Probability Distributions for Associations Between Cognitive Screening and Pure-tone Thresholds in Older Adults.
Jacqueline M Eberhard, Lois J Matthews, Kenneth I Vaden and 2 others
PMID 36607744WHAT IT FOUND
Hearing thresholds explained only 3.6% of the variance in cognitive screening scores.
The association depended almost entirely on the delayed recall item, suggesting that how words are heard and remembered, rather than general cognition, drives the link between hearing loss and lower screening scores.
Key findings
01The two thresholds together explained 3.6% of the variance in MMSE scores.
02The 0.5 kHz threshold, but not the 4.0 kHz threshold, explained unique variance in MMSE scores after accounting for age, sex, education, and multimorbidity.
03Excluding the delayed memory recall item from the total score significantly decreased the association between 0.5 kHz thresholds and MMSE scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot determine if hearing loss causes cognitive decline or if a common factor (like vascular health) causes both. The MMSE is a screening tool, not a full neuropsychological assessment, and its sensitivity to specific cognitive domains is limited. Health history was self-reported, which may be inaccurate for conditions like high blood pressure if participants were medicated or unaware of their status. The sample consisted of relatively healthy older adults who could travel to the study site, which may not represent those with severe hearing loss or significant cognitive impairment. The variance explained by hearing thresholds was very small (3.6%), suggesting that hearing loss is not a major driver of MMSE score variation in this population.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute on Aging (N.I.H., Extramural).
The easy way to misread this
Do not conclude that hearing loss is a primary cause of cognitive decline based on this study. The hearing thresholds explained only 3.6% of the variance in MMSE scores, and the association was largely confined to one memory item. This finding highlights a methodological artifact in screening tools rather than a strong clinical link between hearing sensitivity and global cognition.