Age-related hearing loss and neuropathologic burden: A step inside the cognitive ear

Early age-related hearing loss may influence the boundaries between normal and pathologic cognitive aging. Recent epidemiologic data from large population-based studies have prompted the identification of age-related hearing loss as the most important modifiable risk factor for dementia in midlife.1,2 Age-related hearing loss results from a complex impairment mostly involving central auditory pathways in addition to senescence of the inner ear cells. Several pointers show a possible association between age-related central auditory processing disorder and the likelihood of developing dementia.2 The most plausible association is based on the dynamic interaction between auditory and cognitive processing. The evidence for a strong link between age-related central auditory processing disorder and cognition has led to the provocative term “the cognitive ear” that implies that other associative cortical areas process hearing functions in addition to the ear and the auditory cortex.3

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