Poorer word recognition was linked to more brain amyloid in late middle age

Design

Cross-sectional cohort study with amyloid PET

Population

223 adults, mean age 65.6, mean pure-tone average 21 dB

Primary outcome

Global and regional amyloid SUVR

Effect

Global SUVR +0.064 per 10% worse word recognition (p = 0.005)

A cross-sectional study in The Laryngoscope, published on 13 September, examined 223 adults with an average age of 66 and mostly mild hearing loss (mean pure-tone average 21 dB). Each had audiometry and amyloid PET.

Worse word recognition was associated with higher amyloid across several regions and globally (about 0.06 higher standardised uptake ratio for every 10% fall in word recognition). Pure-tone thresholds showed a weaker association, significant only in the left temporal region. The associations were small and appeared to be driven by those with the most hearing loss and amyloid.

The link between hearing loss and dementia is well established; this study adds a possible biological correlate. It does not show that hearing loss causes amyloid or that hearing aids reduce it.

• Measure word recognition as well as pure-tone thresholds; it carried the stronger association.
• Treat hearing loss in midlife for its own sake — communication and quality of life.
• Ask about cognitive concerns in adults with hearing loss and refer where appropriate.
• Do not tell patients that hearing aids prevent Alzheimer's disease; this study cannot show that.

Why it matters

It strengthens the case for taking midlife hearing loss seriously without promising more than the evidence supports.

Don't overread it

Cross-sectional and observational; it cannot show that hearing loss causes amyloid or that treatment reduces it.

The statistics, in plain English

Several regions were tested, so some significant results may be chance. The effect sizes are small, and an association measured at one time point cannot say which came first.

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