title: The Effect of Functional Hearing and Hearing Aid Usage on Verbal Reasoning in a Large Community-Dwelling Population.
abstract: OBJECTIVE
  Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage mitigated the effect and examined different routes from hearing to verbal reasoning.
  
  
  METHODS
  Cross-sectional data on 40- to 70-year-old community-dwelling participants from the UK Biobank resource were accessed. Data consisted of behavioral and subjective measures of functional hearing, assessments of numerical and linguistic verbal reasoning, measures of executive function, and demographic and lifestyle information. Data on 119,093 participants who had completed hearing and verbal reasoning tests were submitted to multiple regression analyses, and data on 61,688 of these participants, who had completed additional cognitive tests and provided relevant lifestyle information, were submitted to structural equation modeling.
  
  
  RESULTS
  Poorer performance on the behavioral measure of functional hearing was significantly associated with poorer verbal reasoning in both the numerical and linguistic domains (p < 0.001). There was no association between the subjective measure of functional hearing and verbal reasoning. Functional hearing significantly interacted with education (p < 0.002), showing a trend for functional hearing to have a greater impact on verbal reasoning among those with a higher level of formal education. Among those with poor hearing, hearing aid usage had a significant positive, but not necessarily causal, effect on both numerical and linguistic verbal reasoning (p < 0.005). The estimated effect of hearing aid usage was less than the effect of poor functional hearing. Structural equation modeling analyses confirmed that controlling for education reduced the effect of functional hearing on verbal reasoning and showed that controlling for executive function eliminated the effect. However, when computer usage was controlled for, the eliminating effect of executive function was weakened.
  
  
  CONCLUSIONS
  Poor functional hearing was associated with poor verbal reasoning in a 40- to 70-year-old community-dwelling population after controlling for age, gender, and education. The effect of functional hearing on verbal reasoning was significantly reduced among hearing aid users and completely overcome by good executive function skills, which may be enhanced by playing computer games.
authors.affiliation: 1National Acoustic Laboratories, Sydney, New South Wales, Australia; 2Linnaeus Centre HEAD (HEaring And Deafness), Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; and 3Environmental Psychology, Department of Building, Energy and Environmental Engineering, University of Gävle, Gävle, Sweden.
authors.forename: Gitte
authors.initials: G
authors.lastname: Keidser
authors.forename: Mary
authors.initials: M
authors.lastname: Rudner
authors.forename: Mark
authors.initials: M
authors.lastname: Seeto
authors.forename: Staffan
authors.initials: S
authors.lastname: Hygge
authors.forename: Jerker
authors.initials: J
authors.lastname: Rönnberg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001301:Audiometry, Pure-Tone; D003071:Cognition; D003430:Cross-Sectional Studies; D004522:Educational Status; D056344:Executive Function; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D057187:Independent Living; D007360:Intelligence; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012737:Sex Factors; D006113:United Kingdom