Impact and Heterogeneity of Self-reported Hearing on Trajectories of Cognitive Function in Middle-Aged and Older Couples

Abstract

Objectives: Hearing status is identified as a significant predictor of cognitive function. The life course principle of linked lives posits that the lives of couples often become increasingly interconnected or embedded over time, thereby cumulatively intensifying their influence on spouse's health and well-being. We aim to examine the impact of self-reported hearing on cognitive function among married couples across adulthood and whether there is heterogeneity in the associations.

Methods: Utilizing data from the 2011, 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Study (n=2847 middle-aged and older couples, totaling 5694 observations across all waves), we employ the growth curve model (GCM) to examine the impact of self-reported hearing, both individually and from spouses, on the age-related trajectories of cognitive function.

Results: This study demonstrates that poor self-reported hearing is significantly associated with worse cognitive function compared to those with good hearing. Additionally, there is a significant temporal association between poor spousal hearing and cognitive decline, compared to individuals whose spouses have good hearing. Heterogeneity analysis shows that the association between poor spousal hearing and increasing cognitive disadvantage across time is particularly significant among men and rural residents.

Discussion: This research provides new evidence of the longitudinal association between hearing and cognitive function among married couples, thus contributing to a growing body of literature documenting the importance of understanding how spousal health conditions impact health trajectories.

Keywords: Cognitive decline; Life course; Spouses.