Linking hearing, cognition, and social interaction (Arjmandi et al., 2024)
Creators: name: Arjmandi, Meisam K.
name: Neils-Strunjas, Jean
name: Nemati, Samaneh
name: Fridriksson, Julius
name: Newman-Norlund, Sarah
name: Newman-Norlund, Roger
name: Bonilha, Leonardo
Publisher: name: ASHA journals
Year: 2024
Subjects: classificationCode: 420102
subject: Audiology
classificationCode: 460212
subject: Speech recognition
classificationCode: 520401
subject: Cognition
classificationCode: 420301
subject: Aged health care

description: <b>Purpose: </b>Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults.<b>Method: </b>We analyzed data collected from 128 adults (20–79 years of age, <i>M</i><sub>age</sub> = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears.<b>Results: </b>Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population.<b>Conclusions: </b>Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted.<b>Supplemental Material S1.</b> Panel (A) shows the average pure-tone thresholds for 128 participants across 8 frequencies of 0.25, 0.5. 1, 2, 3, 4, 6, and 8 kHz for the right (red squares) and left (blue circles). Error bars show the confidence level of data around mean (i.e., the deviation along the mean values). Panel (B) shows the relationship between age on the<i> x</i>-axis and pure-tone average (dB HL) on the left <i>y</i>-axis (in green) and average WIN threshold (dB S/N) on the right <i>y</i>-axis (in medium orchid).<b>Supplemental Material S2.</b> Results of mediation analysis using bootstrapping to test whether PROMIS-57 social score serves as a mediator in linking WIN Thresholds to MoCA score. The model parameters are presented for the Initial Model (MoCA score ~ WIN Threshold), Mediation Model (MoCA score ~ WIN threshold + PROMIS-57 Social Score), and Bootstrap Analysis of Indirect Effect via PROMIS-57 social score.Arjmandi, M. K., Neils-Strunjas, J., Nemati, S., Fridriksson, J., Newman-Norlund, S., Newman-Norlund, R., &amp; Bonilha, L. (2024). Age-related hearing loss, cognitive decline, and social interaction: Testing a framework. <i>Journal of Speech, Language, and Hearing Research, 67</i>(8), 2743–2760. https://doi.org/10.1044/2024_JSLHR-23-00810