Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 21:12:788045.
doi: 10.3389/fpsyg.2021.788045. eCollection 2021.

Pure Tone Audiometry and Hearing Loss in Alzheimer's Disease: A Meta-Analysis

Susanna S Kwok  1 , Xuan-Mai T Nguyen  1 , Diana D Wu  1 , Raksha A Mudar  2 , Daniel A Llano  1   2   3   4   5
Affiliations

Pure Tone Audiometry and Hearing Loss in Alzheimer's Disease: A Meta-Analysis

Susanna S Kwok et al. Front Psychol. .

Abstract

An association between age-related hearing loss (ARHL) and Alzheimer's Disease (AD) has been widely reported. However, the nature of this relationship remains poorly understood. Quantification of hearing loss as it relates to AD is imperative for the creation of reliable, hearing-related biomarkers for earlier diagnosis and development of ARHL treatments that may slow the progression of AD. Previous studies that have measured the association between peripheral hearing function and AD have yielded mixed results. Most of these studies have been small and underpowered to reveal an association. Therefore, in the current report, we sought to estimate the degree to which AD patients have impaired hearing by performing a meta-analysis to increase statistical power. We reviewed 248 published studies that quantified peripheral hearing function using pure-tone audiometry for subjects with AD. Six studies, with a combined total of 171 subjects with AD compared to 222 age-matched controls, met inclusion criteria. We found a statistically significant increase in hearing threshold as measured by pure tone audiometry for subjects with AD compared to controls. For a three-frequency pure tone average calculated for air conduction thresholds at 500-1,000-2,000 Hz (0.5-2 kHz PTA), an increase of 2.3 decibel hearing level (dB HL) was found in subjects with AD compared to controls (p = 0.001). Likewise, for a four-frequency pure tone average calculated at 500-1,000-2,000-4,000 (0.5-4 kHz PTA), an increase of 4.5 dB HL was measured (p = 0.002), and this increase was significantly greater than that seen for 0.5-2 kHz PTA. There was no difference in the average age of the control and AD subjects. These data confirm the presence of poorer hearing ability in AD subjects, provided a quantitative estimate of the magnitude of hearing loss, and suggest that the magnitude of the effect is greater at higher sound frequencies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021288280.

Keywords: Alzheimer's disease; age-related hearing loss; dementia; peripheral hearing; pure tone audiometry; pure-tone audiogram.

PubMed Disclaimer

Conflict of interest statement

DL has consulted for Eisai Pharmaceuticals in the past year. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of inclusion and exclusion of studies.
Figure 2
Figure 2
Forest plot summarizing meta-analysis findings of hearing threshold (dB HL) difference between subjects with Alzheimer's disease and control subjects at 0.5–2 kHz PTA.
Figure 3
Figure 3
Forest plot summarizing meta-analysis findings of hearing threshold (dB HL) difference between subjects with Alzheimer's disease and control subjects at 0.5–4 kHz PTA.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ally B. A., Jones G. E., Cole J. A., Budson A. E. (2006). The P300 component in patients with Alzheimer's disease and their biological children. Biol. Psychol. 72, 180–187. 10.1016/j.biopsycho.2005.10.004 - DOI - PubMed
    1. Alzheimer's Association . (2021). 2021 Alzheimer's disease facts and figures. Alzheimer's Dement. 17, 327–406. 10.1002/alz.12328 - DOI - PubMed
    1. Anand P., Singh B. (2013). A review on cholinesterase inhibitors for Alzheimer's disease. Arch. Pharm. Res. 36, 375–399. 10.1007/s12272-013-0036-3 - DOI - PubMed
    1. Arijita D., Thornton J. D., Sambamoorthi U., Innes K. (2017). Direct and indirect cost of managing Alzheimer's disease and related dementias in the United States. Exp. Rev. Pharmacoecon. Outcomes Res. 17, 189–202. 10.1080/14737167.2017.1313118 - DOI - PMC - PubMed
    1. Aylward A., Naidu S. R., Mellum C., King J. B., Jones K. G., Anderson J. S., et al. . (2021). Left ear hearing predicts functional activity in the brains of patients with Alzheimer's Disease Dementia. Ann. Otol. Rhinol. Laryngol. 130, 343–349. 10.1177/0003489420952467 - DOI - PubMed

Publication types