Introduction: Hearing impairment is an emerging modifiable risk factor for dementia, but the relative predictive abilities of subjective and objective measures of hearing in dementia risk prediction algorithms are unclear. The objective was to develop and validate prediction models for 3-year incidence of dementia in older Canadians, and to evaluate the independent contribution of self-rated hearing impairment and audiometry-based moderate hearing loss. --
Methods: Baseline (2011 to 2015) and 3-year follow-up data from the Comprehensive cohort of the Canadian Longitudinal Study of Aging were used to build logistic regression models for 3-year incidence of dementia. Individuals who were under 55 years of age, reported physician-diagnosed dementia at baseline, and/or did not have data on dementia status at follow-up were excluded, producing a sample of 19,830 older Canadians. Hearing impairment was defined subjectively as self-reporting fair or poor hearing (versus excellent, very good, or good hearing) and was defined objectively as having a better-ear pure-tone average of the speech-frequencies (500, 1000, 2000, and 4000 Hz) above 40 dB with audiometry. --
Results: Both hearing measures were associated with dementia incidence after adjustment with other risk factors (self-rated fair/poor hearing adjusted odds ratio (aOR) 1.76, CI 0.96-3.23, audiometry-derived hearing loss aOR 2.60, CI 1.38-4.87). Audiometrically-derived hearing loss and self-rated hearing had similar population discrimination (c-statistic of model with self-rated hearing = 0.803, CI 0.752-0.859, c-statistic of model with audiometrically confirmed hearing loss = 0.808, CI 0.762-0.870) and similar calibration. --
Conclusion: Due to the accessibility of the self-reported hearing measure, the use of self-rated hearing in dementia risk prediction tools may have a larger clinical impact than audiometrically-defined hearing ability. Model performance within subgroups (e.g., older age groups, hypertension status, etc.) must be evaluated in future work to assess the magnitude of miscalibration, if any, in the use of self-reported hearing ability compared to audiometry.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/45230 |
| Date | 08 August 2023 |
| Creators | Chan, Therese |
| Contributors | Manuel, Douglas G. |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
| Rights | Attribution-NonCommercial 4.0 International, http://creativecommons.org/licenses/by-nc/4.0/ |
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