Author ORCID Identifier

Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Public Health



First Advisor

Dr. John Watkins

Second Advisor

Dr. Anne Olson


Hearing loss is the most common sensory deficit noted in aging adults. It is commonly known to reduce an individual’s ability to detect, identify, and localize sounds and speech and to cause issues in communication. However, there are other less commonly discussed impacts that hearing loss has beyond the auditory system. Literature suggests a correlation between hearing loss and cognition in aging adults. Similar to hearing loss, the domains of cognition experience performance and functional changes across the life span. In an aging adult, changes related to cognition are also suggested to be associated with hearing loss. This study aimed to add to the corpus of literature surrounding the relationship between hearing loss and cognition, specifically memory, attention, executive functioning, and social cognition in adults with and without hearing loss.

The purpose of this multi-methods study was to describe if group differences in adults with and without hearing loss existed between perceived and performance-related cognitive abilities. The study focused on twenty-eight adults between the ages of 50-69 years; fourteen adults had normal hearing, while fourteen adults had hearing loss which ranged in the mild to moderate sensorineural range. Based on age and hearing loss, adults were separated into four distinct groups: normal hearing between the ages of 50-59 years, hearing loss between the ages of 50-59 years, normal hearing between the ages of 60-69 years, and hearing loss between the ages of 60-69 years. Performance-related cognitive abilities were assessed through five different cognitive assessments: the Weschler Memory Scale, Weschler Adult Intelligence Scale, Faux Pas stories, Advanced Clinical Solutions, and Bluegrass Short-Term Memory task. Perceived abilities were addressed through structured, open-ended questions that centered around the impacts of hearing and hearing loss and an individual’s communication abilities.

The first aim examined how adults described the impacts of hearing loss and their communicative abilities. Individual responses highlighted what impacts adults thought hearing loss had beyond communication and their communicative abilities. The majority of adults expressed that they did not have any communication errors and could accurately express their own thoughts/viewpoints/emotions and understand others’ thoughts/viewpoints/emotions. The second aim determined that group differences were present on memory subtests from the Weschler Memory Scale and a subtest from the Weschler Adult Intelligence Scale. While there was no significant difference between responses on the Bluegrass Short-Term Memory task, there was a group interaction on left frontal theta oscillation (memory & decision-making related), and right frontal beta frequency (attention-related) during data collection on EEG resting state eyes open. The final aim determined that there were group differences on the social cognitive assessment.

Auditory and cognitive processing have previously been viewed as separate and distinct factors that are crucial for communication, yet the growing body of literature suggests that these elements are actually intimately coupled. This research yielded evidence that even a mild HL in adults between the ages of 50-69 is associated with changes in cognitive functioning, specifically on memory, attention, and social cognition. Singularly, the auditory system and cognitive domains are each complex, yet these must be assessed as factors that have the potential to influence each other. The open-ended questions revealed that researchers and clinicians need to continue to address the wideranging impacts of hearing loss among adults. While adults did recognize impacts of hearing loss beyond communication, some participants also reported no thoughts on the impact beyond communication. This is a strong suggestion that adults need to be further educated about hearing loss as a critically prevalent public health matter.

Digital Object Identifier (DOI)

Funding Information

This dissertation was supported through funding from the University of Kentucky Susan Lee Fellowship Fund from 2016-2020, the University of Kentucky Donovan Scholarship in Gerontology in 2019, and the University of Kentucky Student Investigator Research Grants in 2019.