Working memory capacity moderates the effect of hearing aid experience on phonological processing performance

Ning, Ruijing; Holmer, Emil; Danielsson, Henrik; Signoret, Carine; Micula, Andreea; Rönnberg, Jerker · 2025 · Crossref

DOI: 10.3389/fnins.2025.1519934

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Summary

This study investigates how working memory capacity (WMC) moderates the relationship between hearing aid experience and phonological processing performance. While hearing impairment is known to negatively impact cognitive functions, including phonological processing, the specific role of hearing aid use in this context remains underexplored. The authors aimed to distinguish the effects of hearing impairment from those of hearing aid use and to determine how WMC influences phonological processing in individuals with hearing loss, particularly regarding the reliance on compensatory cognitive strategies. The researchers utilized data from the n200 project, analyzing three groups: hearing aid users (HA, n = 202), hearing-impaired individuals without hearing aids (noHA, n = 54), and normal-hearing controls (NH, n = 201). Phonological processing was assessed using a visual rhyme judgment task, where participants determined if printed word pairs rhymed. WMC was measured using three complex span tests (reading span, semantic word pair, and visuo-spatial working memory), which were combined into a weighted WMC score via exploratory factor analysis. Generalized linear mixed models (GLMMs) were employed to analyze accuracy and reaction times, controlling for age, hearing level, and word-pair difficulty. Results indicated that hearing impairment, regardless of hearing aid use, was associated with an increased dependence on WMC for phonological processing. Specifically, higher WMC predicted better accuracy and faster reaction times for both hearing-impaired groups, whereas this relationship was weaker or absent in the normal-hearing group. Furthermore, hearing aid use was positively associated with rhyme judgment performance. Crucially, the study found that WMC moderated the effect of hearing aid experience; the benefits of hearing aid use on processing speed and accuracy were more pronounced for individuals with higher WMC. This interaction suggests that hearing aids do not simply restore auditory input but require cognitive resources to process the amplified signals effectively. The findings conclude that WMC plays a critical role in the effectiveness of hearing aids for phonological processing. The enhanced reliance on WMC in hearing-impaired individuals likely stems from the need for compensatory top-down strategies, such as articulatory recoding, to handle degraded auditory signals. The study implies that hearing aid rehabilitation outcomes are not uniform but depend on the user’s cognitive capacity. Consequently, assessing and potentially training working memory could be integral to optimizing hearing aid benefits and supporting language processing in individuals with hearing loss.

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• cognitive capacity variation