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Loneliness as a Pathway Linking Hearing Decline to Cognitive Aging: Longitudinal and Genetic Evidence
Shuai Yang1, Matthew D Grilli2, Robyn E Wootton3,4,5,6
1Department of Epidemiology and Biostatistics, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Summary
Hearing loss is linked to loneliness and cognitive decline. Loneliness partially mediates this association, but genetic factors may underlie both, suggesting shared liability rather than a direct causal link.
Area of Science:
- Gerontology
- Neuroscience
- Psychology
Background:
- Age-related hearing loss is associated with loneliness and cognitive impairment.
- The mediating role of loneliness in the hearing-cognition relationship and potential causal pathways are not well understood.
Purpose of the Study:
- To examine if loneliness mediates the association between hearing difficulty and cognitive performance, Alzheimer's disease dementia, and all-cause dementia.
- To investigate if hearing aid use buffers these associations.
- To explore shared genetic liability across hearing, loneliness, and cognition.
Main Methods:
- Triangulated analyses using observational data (Survey of Health, Ageing and Retirement in Europe - SHARE, N=10,375) and molecular genetic information.
- Longitudinal parallel-process latent growth curve models over nine waves (approx. 18 years).
- Genetic analyses including shared liability with neuroticism and colocalization analyses.
Main Results:
- Poorer hearing was associated with greater loneliness, which in turn was associated with poorer cognitive performance, indicating partial mediation.
- Worsening hearing over time was not clearly linked to increasing loneliness.
- Current hearing aid use weakened the concurrent association between hearing difficulty and loneliness, but cumulative use did not alter loneliness trajectories.
- Little evidence for direct causal effects of hearing or loneliness on dementia; findings suggest shared genetic liability.
Conclusions:
- A robust cross-domain association exists between poorer hearing, greater loneliness, and poorer cognitive performance.
- Long-term changes and genetic data suggest shared underlying liability rather than a single causal pathway.
- Loneliness may partially explain the link between hearing difficulties and cognitive decline.
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