Self‐reported hearing difficulty increases 3‐year risk of incident cognitive impairment: The role of leisure activities and psychological resilience

Abstract Objective Although hearing difficulty is associated with cognitive impairment, little is known about the potential mechanisms involved. This study assessed the mediating effects of leisure activities and psychological resilience on the association between hearing difficulty and cognitive impairment. Methods Two waves of Chinese Longitudinal Healthy Longevity Survey (2011–2014) were used in the current analysis. Hearing difficulty, leisure activities and psychological resilience were measured at baseline. Cognitive function was assessed using the Chinese version of the Mini‐Mental State Examination. The data were analyzed using generalized structural equation modeling with adjustment for confounding factors. Results Of the 4267 participants at baseline, 33.5% (1430) reported hearing difficulty. The incidence of cognitive impairment was 15.3% (651) during the 3‐year follow‐up. Hearing difficulty increased the risk of cognitive impairment (odds ratio [OR] = 1.59, 95% confidence intervals [CI]: 1.26–1.92). Leisure activities and psychological resilience partly mediated the association between hearing difficulty and cognitive impairment. Hearing difficulty was negatively related to leisure activities ( β = −0.23, 95% CI: −0.41 to −0.05) and psychological resilience ( β = −0.34, 95% CI: −0.57 to −0.11). Furthermore, leisure activities (OR = 0.92, 95% CI: 0.89–0.96) and psychological resilience (OR = 0.95, 95% CI: 0.93–0.98) would significantly decrease the risk of cognitive impairment. Conclusions Hearing difficulty was associated with the incidence of cognitive impairment in older adults. Leisure activities and psychological resilience mediated the relationship. Participation in leisure activity and promoting psychological resilience may be candidate interventions in preventing cognitive impairment among the individuals with hearing difficulty.