Hearing loss and cognitive decline among older adults with atrial fibrillation:the SAGE-AF study

摘要

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation(AF).Methods Patients with AF≥65-year-old(n=1244)in the SAGE(Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and Georgia.Hearing was assessed by a structured questionnaire at baseline.Cognitive function was assessed by Montreal Cognitive Assessment(MoCA)at baseline and one year.Cognitive impairment was defined as score≤23 on the MoCA.The associations between hearing loss and cognitive function were examined by multivariable adjusted logistic regression.Results Participants with hearing loss(n=451,36%)were older,more likely to be male,and have depressive symptoms than patients without hearing loss.At baseline,528(42%)participants were cognitively impaired.Individuals with hearing loss were significantly more likely to have cognitive impairment at baseline[adjusted odds ratio(OR)=1.37,95%confidence interval(CI):1.05–1.81].Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit,106(16%)developed incident cognitive impairment.Individuals with,versus those without,hearing loss were significantly more likely to develop incident cognitive impairment at one year(adjusted OR=1.68,95%CI:1.07–2.64).Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with AF.Assessment for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.