Neurological Sciences

, Volume 38, Issue 2, pp 233–239 | Cite as

Hearing impairment and risk of Alzheimer’s disease: a meta-analysis of prospective cohort studies

  • Yuqiu Zheng
  • Shengnuo Fan
  • Wang Liao
  • Wenli Fang
  • Songhua XiaoEmail author
  • Jun LiuEmail author
Review Article


Observational studies suggested an association between hearing impairment and cognitive disorders. However, whether hearing impairment is an independent risk factor or a harbinger of Alzheimer’s disease remains controversial. Our goal was to assess the association between hearing impairment (HI) and the risk of Alzheimer’s disease (AD) by conducting a meta-analysis of prospective cohort studies. We comprehensively searched the PubMed, Embase, Web of Science and Cochrane Library databases on January 19, 2016 to incorporate all the prospective cohort studies meeting the inclusion criteria to perform a systematic review and meta-analysis. Four prospective cohort studies with comparison between hearing impairment and normal hearing were incorporated, with 7461 participants. The outcomes of three studies were the incidence of Alzheimer’s disease and the outcome of the fourth study was the incidence of mild cognitive impairment. The overall combined relative risk of people with hearing impairment to develop Alzheimer’s disease was 4.87 (95% CI 0.90–26.35; p = 0.066), compared with the control group. Since both Alzheimer’s disease and mild cognitive impairment are cognitive disorders, we incorporated all the four studies and the overall combined relative risk was 2.82 (95% CI 1.47–5.42; p = 0.002), indicating that the difference was significant. This meta-analysis suggests that hearing impairment significantly increases the risk of cognitive disorders and future well-designed prospective cohort studies are awaited to confirm the association between hearing impairment and risk of Alzheimer’s disease.


Alzheimer’s disease Hearing impairment Meta-analysis 



This work was supported by Grants to Jun Liu from the National Natural Science Foundation of China (No. 81372919) and we want to thank the authors of the included studies for their original studies.

Compliance with ethical standards

Conflict of interest

The authors have declared that no competing interests exist.


  1. 1.
    Anstey KJ, Hofer SM et al (2003) A latent growth curve analysis of late-life sensory and cognitive function over 8 years: evidence for specific and common factors underlying change. Psychol Aging 18(4):714–726CrossRefPubMedGoogle Scholar
  2. 2.
    Anstey KJ, Luszcz MA et al (2001) Two-year decline in vision but not hearing is associated with memory decline in very old adults in a population-based sample. Gerontology 47(5):289–293CrossRefPubMedGoogle Scholar
  3. 3.
    Baloyannis SJ, Mauroudis I et al (2009) Synaptic alterations in the medial geniculate bodies and the inferior colliculi in Alzheimer’s disease: a Golgi and electron microscope study. Acta Otolaryngol 129(4):416–418CrossRefPubMedGoogle Scholar
  4. 4.
    Bennett DA, Schneider JA et al (2006) The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurol 5(5):406–412CrossRefPubMedGoogle Scholar
  5. 5.
    Boyle PA, Wilson RS et al (2008) Processing resources reduce the effect of Alzheimer pathology on other cognitive systems. Neurology 70(17):1534–1542CrossRefPubMedGoogle Scholar
  6. 6.
    Cota GF, de Sousa MR et al (2013) Efficacy of anti-leishmania therapy in visceral leishmaniasis among HIV infected patients: a systematic review with indirect comparison. PLoS Negl Trop Dis 7(5):e2195CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Davis A, McMahon CM et al (2016) Aging and hearing health: the life-course approach. Gerontologist 56(Suppl 2):S256–S267CrossRefPubMedGoogle Scholar
  8. 8.
    Dawes PR, Emsley R et al (2015) Hearing loss and cognition: the role of hearing aids, social isolation and depression. PLoS One 10(3):e0119616CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Deal JA, Sharrett AR et al (2015) Hearing impairment and cognitive decline: a pilot study conducted within the atherosclerosis risk in communities neurocognitive study. Am J Epidemiol 181(9):680–690CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Dong JY, Zhang YH et al (2011) Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol 58(13):1378–1385CrossRefPubMedGoogle Scholar
  11. 11.
    Fan X, Lin T et al (2012) Laparoendoscopic single-site nephrectomy compared with conventional laparoscopic nephrectomy: a systematic review and meta-analysis of comparative studies. Eur Urol 62(4):601–612CrossRefPubMedGoogle Scholar
  12. 12.
    Fratiglioni L, Wang HX et al (2000) Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet 355(9212):1315–1319CrossRefPubMedGoogle Scholar
  13. 13.
    Gates GA, Anderson ML et al (2011) Central auditory dysfunction as a harbinger of Alzheimer dementia. Arch Otolaryngol Head Neck Surg 137(4):390–395CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gates GA, Beiser A et al (2002) Central auditory dysfunction may precede the onset of clinical dementia in people with probable Alzheimer’s disease. J Am Geriatr Soc 50(3):482–488CrossRefPubMedGoogle Scholar
  15. 15.
    Gates GA, Karzon RK et al (1995) Auditory dysfunction in aging and senile dementia of the Alzheimer’s type. Arch Neurol 52(6):626–634CrossRefPubMedGoogle Scholar
  16. 16.
    Gennis V, Garry PJ et al (1991) Hearing and cognition in the elderly. New findings and a review of the literature. Arch Intern Med 151(11):2259–2264CrossRefPubMedGoogle Scholar
  17. 17.
    Gurgel RK, Ward PD et al (2014) Relationship of hearing loss and dementia: a prospective, population-based study. Otol Neurotol 35(5):775–781CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Gussekloo J, de Craen AJ et al (2005) Sensory impairment and cognitive functioning in oldest-old subjects: the Leiden 85+ Study. Am J Geriatr Psychiatry 13(9):781–786CrossRefPubMedGoogle Scholar
  19. 19.
    Helzner EP, Patel AS et al (2011) Hearing sensitivity in older adults: associations with cardiovascular risk factors in the health, aging and body composition study. J Am Geriatr Soc 59(6):972–979CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558CrossRefPubMedGoogle Scholar
  21. 21.
    Idrizbegovic E, Hederstierna C et al (2011) Central auditory function in early Alzheimer’s disease and in mild cognitive impairment. Age Ageing 40(2):249–254CrossRefPubMedGoogle Scholar
  22. 22.
    Kurniawan C, Westendorp RG et al (2012) Gene dose of apolipoprotein E and age-related hearing loss. Neurobiol Aging 33(9):2230.e2237–2230.e2212CrossRefGoogle Scholar
  23. 23.
    Liberati A, Altman DG et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lin FR, Ferrucci L et al (2011) hearing loss and cognition in the baltimore longitudinal study of aging. Neuropsychology 25(6):763–770CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Lin FR, Yaffe K et al (2013) Hearing loss and cognitive decline in older adults. JAMA Intern Med 173(4):293–299CrossRefPubMedGoogle Scholar
  26. 26.
    Masters CL, Bateman R et al (2015) Alzheimer’s disease. Nat Rev Dis Primers 1:15056. doi: 10.1038/nrdp.2015.56 CrossRefPubMedGoogle Scholar
  27. 27.
    Panza F, Solfrizzi V et al (2015) Age-related hearing impairment—a risk factor and frailty marker for dementia and AD. Nat Rev Neurol 11(3):166–175CrossRefPubMedGoogle Scholar
  28. 28.
    Panza F, Solfrizzi V et al (2015) Age-related hearing impairment and frailty in Alzheimer’s disease: interconnected associations and mechanisms. Front Aging Neurosci 7:113. doi:  10.3389/fnagi.2015.00113 CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Peracino A (2014) Hearing loss and dementia in the aging population. Audiol Neuro-Otol 19:6–9CrossRefGoogle Scholar
  30. 30.
    Peters CA (1988) Hearing impairment as a predictor of cognitive decline in dementia. J Am Geriatr Soc 36(11):981–986CrossRefPubMedGoogle Scholar
  31. 31.
    Petersen RC, Doody R et al (2001) Current concepts in mild cognitive impairment. Arch Neurol 58(12):1985–1992CrossRefPubMedGoogle Scholar
  32. 32.
    Rodriguez-Manas L, Feart C et al (2013) Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci 68(1):62–67CrossRefPubMedGoogle Scholar
  33. 33.
    Sinha UK, Hollen KM et al (1993) Auditory system degeneration in Alzheimer’s disease. Neurology 43(4):779–785CrossRefPubMedGoogle Scholar
  34. 34.
    Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605CrossRefPubMedGoogle Scholar
  35. 35.
    Taggart DP, D’Amico R et al (2001) Effect of arterial revascularisation on survival: a systematic review of studies comparing bilateral and single internal mammary arteries. Lancet 358(9285):870–875CrossRefPubMedGoogle Scholar
  36. 36.
    Uhlmann RF, Larson EB et al (1986) Hearing impairment and cognitive decline in senile dementia of the Alzheimer’s type. J Am Geriatr Soc 34(3):207–210CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  1. 1.Department of Neurology, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina

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