Cross-National Comparison of Hearing Difficulty, Social Activities, and Verbal Memory: United States, Mexico, and China.

This paper examines whether social activities mediate the association between hearing difficulty and cognitive function across contexts. Data come from the Health and Retirement Study (2012-2020), Mexican Health and Aging Study (2015-2021), and China Health and Retirement Longitudinal Study (2011-2018). Weighted multilevel generalized models were used. Hearing difficulty was associated with lower verbal memory in each database while the MHAS showed a comparatively smaller effect (b = -0.094, < .001; b = -0.080, < 0.01, and b = -0.093, < 0.001). These associations remained statistically significant after adjusting for social activities. Hearing difficulty is associated with decreased social activities in HRS and CHARLS, but not in MHAS. Social activities partially mediate the hearing-verbal memory association in HRS and CHARLS, but not in MHAS, which highlights a non-uniform association between hearing difficulty, social activities, and cognition across contexts.