Physical function impacts hearing without mediation from systolic blood pressure

The common cause theory of age-related hearing loss and age-related disorders of cognition suggests that there are shared underlying physiological variables that may be modified with intervention. This study examined the interrelationships among physical function (PF), systolic blood pressure (SBP), hearing, and cognition in 150 adults aged 50-80 years old, utilizing a Bayesian generalized structural equation modeling approach. The findings suggest that every 10-point increase in PF results in a decrease of hearing threshold by 1.35 dB HL (95% CrI: -0.232, -0.038) independent of SBP, while every 10-year increase in age increases SBP by 7.5 mm Hg (95% CrI: 0.417, 1.098) and increases hearing threshold by 8.78 dB HL (95% CrI: 0.608, 1.152). This indicates a more active lifestyle is associated with better hearing and that while SBP increases with age, it does not mediate the relationship between PF and hearing. Sex differences were observed in hearing outcomes, with males exhibiting poorer hearing. Additionally, there was only a minimal effect of PF on cognition, and this modest improvement was not explained by systolic blood pressure in our analytical sample. These results underscore the complexity of the pathways linking cardiovascular health, sensory function, and cognitive aging. The lack of mediation by SBP highlights the importance of targeting PF directly, rather than relying solely on blood pressure management for preserving auditory and cognitive health.