Association Between Age-Related Sensory and Metabolic Hearing Loss and Cognitive Performance.

Cross-sectional design: correlations cannot establish that hearing loss causes cognitive slowing or vice versa. The metabolic and sensory estimates come from a mathematical model fitted to audiogram shapes, not from tissue measurement. Other researchers have argued that audiogram shape cannot reliably identify strial degeneration because hair cell loss may mask it. The metabolic component is more correlated with the pure-tone average than the sensory component, so the finding may partly reflect this overlap rather than a distinct biological effect. No lifetime noise exposure data were collected, and no objective vascular measures were taken. Sample size of 100 (5 excluded) limits statistical power, particularly for the executive function outcome where the association disappeared with age adjustment. Hypertension was self-reported only, with no information on whether participants were actively treating it.

Funded by the GN Store Nord Foundation. The foundation was not involved in study design, conduct, or interpretation. Authors declared no conflicts of interest.

Do not read the metabolic-hearing-loss link to processing speed as proof of a shared biological pathway. The metabolic and sensory estimates come from a mathematical model fitted to audiogram shapes, not from tissue measurement, and the executive function association disappeared once age was controlled.