Sensorineural Hearing Loss Negatively Impacts Cognition in Older Subjects with Normal Lateral Semi-Circular Canal Function

Introduction: Worldwide around 400 million people suffer from hearing loss. There is increasing evidence that hearing loss is a modifiable risk factor for cognitive decline. However, several risk factors for cognition are common in hearing-impaired individuals, including vestibular dysfunction, anxiety, and depression. This study aimed to explore the effect of hearing loss on cognitive functioning in older adults, considering the effects of vestibular function, anxiety, and depression on cognitive performance. Method: A cross-sectional study was performed on 42 subjects with moderate-to-severe sensorineural hearing loss (SNHL) and 42 matched normal-hearing controls. Matching was based on the following factors; sex, age, education level, level of anxiety and depression, and vestibular function. The test battery consisted of a cognitive assessment (Repeatable Battery for the Assessment of Neuropsychological Status adjusted for the Hearing Impaired [RBANS-H]), hearing assessment (Pure Tone Average and speech-in-noise testing), and vestibular assessment (video Head Impulse Test [vHIT]). Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI) questionnaires. Results: A significantly lower total cognitive (RBANS-H) score was observed in the group with SNHL compared to controls (100.93 [12.94] vs. 108.88 [10.47], p = 0.003). The difference among both groups was most pronounced in the subdomains Visuospatial/Constructional (92.90 [16.32] vs. 103.12 [12.83], p = 0.002) and Attention (96.62 [12.52] vs. 104.02 [11.81], p = 0.007). The other subdomains Immediate Memory, Language, and Delayed Memory did not differ significantly between the groups with SNHL and the normal-hearing controls. Conclusion: The results of this study indicate that hearing loss negatively affects cognitive functioning, even in older adults with normal vestibular function.