[P2–554]: SELF‐REPORTED HEARING LOSS, COGNITIVE PERFORMANCE, AND RISK OF MCI: FINDINGS FROM THE WISCONSIN REGISTRY FOR ALZHEIMER's PREVENTION

15004 / Proposal ID P1-554 Public Health and Psychosocial: Epidemiology Posters Sunday, July 16, 2017: 9:30 AM Self-Reported Hearing Loss, Cognitive Performance, and Risk of MCI: Findings from the Wisconsin Registry for Alzheimer’s Prevention Taylor N. Fields(tfields@wisc.edu), Ozioma C. Okonkwo, PhD, Sterling C. Johnson, PhD, Kimberly D Mueller, MS and Ruth Y. Litovsky, PhD Neuroscience Training Program, University of Wisconsin Madison, Madison, WI, USA, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, Binaural Hearing and Speech Lab, Madison, WI, USA, Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA, University of Wisconsin, Madison, Madison, WI, USA, Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI, USA, Department of Communication Sciences and Disorders, University of Wisconsin Madison, Madison, WI, USA, Department of Surgery, Division of Otolaryngology, University of Wisconsin Madison, Madison, WI, USA Background: Auditory deficits are present in Alzheimer’s disease dementia (AD) but it remains largely unknown whether they precede or are concomitant with the disease. The aim of this study was to determine the prevalence of hearing loss in a cohort of middle-aged adults at risk for AD, and evaluate whether hearing loss is associated with prospective cognitive decline and progression to mild cognitive impairment (MCI). Methods: Seven hundred and eighty-three cognitively-normal adults (age=53.55±6.52 years, 71% women, and 42% with maternal history of AD) enrolled in the Wisconsin Registry for Alzheimer’s Prevention participated in this study. Participants underwent serial cognitive and clinical assessments and self-reported whether they had ever been diagnosed with hearing loss as part of a medical history questionnaire. Diagnosis of MCI was rendered via a multidisciplinary consensus conference. Frequency distribution was used to assess prevalence of hearing loss. Covariate-adjusted linear regression was used to assess the relationship between hearing loss at initial assessment and cognitive performance at a subsequent visit four years later. Binary logistic regression was used to estimate risk of incident MCI as a function of prior hearing loss, after controlling for relevant covariates. Results: 72 (9.20%) participants reported having a diagnosed hearing loss whereas 711 (90.80%) participants reported having normal hearing. Relative to those who reported normal hearing, individuals who reported hearing loss scored significantly poorer on tests of processing speed and set switching (Trail Making Test parts A&B, p=.046 and .025, respectively), cognitive flexibility (Stroop Color-Word Interference, p=.014), psychomotor speed (WAIS-R Digit Symbol Substitution Test, p=.012) and a composite measure of Speed and Flexibility (p=.030) four years later. The odds of being characterized as having MCI at the latter visit were over three times higher for those who had reported hearing loss at the initial or intermediate visits (mean time interval=2.50±.47 years), relative to those who had not (OR=3.26 p=.047, 95% CI 1.02-10.44). Conclusions: In this cognitively-normal, at-risk cohort, self-reported hearing loss was prospectively associated with poorer cognitive performance and increased incidence of progression to MCI. Identification and treatment of hearing loss might be a viable approach to forestall the public health crisis posed by AD. EMBARGOED FOR RELEASE UNTIL MONDAY, JULY 17, 2017, 8 AM BST / 3 AM EDT Page 7 of 7 Abstract 17960 / Proposal ID O2-06-05 Epidemiology: Novel Risk Factors, Comorbidities and Biomarkers Oral session, Monday, July 17, 2017: 2:00-3:30 PM Cognitive Decline after Elective and Nonelective Hospitalization in Community-Dwelling Older Adults Bryan D James, PhD (bryan_james@rush.edu), Raj C Shah, MD, Robert S Wilson, PhD, Patricia A Boyle, PhD, Ana W. Capuano, Ph.D., Melissa Lamar, PhD, David A. Bennett, MD and Julie A. Schneider, M.D., M.S., Rush Alzheimer's Disease Center, Chicago, IL, USA Background: Accelerated cognitive decline after hospitalization of older adults is widely recognized, but there is little data as to whether elective hospital admissions are associated with the same negative cognitive outcomes as nonelective (emergent or urgent) admissions. We tested the hypothesis that elective hospitalizations are associated with less acceleration in cognitive decline as compared to nonelective hospitalizations in older adults. Methods: Data came from 930 older adults (74.5% female, mean age = 80.8 years) enrolled in the Rush Memory and Aging Project for which annual cognitive assessments (battery of 19 cognitive tests) were linked to over a decade of Medicare claims records. The MedPAR file codes all hospital admissions as elective, emergency, or urgent. We fit a series of mixed effects regression models with global cognitive function as the outcome with time-varying separate indicators for having elective or nonelective hospitalizations, and their interactions with time. Results: Of the 930 participants, 613 were hospitalized at least once over an average of 4.8 (SD=2.6) years of follow-up; 260 (28.0%) had at least one elective hospital admission, and 553 (59.5%) had at least one nonelective hospital admission. Two hundred participants (21.5%) had both an elective and nonelective hospitalization. In separate models adjusted for age at baseline, sex, education, and self-reported chronic medical conditions, the rate of cognitive decline accelerated (as compared to rate of change with no hospitalization) after elective hospitalizations (estimate = -0.025, p<0.001) and the acceleration was almost twice as fast after nonelective hospitalizations (estimate = -0.043, P<0.001). When both types of hospitalizations were put in the same model, nonelective hospitalizations were related to faster cognitive decline (estimate= -0.042, p<0.001) but the association for elective hospitalizations was markedly attenuated and not significant (estimate= -0.002, p=0.81). Inferences were essentially unchanged after adding terms for mean length of stay, surgeries, ICU stays, and Charlson comorbidity index, a measure of seriousness of illness. Conclusions: These data indicate that elective hospitalizations are not significantly related to acceleration in cognitive decline in older persons after accounting for nonelective hospitalizations.