Association Between TBI-Related Hearing Impairment and Cognition: A TRACK-TBI Study.
Phillip H Hwang, Lindsay D Nelson, Jeffrey D Sharon and 5 others
PMID 34698685WHAT IT FOUND
Among adults after TBI, self-reported hearing impairment at 2 weeks was associated with worse executive-function scores at 6 months, but not with processing-speed scores.
The association was small and based on self-report, not audiometry.
Key findings
01The adjusted TMT B/A ratio was 0.25 greater among participants with TBI-related hearing impairment at 2 weeks, indicating worse executive-function performance because lower values on this ratio are better.
02No significant association was found between TBI-related hearing impairment at 2 weeks and WAIS-IV processing speed score at 6 months.
03Bilateral hearing impairment was associated with a TMT B/A ratio 0.37 greater, while single-ear impairment was not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Hearing impairment was measured by participant or surrogate self-report at 2 weeks, not by audiometry, so some participants may have been misclassified. The analytic sample was 1,267 participants, while 2,552 participants were eligible, so missing hearing or cognitive data may affect the results. The cohort included only English or Spanish speakers, participants at least 17 years old, and people seen at academic Level I trauma centers who received a head CT scan, so results may not apply to younger patients, other languages, or settings without CT. The moderate-to-severe TBI subgroup had 97 participants, so subgroup estimates were imprecise. The study reports associations, not causal effects, and residual confounding may remain. Authors note that the TMT B/A ratio may not add clinical utility in TBI, although their Part B sensitivity analysis was similar. Participants with more severe injuries who could not provide self-reported hearing impairment were not included.
Declared interests
No conflicts of interest statement is provided in the supplied text. The publication types list NIH extramural and U.S. government non-PHS research support.
The easy way to misread this
Do not conclude that hearing impairment caused worse cognition or that treating hearing loss will improve cognition. This was an observational cohort using self-reported hearing at 2 weeks and non-auditory tests at 6 months, and the authors say the results are associations rather than causal relationships.