The impact of hearing loss on annual incident age-associated dementia cases and quality of life in the United States

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BACKGROUND: One-third of persons age 60 y+ have hearing loss, and hearing loss is a leading preventable risk factor for dementia. We estimated the number of age-associated dementia cases attributable to hearing loss in 2022. METHODS: We used DeciBHAL, a validated microsimulation of hearing loss that includes age- and sex-specific annual probabilities of incident hearing loss (0.1%-10.4%) and dementia (0.3%-7.1%). Utility decrements are incorporated yearly, based on hearing loss (-0.13 to -0.31) and dementia severity (-0.04 to -0.42), to calculate quality-adjusted life-years (QALYs). We estimated dementia incidence for persons with and without hearing loss by removing the estimated proportion attributable to hearing loss (adjusted incidence risk ratio, 2.0 [range: 1.5-2.5]). We projected two cohorts: the general US population and a hypothetical US population without hearing loss (counterfactual). We applied model-projected dementia incidence and utility among both cohorts to the 74 190 000 US adults >60 y and without dementia in 2022. RESULTS: Model-projected incident cases of dementia are 412 000/year (males) and 523 000/year (females). In the simulation without hearing loss, dementia cases/year fall to 339 000 for males and 455 000 for females projecting that 141 000 new dementia cases in 2022 would be attributable to hearing loss. In probabilistic sensitivity analysis, 95% of simulations projected the proportion of dementia cases attributable to hearing loss were 11.5%-23.6% for males and 6.7%-18.7% for females. Hearing loss and associated dementia reduced life-time QALYs by 1.38 for females and 1.69 for males. CONCLUSION: Model-projected estimates support that hearing loss prevention could substantially reduce new dementia cases and should be a priority.

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