PP1022 - Subjective Hearing Concerns and Memory Processes in Older Adults with Mild Hearing Loss

Abstract:
Emerging research suggests memory changes in older adults with hearing loss. Whether these alterations are observed in various memory processes and in mild hearing loss needs further investigation. We examined working and semantic memory in 10 older adults with mild hearing loss (OAMHL) and 10 older adults with normal hearing (OANH). Additionally, we examined if subjective hearing relates to memory. No significant group differences were found on memory measures. Bivariate correlations revealed that higher self-ratings of listening effort related to worse performance on working memory in OAMHL. These preliminary findings indicate working memory involvement during effortful listening, even in OAMHL.

Summary:
Rationale
Hearing loss in older adults is a modifiable risk factor for cognitive impairment. Studies have reported various cognitive changes; however, investigation of memory processes in this population remains understudied. Since memory changes are common in dementia—a risk for older adults with hearing loss—it is worth investigating if these changes also occur in older adults with mild hearing loss (OAMHL). Specifically, changes in both working and semantic memory should be examined, given the paucity of research in this area in OAMHL. Furthermore, since older adults often report subjective hearing concerns, it would be pertinent to examine if these concerns relate to memory processes. We aimed to examine 1) differences in working memory and semantic memory in OAMHL and normal hearing (NH) controls of comparable age and education, and 2) the relationship between subjective hearing measures and objective measures of memory performance. We hypothesized worse memory performance in OAMHL relative to NH controls and that greater subjective hearing concerns will be related to worse memory performance.

Design
This cross-sectional, quantitative study included 20 participants, 10 OAMHL and 10 NH controls. Hearing loss was defined as a pure tone average of greater than 25 dB HL at 0.5, 1, 2, and 4 kHz in the better ear. Working memory was examined using the National Alzheimer’s Coordinating Center Forward and Backward Digit Span tests; semantic memory was examined using verbal fluency tests on the Delis-Kaplan Executive Function System and phonemic fluency on the Montreal Cognitive Assessment. The total score and longest span were obtained on the working memory tests, and the number of words recalled was obtained for the semantic memory tests. To evaluate subjective hearing concerns, we used the Hearing Handicap Inventory for the Elderly – Screening; the Social and Emotional Impact of Hearing Impairment; and an Effort Assessment scale, which indexed listening effort. Total scores were calculated for each measure. Group differences on memory measures were analyzed using Analyses of Variance (ANOVA), and associations between subjective hearing and memory measures were analyzed using bivariate correlations. We also conducted ANOVA on subjective hearing measures to characterize the sample.?

Results and Conclusion
Findings revealed greater hearing handicap in the OAMHL group relative to NH controls (p = .02). We found no significant group differences on working memory and semantic memory measures (p > .05). On correlational analyses, findings revealed some trends, specifically, negative correlations between scores on the Effort Assessment Scale and longest span length recalled (r = -.626; p = .053), and with total score (r = -.615; p = .059) on the forward span task in the OAMHL group. Our findings suggest that OAMHL perform comparably to NH controls of similar age and education on auditory measures of working and semantic memory. However, in OAMHL, greater listening effort is related to poorer working memory performance. Our preliminary findings suggest that working memory challenges may be more evident when older adults with hearing loss experience greater listening effort (e.g., others whispering), and this is evident even with mild hearing loss.