[Correlation analysis between pure-tone thresholds at different frequencies and cognitive scores]

Objective:To examine the association between pure-tone thresholds at different frequencies and cognitive performance among adults aged 60-69 years using data from the NHANES. Methods:This cross-sectional study included NHANES participants aged 60-69 years who completed standardized pure-tone audiometry and the digit symbol substitution test（DSST）. Low-frequency, speech-frequency, and high-frequency PTAs were calculated. Weighted multivariable linear regression models were applied with progressive adjustment for sociodemographic factors, education, smoking status, obesity, and cardiovascular disease risk. Subgroup and interaction analyses were also performed. Results:A total of 1 232 participants were included, of whom 486（39.4%） comprised the hearing loss group. The median DSST score in the hearing loss group was significantly lower than that in the normal hearing group（54 vs 62, P<0.001）. In the unadjusted model, elevated pure-tone average（PTA） thresholds across all tested frequencies were significantly associated with lower DSST scores（P<0.001）. After multivariate adjustment, elevated PTA thresholds at low frequencies, speech frequencies, and high frequencies remained independently associated with lower DSST scores, with the strongest association observed for speech-frequency PTA. Subgroup analysis revealed a significant interaction between race and the association of PTA with DSST score（P for interaction=0.047）. Conclusion:Among adults aged 60-69 years, elevated pure-tone thresholds across frequency bands are independently associated with poorer cognitive performance, particularly at speech frequencies. Sociodemographic factors and cardiovascular disease risk factors may partially explain the observed associations.