Hearing Impairment, Hearing Aid Use, and Cognitive Outcomes in Older Adults: <i>A Cross‐Sectional Study</i>
Bibliographic record
Abstract
BACKGROUND: The 2024 Lancet Commission on Dementia Prevention recognizes midlife hearing loss as a modifiable contributor to dementia risk. Hearing impairment affects approximately 68% of U.S. adults over 70 and is associated with accelerated cognitive aging, with a 25 dB hearing deficit linked to cognitive decline equivalent to 6.8 years of aging. This study assessed hearing impairment, measured via NIH Toolbox Words-in-Noise (WIN), and its influence on cognition while adjusting for area deprivation index (ADI), race, neighborhood noise levels, and self-perceived hearing difficulty using the Hearing Handicap Inventory (HHI). Secondary analysis examined if associations differed by race and hearing aid use. METHOD: We conducted a cross-sectional study of 420 older adults (mean age 72.5 ± 5.15 years) classified as having impaired (n = 179) or normal hearing (n = 241) based on WIN thresholds. Data on hearing aid use, HHI scores, demographics, neighborhood noise, and ADI were collected. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Preclinical Alzheimer Cognitive Composite (PACC). Multiple linear regressions examined associations between hearing measures and cognition, adjusting for covariates. Interaction terms for hearing, race, and hearing aid use were tested. Statistical significance was set at p <0.05. RESULT: Participants with impaired hearing (n = 179) were older (73.9 vs. 71.4 years, p <0.001), often male (61.5% vs. 36.5%, p <0.001), and had lower cognitive scores than normal-hearing individuals (n = 241). Both PACC and MoCA assessments showed similar results, with impaired-hearing participants performing worse on PACC (-0.35 vs. 0.009, p <0.001) and MoCA (23.9 vs. 25.7, p <0.001). Race distributions differed (p = 0.009), but neighborhood-level deprivation (p = 0.518) did not. In adjusted models, higher (worse) WIN thresholds were significantly associated with lower cognitive scores (p <0.01) in MoCA and PACC, controlling for age, sex, race, education, and neighborhood noise levels. Hearing aid use was associated with higher PACC scores (p = 0.003), suggesting a protective effect on cognitive function. However, HHI scores were still not significantly related to cognitive outcomes. All interaction terms were not significant. CONCLUSION: Hearing impairment is significantly associated with lower cognitive performance, while hearing aid use may provide cognitive benefits. However, self-reported hearing difficulty (HHI) was not a significant predictor of cognition, highlighting the importance of objective hearing assessments.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".