Association of social relationships and hearing impairments with behavioural and psychological symptoms of dementia in a Japanese memory clinic.

Background: Behavioural and psychological symptoms of dementia (BPSD) negatively impact the quality of life of patients with dementia and their surrounding caregivers. Therefore, identifying modifiable factors to prevent BPSD is crucial. This cross-sectional study investigated the association between hearing impairment (HI), social relationships, and BPSD.

Methods: A survey involving 179 patients who attended a memory clinic was conducted between July 2023 and March 2024. Pure-tone audiometry and questionnaire interviews were conducted, while medical records were reviewed. HI was defined as an average hearing level ≥ 40 dB, measured by pure-tone audiometry using the better-hearing ear. BPSD presence and severity were assessed using the BPSD25Q-based questionnaire. Multiple regression analysis was used for calculating partial regression coefficients to assess the association between HI, social relationship indicators, and BPSD presence and severity, adjusting for confounders.

Results: Among the 144 participants included in the analysis, the mean age was 82.7 years, and 96 (66.7%) were female individuals. Using multiple regression analysis, individuals with HI, whether living with others (β = 1.49, P = 0.038) or living alone (β = 2.23, P = 0.044) had a higher presence of BPSD, compared with those without HI who live with others. Additionally, those with HI who regularly engaged in conversations (β = 1.51, P = 0.027) or did not participate in social interactions (β = 2.02, P = 0.020) also had a higher presence of BPSD, compared with individuals without HI in similar circumstances. Similarly, those with HI and living alone (β = 4.54, P = 0.033) and lacking social interaction (β = 3.89, P = 0.020) experienced increased BPSD severity.

Conclusion: Our findings indicated that living alone and lacking social interaction with having HI were linked to both the presence and severity of BPSD. Additionally, increased verbal communication through conversations with cohabiting family members and others in patients with HI was associated with a higher presence of BPSD. Reducing communication stress and maintaining social connections are essential for managing these challenges.