Temporal sequence of hearing impairment and cognition in the baltimore longitudinal study of aging

Nicole M. Armstrong, Yang An, Luigi Ferrucci, Jennifer A. Deal, Frank R. Lin, Susan M. Resnick

Research output: Contribution to journalArticlepeer-review


Background: Hearing impairment (HI) could be a risk factor for cognitive decline, but cognition could plausibly also affect psychoacoustic assessment of hearing with audiometry. We examined the temporal sequence of hearing and cognitive function among nondemented, community-dwelling older adults. Methods: Hearing and cognition were assessed between 2012 and 2015 and 2 years thereafter in 313 nondemented participants aged ≥60 years in the Baltimore Longitudinal Study of Aging. Poorer hearing was defined by pure-tone average of 0.5-4 kHz tones in the better-hearing ear. Cognitive measures with either visual or auditory inputs were Trail-making Test Part B; Digit Symbol Substitution Test; California Verbal Learning Test immediate recall, short delay, and long delay; Digit Span Forward/Backward; Benton Visual Retention Test; and Mini-Mental State Examination. We used linear regression models for cross-sectional associations at each timepoint and autoregressive, cross-lagged models to evaluate whether baseline hearing impairment (Time 1) predicted cognitive performance 2 years after baseline (Time 2) and vice versa. Results: Cross-sectionally, there were no associations between poorer hearing and cognitive performance. Longitudinally, poorer hearing was associated with declines in California Verbal Learning Test immediate (β = -0.073, SE = 0.032, p =. 024), short-delayed (β = -0.134, SE = 0.043, p =. 002), long-delayed (β = -0.080, SE = 0.032, p =. 012) recall, and Digit Span Forward (β = -0.074, SE = 0.029, p =. 011).) from Time 1 to Time 2. Cognitive performance at Time 1 did not predict change in hearing status at Time 2. Conclusions: Audiometric hearing impairment predicted short-term cognitive declines in both California Verbal Learning Test and auditory stimuli for attention.

Original languageEnglish (US)
Pages (from-to)574-580
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number3
StatePublished - Feb 14 2020


  • Cognition
  • Executive function
  • Hearing
  • Memory

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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