This Month in Psychopharmacology

Hearing Loss, Hearing Aid Use, and Neuropsychiatric Symptoms among Persons Living with Dementia

Neuropsychiatric symptoms (NPS) such as depression, apathy, and agitation are highly prevalent in individuals living with dementia. NPS are associated with worse outcomes, increased caregiver burden, and higher health care costs. Sensory impairments, particularly hearing loss, have been implicated in the development of NPS, yet little is known about whether hearing interventions such as hearing aids may mitigate this risk. A recent cross-sectional study published in The American Journal of Geriatric Psychiatry used data from over 10,000 older adults with dementia in the National Alzheimer’s Coordinating Center (NACC) dataset to explore these associations.


Nearly a quarter of participants (24%) self-reported functional hearing loss. However, self-reported hearing loss was not associated with more or more severe NPS after adjusting for clinical and demographic covariates. Despite this, among individuals with hearing loss, hearing aid use was associated with a modest but statistically significant reduction in both the number and severity of NPS. These associations persisted after matching hearing aid users and non-users on key sociodemographic variables to reduce selection bias. The most common symptoms in both groups were apathy (~44%) and irritability (~40%), while hallucinations and elation were least common.


These findings suggest that hearing aid use may be a low-risk, underutilized strategy for managing NPS in dementia. Although causality cannot be inferred from this cross-sectional analysis, the data support a broader role for hearing care as part of a nonpharmacological approach to neuropsychiatric symptom management in dementia, especially given the known under-treatment of hearing loss in this population.


Reference:
Shankar A et al. Am J Geriatr Psychiatry. 2025;33(8):ePrint. Abstract


Alzheimer's Disease Education and Practice Resources

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Encore Presentation
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Encore Presentation
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