Sex-Specific Interactions Between Hearing and Memory in Older Adults With Mild Cognitive Impairment: Findings From the COMPASS-ND Study

Abstract

Objectives: Hearing loss (HL) in older adults is associated with a decline in performance on cognitive tasks and the risk of developing dementia. However, very few studies have investigated sex-related effects on these associations. A previous study of cognitively healthy older adults showed an association between HL and lower cognitive performance in females only. In the present study, we examined the effects of sex and hearing on cognition in individuals with mild cognitive impairment (MCI). We predicted that females with HL would be more likely to show poorer performance on the cognitive measures compared to females with normal hearing (NH), while cognitive performance in males would not depend on hearing. We further predicted that these auditorycognitive associations would not depend on test modality, and would thus be observed in females for both auditory and visual tests. Design: Participants were 101 older adults with amnestic MCI (M = 71 years, 45% females) in the Canadian Consortium on Neurodegeneration in Aging (CCNA) COMPASS-ND study. Performance on the Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning (RAVLT), and Brief Visuospatial Memory Test-Revised (BVMT-R) was analyzed to investigate sex-related differences and/or hearing-related differences. Participants were categorized as having NH or HL using two different measures: pure-tone hearing screening results (normal based on a puretone threshold < 25 dB HL at 2000 Hz in the worse ear) and speech-innoise speech reception thresholds (SRTs; normal < −10 dB SNR on the Canadian Digit Triplet Test [CDTT]).Results: Males and female groups did not differ in age, years of education, or other relevant covariates. Yet, females with better hearing on either puretone or speech-in-noise measures outperformed their worse hearing counterparts on the MoCA total score. Additionally, females with better hearing were more likely to recall several words on the MoCA delayed recall trial relative to those with worse hearing. Females with NH showed significant correlations between CDTT SRTs and both MoCA and RAVLT scores, while no correlations were observed in males. In contrast, males but not females showed an effect of hearing group on BVMT-R test status.Conclusions: There were sex-specific differences in auditory-cognitive associations in individuals with MCI. These associations were mostly observed in females and on auditory tests. Potential mechanisms and implications are discussed.

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) Study neuropsychology battery of the Canadian Consortium on Neurodegeneration in Aging (CCNA): Design overview and initial validation

“…There are known sex-and gender differences in dementia risk and trajectories (e.g., Au et al, 2017;Mielke et al, 2022;Sundermann et al, 2016;Sundermann et al, 2019); Sohn et al, 2018). For instance, we have initial evidence that hearing loss is more closely coupled with cognitive performance in women than in men in COMPASS-ND MCI participants (Al-Yawer et al, 2022). We also note that our sample is highly educated, which might relate to the fact that performance on relatively few of our measures correlated with education.…”

The Association between Untreated and Treated Hearing Loss and Cognitive Performance in Men and Women Aged 60–96 Years: Data from the Swedish “Good Aging in Skåne” Population Study

“…There is of course also the possibility that hearing loss per se has a greater negative impact on global cognitive function in women than in men. This has been indicated by results from earlier studies revealing an association between hearing loss and global cognitive decline in both cognitive intact women [31,32] and women with mild cognitive impairment [55] but not in their male counterparts. In contrast, a negative association between hearing loss, visual memory [55], and global cognitive decline [30] has been observed in men but not in women.…”

“…This has been indicated by results from earlier studies revealing an association between hearing loss and global cognitive decline in both cognitive intact women [31,32] and women with mild cognitive impairment [55] but not in their male counterparts. In contrast, a negative association between hearing loss, visual memory [55], and global cognitive decline [30] has been observed in men but not in women. Furthermore, Huang et al documented a significant protective effect of hearing aid use in men but not in women [30].…”

Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health

“…It is possible that sex-linked biological differences in auditory-cognitive associations become evident as cognitive performance declines due to neurological disease. Recent evidence suggests sex-related differences in sensory-cognitive relationships in participants with MCI (Al-Yawer et al, n.d.); women with hearing loss were more likely to fail the MoCA and an auditory verbal memory test than women with normal hearing, whereas men only showed an effect of hearing loss on a visual memory test. These findings raise the intriguing possibility which hearing loss has different implications for the cognitive performance of men and women.…”