The Relationship between Hearing Impairment and Cognitive Function in Middle-Aged and Older Adults: A Meta-Analysis

Lee, Soo Jung · 2018 · OpenAlex-citations

DOI: 10.12963/csd.18492

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Summary

This meta-analysis addresses the inconsistent findings in prior research regarding the relationship between hearing impairment and cognitive function in middle-aged and older adults. While some longitudinal and cross-sectional studies suggest that hearing loss accelerates cognitive decline, others report no significant association. The authors aimed to synthesize evidence from cross-sectional studies to determine whether hearing impairment is associated with specific cognitive deficits in this population, addressing previous limitations where studies varied in cognitive domains assessed and auditory dependency of tests. The study employed a systematic literature review and meta-analysis using Comprehensive Meta-Analysis version 3.0. Researchers searched five databases (PubMed, ProQuest, EBSCOhost, RISS, DBPIA) for studies published after 2000. From an initial pool of 1,500 records, 11 cross-sectional studies meeting strict inclusion criteria were selected. These studies compared cognitive performance between older adults with hearing impairment and normal-hearing controls. To account for variations in study design, four studies were split into separate data points based on hearing severity or distinct cognitive measures, resulting in 15 final data sets. Effect sizes were calculated using Hedges’ g with 95% confidence intervals under a random-effects model. Cognitive measures were categorized into six domains (general cognition, executive function/processing speed, working memory, language, verbal memory, and visuospatial ability) and classified by their reliance on auditory function. The results indicated that middle-aged and older adults with hearing impairment demonstrated significantly lower cognitive performance compared to normal-hearing controls across most domains. Specifically, significant deficits were found in general cognition (Hedges’ g = -0.468), executive function/processing speed (g = -0.521), working memory (g = -0.447), language (g = -0.242), and verbal memory (g = -0.276). However, no significant difference was observed in visuospatial ability (g = -0.196, p = 0.188). Crucially, hearing-impaired adults showed lower performance regardless of whether the cognitive measures primarily relied on auditory function or not, suggesting the deficit is not merely an artifact of test administration. Publication bias was assessed via Egger’s regression test and found to be absent. The study concludes that hearing impairment is significantly associated with cognitive deficits in middle-aged and older adults, particularly in executive function, memory, and language. The finding that deficits persist even in non-auditory dependent tasks supports theories such as the sensory deprivation hypothesis, which posits that reduced sensory input leads to long-term cognitive decline, rather than just the cognitive load hypothesis, which attributes deficits to the immediate effort of processing degraded auditory signals. These findings highlight the importance of considering hearing status in cognitive assessments and suggest that hearing impairment may be a modifiable risk factor for cognitive decline.

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• age related perceptual decline