Age-Related Sensory Impairment and Cognitive Decline in Geriatric


  • Dewi Pratiwi Department of Otorhinolaryngology Head and Neck Surgery, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret Surakarta, Central Java
  • Aulia Hervi Anggraini Department of Otorhinolaryngology Head and Neck Surgery, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret Surakarta, Central Java
  • Febri Arianto Bayu Department of Otorhinolaryngology Head and Neck Surgery, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret Surakarta, Central Java


Background: Incidence of sensory impair­ment and cognitive decline were increase with aging, each would give a considerable impact on public health and quality of life especially in geriatric population. Several mechanisms have been proposed to account for the correlation between sensory impairment and cognitive decline and the common mechanisms were sensory deprivation, information degradation, cognitive load, resource allocation and or social isolation. Prolonged reductions in the quality or quantity of sensory input lead to cognitive deterioration due to neuronal atrophy. This study aimed to determine whether age related sensory impairment with cognitive decline.

Subjects and Method: This was a cross-sectional study design conducted at geriatric clinic, Dr. Moewardi General Hospital, Sura­karta, from May 31 to July 1, 2018. A sample of 54 elderly aged ≥60 years old was selected by consecutive sampling. The dependent variable was cognitive decline. The independent varia­bles were presbyacusis, presbyastasis, olfactory impairment, diabetes, and hypertension. Pres­bycusis was measured by Pure Tone Audio­metry. Presbyastasis was measured by Dynamic Visual Acuity (DVA) test. Olfactory dysfunction was measured by sniffing test. Cognitive decline was assessed by MoCA-Ina questionnaire. The data were analyzed by Chi-square test.

Results: The mean age of subjects was 70.5 years old ranging from 61-81 years old and most of the subjects were females (72.2%). Pure tone audiometry test revealed that 44.4% pati­ents had presbycusis. Dynamic Visual Acuity test showed that 25.9% patients had pres­byas­tasis. Sniffing test revealed that 29.6% patients had olfactory dysfunction. Presbyacusis (OR= 11.9; 95% CI= 1.3 to 105.5; p= 0.008) and olfac­tory dysfunction (OR= 10.8; 95% CI= 1.8 to 61.9; p= 0.002) increased cognitive decline, and they were statistically significant. Presbyas­tasis decreased cognitive decline (or= 0.9; 95% CI= 0.1 to 5.3; p= 0.948), but it was statis­tically non-significant

Conclusion: Sensorineural health may serve as a marker of brain aging therefore sensory measures can be used as screening tools for cognitive decline risk.

Keywords: sensory impairment, presbycusis, presbyastasis, olfactory dysfunction, cognitive decline

Correspondence: Dewi Pratiwi. Department of Otorhinolaryngo­logy Head and Neck Surgery, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret Surakarta, Central Java. Email: pratiwi­

Indonesian Journal of Medicine (2020), 05(02): 153-161


Ben Assayag E, Eldor R, Korczyn AD, Kliper E, Shenhar Tsarfaty S, Tene O, Molad J, Shapira I, et al. (2017). Type 2 diabetes mellitus and impaired renal function are associated with brain alterations and poststroke cognitive decline. Stroke, 48(9): 2368–2374.

Attems J, Walker L, Jellinger KA (2015). Olfaction and aging: A mini review. Gerontology, 61(6): 485–490.

Baek JH, Zheng Y, Darlington CL, Smith PF (2010). Evidence that spatial memory deficits following bilateral vestibular deafferentation in rats are probably permanent. Neurobiology of Learning and Memory, 94(3): 402–413.

Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS (2006). The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurology. 5(5): 406–412.

Brandt T, Schautzer F, Hamilton DA, Brüning R, Markowitsch HJ, Kalla R, Darlington C, Smith P, Strupp M (2005). Vestibular loss causes hippocampal atrophy and impaired spatial memory in humans. Brain, 128 (11): 2732–2741.

Conti MZ, Vicini Chilovi B, Riva M, Zanetti M, Liberini P, Padovani A, Rozzini L (2013). Odor identification deficit predicts clinical conversion from mild cognitive impairment to dementia due to alzheimer’s disease. Archives of Clinical Neuropsychology, 28(5): 391–399.

Dieterich M, Brandt T (2008). Functional brain imaging of peripheral and central vestibular disorders. Brain, 131 (10): 2538–2552.

Dobbels B, Peetermans O, Boon B, Mertens G, Van de Heyning P, Van Rompaey V (2019). Impact of bilateral vestibulopathy on spatial and nonspatial cognition. Ear and Hearing. 40:. 757–765.

Gurgel RK, Ward PD, Schwartz S. Norton MC, Foster NL, Tschanz JT (2014). Relationship of hearing loss and dementia: A prospective, populationbased study. Otology and Neurotology, 35(5): 775–781.

Gurvich C, Maller JJ, Lithgow B, Haghgooie S, Kulkarni J (2013). Vestibular insights into cognition and psychiatry. Brain Research, 1537: 244–259.

Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, Seeber H, Pauli E, Hummel T (2000). Multicenter investigation of 1,036 subjects using a standardized method for the the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Otorhinolaryngol. 257(4):205-11.

Kovács T (2004). Mechanisms of olfactory dysfunction in aging and neurodegenerative disorders. Ageing Research Reviews. 3: 215–232.

Lazarov O, Robinson J, Tang YP, Hairston IS, Korade Mirnics Z, Lee VM, Hersh LB, et al. (2005). Environmental enrichment reduces Aβ levels and amyloid deposition in transgenic mice. Cell, 120(5): 701–713.

Lin FR (2011). Hearing loss and cognition among older adults in the United States. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 66(10): 1131–1136.

Lin FR, Ferrucci L, Metter EJ, An Y, Zonderman AB, Resnick SM (2011). Hearing loss and cognition in the baltimore longitudinal study of aging. Neuropsychology, 25(6): 763–770.

Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase Helzner E, et al. (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine.

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, et al. (2017). Dementia prevention, intervention, and care. Lancet (London, England), 390(10113): 2673–2734.

Barnes LL, Mendes de Leon CF, Wilson RS, Bienias JL, Evans DA (2004). Social resources and cognitive decline in a population of older African Americans and whites. Neurology. 63(12): 2322–2326.

Loughrey DG, Kelly ME, Kelley GA, Brennan S, Lawlor BA (2018). Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia a systematic review and meta-analysis. JAMA Otolaryngology - Head and Neck Surgery, 144(2): 115–126.

Lucieer F, Duijn S, Van Rompaey VV, Fornos AP, Guinand N, Guyot JP, Kingma H, Raymond van de Berg (2018). Full spectrum of reported symptoms of bilateral vestibulopathy needs further investigation A systematic review. Frontiers in Neurology, 9: 1–7.

Roberts RO, Christianson TJ, Kremers WK, Mielke MM, Machulda MM, Vassilaki M, Alhurani RE, Geda YE, Knopman DS, Petersen RC (2016). Association between olfactory dysfunction and amnestic mild cognitive impairment and alzheimer disease dementia. JAMA Neurol. 73(1):93-101. doi: 10.1001/jamaneurol.2015.2952.

Nascimbeni A, Gaffuri A, Penno A, Tavoni M (2010). Dual task interference during gait in patients with unilateral vestibular disorders. Journal of Neuroengineering and Rehabilitation, 7: 47.

Rambe AS, Fitri FI (2017). Correlation between the Montreal cognitive assessment-Indonesian version (Moca-INA) and the mini mental state examination (MMSE) in elderly. Open Access Macedonian Journal of Medical Sciences, 5(7): 915–919.

Semenov YR, Bigelow RT, Xue Q, Lac S, Agrawal Y (2016). Association between vestibular and cognitive function in U.S. adults: Data From the National Health and Nutrition Examination Survey. 71(2): 243–250.

Smith PF (2017). The vestibular system and cognition. Current Opinion in Neurology. 30: 84–89.

Sogebi OA, Adefuye BO, Adebola SO, Oladeji SM, Adedeji TO, et al. (2016). Hearing loss and incident dementia. Archives of Neurology, 21(1): 214–221.

Ventre Dominey J (2014). Vestibular function in the temporal and parietal cortex: distinct velocity and inertial processing pathways. Frontiers in Integrative Neuroscience, 8: 1–13.

WHO (2016). Grades of hearing impairment. Prevention of Blindness and Deafness. Retrieved from

Wilson RS, Arnold SE, Schneider JA, Tang Y, Bennett DA (2007). The relationship between cerebral Alzheimer’s disease pathology and odour identification in old age. Journal of Neurology, Neurosurgery and Psychiatry, 78(1): 30–35.

World Health Organisation. (2018). Addressing the rising prevalence of hearing loss.

Wysocki M, Luo X, Schmeidler J, Dahlman, K, Lesser GT, Grossman H, et al. (2012). Hypertension is associated with cognitive decline in elderly people at high risk for dementia. American Journal of Geriatric Psychiatry. 20: 179–187.

Yamada Y, Denkinger MD, Onder G, Henrard JC, Van Der Roest HG, Finne Soveri H., et al. (2015). Dual sensory impairment and cognitive decline: The results from the shelter study. Journals of Gerontology - Series A Biological Sciences and Medical Sciences.