Age-Related Hearing Loss and Cognition: The Role of Bilingualism

PURPOSE: Age-related hearing loss (ARHL) has been associated with cognitive decline. Although bilingualism may influence cognitive performance, its interaction with hearing loss remains unclear. This study aimed to investigate the effects of ARHL and bilingualism on cognitive functioning in older adults. METHOD: In this cross-sectional study, 100 older adults (≥ 50 years) were recruited from a hospital-based audiology clinic, with 50 participants in each group (monolingual Persian speakers or balanced Persian-Turkish bilinguals). Cognitive performance was assessed using the Persian version of the Montreal Cognitive Assessment (MoCA), and hearing sensitivity was measured via pure-tone audiometry. Multivariate analyses were conducted, adjusting for age, sex, and hearing sensitivity. RESULTS: There were no significant differences between the two groups in terms of age, hearing sensitivity, or sex. Bilingual participants outperformed monolinguals in total MoCA scores, as well as in the attention and delayed recall domains. However, after controlling for age, sex, and hearing thresholds in a multiple regression analysis, language group was no longer a significant predictor of MoCA performance. Both hearing loss and age remained significant negative predictors of cognitive functioning, whereas sex and language group showed no significant effect. CONCLUSIONS: The potential cognitive benefits of bilingualism may be influenced by demographic factors and hearing loss, with age and hearing loss emerging as major contributors to cognitive decline. Therefore, early detection and intervention for hearing loss may be critical for preserving cognitive health in aging populations.