Is Hearing Impairment Associated With Specific Behavioural and Psychological Symptoms of Dementia in Japanese Older Adults Attending a Memory Clinic?

Background: Behavioural and psychological symptoms of dementia (BPSD), encompassing disturbances in perception, thought, mood and behaviour, are prevalent among individuals with dementia and can substantially affect their quality of life. Although prior research has suggested that hearing impairment (HI) may exacerbate BPSD due to communication difficulties and diminished social engagement, the relationship between HI and specific BPSD manifestations remains insufficiently explored. This study aims to examine the association between HI and distinct BPSD in individuals with cognitive decline attending a memory clinic.

Methods: This study included 179 individuals with cognitive decline and their accompanying persons who visited a memory clinic between July 2023 and March 2024. Pure-tone audiometry and a questionnaire survey were conducted. HI was defined as an average hearing level of 40 dB or higher. BPSD was assessed using a questionnaire derived from the BPSD25Q, a 25-item questionnaire designed to evaluate BPSD. The association between HI and BPSD was analyzed using modified Poisson regression, with adjusted risk ratios (aRR) and 95% confidence intervals (CI) calculated.

Results: A total of 144 individuals were included in the analysis, with a mean age of 82.7 years, approximately 70% of whom were female. The aRR (95% CI) for the presence of specific BPSD among individuals with HI were as follows: anxiety, 2.08 (1.09-3.99); irritability, 1.73 (1.05-2.86); verbally aggressive behaviour, 3.41 (1.24-9.40); physically aggressive behaviour, 5.54 (1.31-23.40); leaving home unannounced, 4.22 (1.25-14.16); hoarding behaviour, 1.83 (1.06-3.16); resistance to care, 2.12 (1.02-4.40); and carelessness with fire, 4.46 (1.12-17.83). No significant association was observed between HI and other BPSD.

Conclusions: These findings suggest that HI may contribute to the presence of specific BPSD. Tailored interventions incorporating communication strategies and environmental modifications may help mitigate BPSD in individuals with cognitive decline and HI.