Hearing loss, depression, and cognition in younger and older adult CI candidates

Maria Huber; Lisa Reuter; Lennart Weitgasser; Belinda Pletzer; Sebastian Rösch; Angelika Illg

doi:10.3389/fneur.2023.1272210

Hearing loss, depression, and cognition in younger and older adult CI candidates

Front Neurol. 2023 Oct 13:14:1272210. doi: 10.3389/fneur.2023.1272210. eCollection 2023.

Authors

Maria Huber¹, Lisa Reuter², Lennart Weitgasser¹, Belinda Pletzer³, Sebastian Rösch¹, Angelika Illg²

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
² Clinic for Otorhinolaryngology, Medical University of Hannover, Hannover, Germany.
³ Department of Psychology, Center for Neurocognitive Research, University of Salzburg, Salzburg, Austria.

Abstract

Background and aim: Hearing loss in old age is associated with cognitive decline and with depression. Our study aimed to investigate the relationship between hearing loss, cognitive decline, and secondary depressive symptoms in a sample of younger and older cochlear implant candidates with profound to severe hearing loss.

Methods: This study is part of a larger cohort study designated to provide information on baseline data before CI. Sixty-one cochlear implant candidates with hearing loss from adulthood onwards (>18 years) were enrolled in this study. All had symmetrical sensorineural hearing loss in both ears (four-frequency hearing threshold difference of no more than 20 dB, PTA). Individuals with primary affective disorders, psychosis, below-average intelligence, poor German language skills, visual impairment, and a medical diagnosis with potential impact on cognition (e.g., neurodegenerative diseases,) were excluded. Four-frequency hearing thresholds (dB, PTA, better ear) were collected. Using the Abbreviated Profile of Hearing Aid Benefit, we assessed subjective hearing in noise. Clinical and subclinical depressive symptoms were assessed with the Beck Depression Inventory (BDI II). Cognitive status was assessed with a neurocognitive test battery.

Results: Our findings revealed a significant negative association between subjective hearing in noise (APHAB subscale "Background Noise") and BDII. However, we did not observe any link between hearing thresholds, depression, and cognition. Additionally, no differences emerged between younger (25-54 years) and older subjects (55-75 years). Unexpectedly, further unplanned analyses unveiled correlations between subjective hearing in quiet environments (APHAB) and cognitive performance [phonemic fluency (Regensburg Word Fluency), cognitive flexibility (TMTB), and nonverbal episodic memory (Nonverbal Learning Test), as well as subjective hearing of aversive/loud sounds (APHAB)], cognitive performance [semantic word fluency (RWT), and inhibition (Go/Nogo) and depression]. Duration of hearing loss and speech recognition at quiet (Freiburg Monosyllables) were not related to depression and cognitive performance.

Conclusion: Impact of hearing loss on mood and cognition appears to be independent, suggesting a relationship with distinct aspects of hearing loss. These results underscore the importance of considering not only conventional audiometric measures like hearing thresholds but also variables related to hearing abilities during verbal communication in everyday life, both in quiet and noisy settings.

Keywords: cognition; hearing loss from adulthood; hearing restrictions during communication in quiet and in noise; secondary depression; younger and older adults.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants of DFG (Deutsche Forschungsgemeinschaft) Nr. 675532, the International Hearing Foundation (www.internationale-hoerstiftung.de), and CochlearTM (IIR 1947).