Cognitive Shifting Ability Does Not Predict Self-Perceived Hearing Difficulties in Adult Hearing-Aid Users

Age-related hearing loss (ARHL) often leads to hearing difficulties, impacting communication and daily functioning even among hearing-aid users. While hearing loss and cognitive functions, such as cognitive shifting ability, have been proposed as predictors of hearing difficulties, their specific contributions remain unclear. This study investigated whether hearing loss and cognitive shifting ability predict self-reported hearing difficulties across the Speech, Spatial, and Qualities of Hearing Scale questionnaire (SSQ) subscales in adults with ARHL who use hearing aids, and whether sex moderates these associations, while controlling for age and level of education. A total of 215 adults underwent audiometry, completed a cognitive flexibility task, and answered the SSQ questionnaire, of which 203 (89 females) were included in our analysis. Hierarchical multiple regression analyses revealed that less hearing loss predicted lower levels of hearing difficulties in the three subscales of the SSQ, and higher education level was a significant predictor of less reported difficulties in the Speech and Spatial subscales. Contrary to our expectations, cognitive shifting ability was not associated with hearing difficulties in any subscale, nor did sex moderate the associations between cognitive shifting ability, degree of hearing loss and hearing difficulties. The findings highlight the influence of hearing loss and education on self-reported hearing difficulties and suggest that cognitive shifting ability does not play a significant role. Future studies should explore other cognitive and demographic factors that might contribute to hearing difficulties in hearing-aid users.