Self-reported hearing loss, hearing aid use, and cognitive function among U.S. older adults

There has been increasing attention to the role of hearing loss as a potentially modifiable risk factor for Alzheimer's disease and related dementias. However, more nationally-representative studies are needed to understand the co-occurring changes in hearing loss and cognitive function in older adults over time, and how hearing aid use might influence this association. The purpose of this report is to examine how age-related changes in hearing loss and hearing aid use are associated with trajectories of cognitive function in a nationally-representative sample of U.S. older adults. We used 11 waves of longitudinal data from the Health and Retirement Study (HRS) from 1998 to 2018 to examine changes in self-reported hearing loss, hearing aid use, and cognitive function in adults 65 and older by race and ethnicity. Results from mixed models showed that greater levels of hearing loss were associated with lower levels of cognitive function at age 65 in non-Hispanic White, non-Hispanic Black, and Hispanic older adults. We also found that the associations diminished across age in White and Black individuals; but remained persistent in Hispanic individuals. The use of hearing aids was not associated with cognitive function in Black older adults but appeared protective for White and Hispanic older adults. Overall, the findings from this report suggest that the timely identification of hearing loss and subsequent acquisition of hearing aids may be important considerations for reducing declines in cognitive function that manifests differently in U.S. population subgroups.