UMMS Affiliation

Division of Cardiovascular Medicine, Department of Medicine; Department of Population and Quantitative Health Sciences; Meyers Primary Care Institute

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Epidemiology | Geriatrics | Otorhinolaryngologic Diseases | Psychiatry and Psychology


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.


Atrial fibrillation, Cognitive function, Hearing

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Copyright ©2020 Institute of Geriatric Cardiology. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.

DOI of Published Version



Wang WJ, Lessard D, Abu H, McManus DD, Mailhot T, Gurwitz JH, Goldberg RJ, Saczynski J. Hearing loss and cognitive decline among older adults with atrial fibrillation: the SAGE-AF study. J Geriatr Cardiol. 2020 Apr;17(4):177-183. doi: 10.11909/j.issn.1671-5411.2020.04.002. PMID: 32362915; PMCID: PMC7189266. Link to article on publisher's site

Journal/Book/Conference Title

Journal of geriatric cardiology : JGC

PubMed ID


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Link to Article in PubMed

Creative Commons License

Creative Commons Attribution-Noncommercial-Share Alike 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.