Hearing Loss and Cognition in the Busselton Baby Boomer Cohort: An Epidemiological Study

Objectives/Hypothesis: To determine the relationship between peripheral hearing loss (HL) in baby boomers (better ear measure) and cognitive function, taking into account the impact of depression or cognitive reserve on this relationship and exploring binaural hearing. Study Design: A prospective, epidemiology study. Methods: Data from 1,969 participants aged 45 to 66 years were collected in the Busselton Healthy Ageing Study. Participants were assessed using pure-tone air-conduction thresholds at octave frequencies (250; 500; 1,000; 2,000; 4,000; and 8,000 Hz). Hearing loss was grouped using 1) pure-tone averages across 4 frequencies (500 to 4000Hz) in the better ear (BE4FA) or 2) latent profile analysis (LPA) using all thresholds from both ears. Cognition was tested with the Cognitive Drug Research System, verbal fluency, and National Adult Reading Test (premorbid-lQ). Regression was used to determine the impact of HL relative to no HL on age and education-adjusted cognition, controlling for mood, sex, and premorbid-lQ. Results: According to BE4FA, 4.7% had mild (26-40 dB) HL; 0.8% had moderate (41-60 dB) HL; and 0.3% had severe (61-80 dB) HL. Based on the LPA, 20.5% had high-frequency HL; 7.8% had mid- to high-frequency HL; and 1.9% had significant HL across all frequencies. The HL group was not a predictor of cognitive performance in any domain using BE4FA and explained just 0.5% and 0.4% of variance in continuity-of-attention and speed-of-memory retrieval using LPA. Critically, those with the worst hearing did not differ cognitively from those with the best. Conclusion: Hearing loss is not an important determinant of contemporaneous attention, memory, or executive function in middle-aged adults once age, education, depression, cognitive reserve, and sex are controlled.