Self-reported hearing loss, hearing aid use, and cognitive function among U.S. older adults

There has been increasing attention to the role of hearing loss as a potentially
modifiable risk factor for Alzheimer’s disease and related dementias. However, more
nationally-representative studies are needed to understand the co-occurring changes in hearing
loss and cognitive function in older adults over time, and how hearing aid use might influence
this association. The purpose of this report is to examine how age-related changes in hearing
loss and hearing aid use are associated with trajectories of cognitive function in a nationallyrepresentative sample of U.S. older adults. We used 11 waves of longitudinal data from the
Health and Retirement Study (HRS) from 1998 to 2018 to examine changes in self-reported
hearing loss, hearing aid use, and cognitive function in adults 65 and older by race and ethnicity.
Results from mixed models showed that greater levels of hearing loss were associated with
lower levels of cognitive function at age 65 in non-Hispanic White, non-Hispanic Black, and
Hispanic older adults. We also found that the associations diminished across age in White and
Black individuals; but remained persistent in Hispanic individuals. The use of hearing aids
was not associated with cognitive function in Black older adults but appeared protective for
White and Hispanic older adults. Overall, the findings from this report suggest that the timely
identification of hearing loss and subsequent acquisition of hearing aids may be important
considerations for reducing declines in cognitive function that manifests differently in U.S.
population subgroups.