Distinct Patterns of Cortical Atrophy Predict Cognitive Progression in Age-Related Hearing Loss: A Longitudinal MRI Study

BACKGROUND AND OBJECTIVE: Age-related hearing loss (ARHL) and dementia are common chronic conditions among the elderly, significantly impacting the quality of life of older adults. Additionally, ARHL is an important and modifiable risk factor for dementia. This study aimed to investigate distinct patterns of cortical atrophy in patients with ARHL and mild cognitive impairment (MCI), comparing those with stable cognition (sMCI) versus those who progressed to dementia (pMCI), using longitudinal MRI data. MATERIALS AND METHODS: A total of 93 participants from ADNI were included: 51 sMCI with normal hearing (sMCI+HC, Group 1), 20 sMCI with ARHL (sMCI+ARHL, Group 2), and 22 pMCI with ARHL (pMCI+ARHL, Group 3). All subjects underwent three longitudinal T1-weighted MRI scans at approximately one-year intervals. Cortical thickness was measured using Freesurfer 6.0 in regions including the entorhinal cortex, parahippocampal gyrus, and temporal gyri. Repeated-measures ANOVA was used to compare atrophy rates, and ROC analysis evaluated the predictive value of significant regions. RESULTS: Group 3 showed significantly faster annual atrophy rates in the left entorhinal cortex, left middle temporal gyrus, and bilateral superior temporal gyri compared to Group 1. Group 2 also exhibited faster atrophy in temporal regions than Group 1. ROC analysis demonstrated that combined use of these regions improved predictive accuracy for cognitive progression. CONCLUSIONS: ARHL patients with progressive cognitive decline exhibit accelerated atrophy in auditory and early AD-vulnerable regions. Combined cortical thickness measures may serve as a neuroimaging biomarker to predict cognitive progression in ARHL populations.