Gait and Hearing Performance in Cognitively Unimpaired Adults: A Sex-Stratifyed Analysis

Hearing loss may contribute to mobility decline, but its relationship with gait in cognitively unimpaired adults and whether it differs by sex is unclear.

In this cross-sectional study, cognitively unimpaired adults aged 50-80 years from the DataCOG study were included. Gait was assessed using the instrumented Timed Up and Go test, and pure-tone audiometry (better-ear PTA exposure). Three prespecified composite gait outcomes (global duration, turning, walking duration) were modeled unadjusted, age/sex-adjusted, and sex-stratified, with HC3-robust linear regression. The a priori criterion was Holm-adjusted p < 0.05 across the three composites per model; sensitivity analyses added education, comorbidities/cognition, high-frequency PTA, and a WHO 20 dB HL threshold. Sex-stratified analyses were also performed.

A total of 172 participants were included (119 women; mean age 63.9 ± 8.1 years) all with complete exposure, outcome, age, sex, and education data. Unadjusted, worse hearing was associated with poorer performance on all three composites (Holm p ≤ 0.015). Adjusted for age and sex, global duration was borderline (Holm p = 0.050) and turning/walking duration no longer met the Holm-adjusted threshold (Holm p = 0.064, 0.131). Sex-stratified, age-adjusted estimates were larger in men (n = 53) than women (n = 119), but neither sex reached the Holm-adjusted threshold (men, Holm p = 0.054; women, Holm p ≥ 0.459).

Worse peripheral hearing was associated with poorer unadjusted gait performance. Adjustment and multiplicity correction attenuated this to borderline or non-significant, and apparent sex differences did not reach the prespecified threshold. These findings are hypothesis-generating and warrant confirmation.