Longitudinal Associations Between Speech-in-Noise Deficits and Cognitive Function Over 8-Years: The Role of Hearing Aid Use and Environmental Noise Exposure

Semere Bekena; Ramkrishna K Singh; Nikitha Damera; Yiqi Zhu; Jean-Francois Trani; Kate McClannahan; Mollie Webb; Ganesh M Babulal

doi:10.1093/geronb/gbaf115

Longitudinal Associations Between Speech-in-Noise Deficits and Cognitive Function Over 8-Years: The Role of Hearing Aid Use and Environmental Noise Exposure

J Gerontol B Psychol Sci Soc Sci. 2025 Jun 24:gbaf115. doi: 10.1093/geronb/gbaf115. Online ahead of print.

Authors

Semere Bekena¹, Ramkrishna K Singh¹, Nikitha Damera¹, Yiqi Zhu¹, Jean-Francois Trani^{2

3}, Kate McClannahan⁴, Mollie Webb⁵, Ganesh M Babulal^{1

3}

Affiliations

¹ Department of Neurology, Washington University School of Medicine, St Louis, Missouri.
² Brown School of Social Work, Washington University in St Louis, Missouri.
³ Department of Psychology, University of Johannesburg, Johannesburg, South Africa.
⁴ Department of Otolaryngology-Head & Neck Surgery, St Louis, Missouri.
⁵ Data Services, WashU Libraries, Washington University in St Louis, St Louis, Missouri.

PMID: 40581785
DOI: 10.1093/geronb/gbaf115

Abstract

Objective: Hearing loss is a potentially modifiable risk factor for dementia, yet questions remain about its impact on cognitive trajectories. Hearing aid use has been proposed as a protective intervention, but findings are mixed. This study examined longitudinal associations between hearing loss, hearing aid use, and cognitive function, and explored the role of environmental noise exposure.

Methods: We prospectively studied 398 adults aged ≥65 years. Hearing status was assessed using the NIH Toolbox Words-in-Noise test and Hearing Handicap Inventory for the Elderly. Cognitive function was measured using the Preclinical Alzheimer's Cognitive Composite (PACC). Associations between hearing status, hearing aid use, and cognitive outcomes were evaluated using linear regression and mixed-effects models, adjusting for demographic and environmental covariates.

Results: Participants had a mean age of 73 years, with 53.5% female and 86.9% identifying as non-Hispanic White. Hearing loss was associated with lower PACC scores cross-sectionally (β = -0.04, p < 0.001). Longitudinally, poorer speech-in-noise was linked to lower cognitive scores (β = -0.02, p = 0.003). Compared to those with normal hearing, participants with hearing loss who did not use hearing aids had lower PACC scores (β = -0.17, p = 0.039). Hearing aid users did not differ significantly from the normal hearing group. However, hearing aid use was not a significant predictor in adjusted models. Environmental noise and neighborhood deprivation were not significant predictors.

Discussion: Hearing loss was associated with lower cognitive function, but hearing aid use did not significantly influence trajectories. Further research is warranted to clarify its role.

Keywords: Cognitive aging; Environmental acoustics; Hearing intervention; Self-perceived hearing handicap; Speech-in-noise processing; dementia risk.

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