both individual links. Causal and common mechanisms have been theorized for the relationship between ARHL and impaired cognition, including dementia. The causal mechanisms include increased cognitive load, social isolation, and structural brain changes. Common mechanisms include neurovascular disease as well as other known or as-yet undiscovered neuropathologic processes. Behavioral mechanisms have been used to explain the potentially causal association of ARHL with depression. Behavioral mechanisms include social isolation, loneliness, as well as decreased mobility and impairments of activities of daily living, all of which can increase the risk of depression. The mechanisms underlying the associations between hearing loss and impaired cognition, as well as hearing loss and depression, are likely not mutually exclusive. ARHL may contribute to both impaired cognition and depression through overlapping mechanisms. Furthermore, ARHL may contribute to impaired cognition which may, in turn, contribute to depression. Because ARHL is highly prevalent and greatly undertreated, targeting this condition is an appealing and potentially influential strategy to reduce the risk of developing two potentially devastating diseases of later life. However, further studies are necessary to elucidate the mechanistic relationship between ARHL, depression, and impaired cognition.

Keywords: age-related hearing loss; cognitive decline; dementia; depression; presbycusis.

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Conflict of interest statement

Conflicts of Interest J.S.G. received travel expenses for industry-sponsored meetings (Cochlear, Advanced Bionics, Oticon Medical) and consulting fees or honoraria (Oticon Medical, Auditory Insight, Optinose, Abbott, Decibel Therapeutics), and also the department received unrestricted educational grants (Storz, Stryker, Acclarent, 3NT, Decibel Therapeutics). R.K.S.: None. A.C.: None.

Figures

Figure 1
Figure 1
Proposed mechanistic relationship between age-related hearing loss, cognitive impairment, and depression. Common mechanisms are also called confounders. Factors that appear along an arrow between hearing loss and cognitive impairment (cognitive load, social isolation, brain changes) or between hearing loss and depression (behavioral, neural) are also called mediators.
Figure 2
Figure 2
Additional mechanistic detail showing the interrelationship between age-related hearing loss, cognitive impairment, and depression.
See this image and copyright information in PMC

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