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Hearing loss, plasma neurodegenerative biomarkers, and cognitive function: Independent and additive effects
Semere Bekena, Ramkrishna K Singh, Yiqi Zhu, Carlos Cruchaga, Steven E Arnold, Beau M Ances, Ganesh M Babulal. Journal of Alzheimer's disease : JAD, 2025-09-17
Topic: Plasma and spinal-fluid biomarkers
BackgroundHearing loss is one of the most prominent modifiable risk factors for dementia, accounting for one of the largest population-attributable risk among midlife exposures according to the Lancet Commission on Dementia. Plasma biomarkers such as neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and phosphorylated tau-217 (Ptau217) have emerged as promising indicators of neurodegeneration and Alzheimer's disease (AD) pathology.ObjectiveTo evaluate whether hearing loss and plasma biomarker concentrations are independently associated with cognitive function in aging adults, and to examine if these associations vary by age group.MethodsThis cross-sectional study used data from 373 participants in the Aging Adult Brain Connectome (AABC) study. Hearing was assessed using the NIH Toolbox Words-in-Noise test, and cognitive function was measured by a Preclinical Alzheimer's Cognitive Composite (PACC). Plasma biomarkers included NfL, GFAP, total tau (tTau), and Ptau217. General linear models tested associations with cognition, adjusting for demographic, genetic, and cardiometabolic covariates. Interaction terms assessed modification by age and hearing.ResultsHearing loss was independently associated with lower PACC scores (β = -0.03, p < 0.001), after adjusting for covariates. Higher levels of NfL, GFAP, and Ptau217 were each associated with worse cognition. Age significantly moderated these associations, with stronger biomarker-cognition links observed in adults aged 65 and older. No significant interactions were observed between hearing loss and plasma biomarkers.ConclusionsHearing loss and plasma biomarkers reflect distinct, additive pathways of cognitive decline. These findings support integrated dementia risk models and highlight the potential of age- and biomarker-informed cognitive monitoring.
Key findings
- Plasma biomarkers such as neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and phosphorylated tau-217 (Ptau217) have emerged as promising indicators of neurodegeneration and Alzheimer's disease (AD) pathology.ObjectiveTo evaluate whether hearing loss and plasma biomarker concentrations are independently associated with cognitive function in aging adults, and to examine if these associations vary by age group.MethodsThis cross-sectional study used data from 373 participants in the Aging Adult Brain Connectome (AABC) study.
- Interaction terms assessed modification by age and hearing.ResultsHearing loss was independently associated with lower PACC scores (β = -0.03, p < 0.001), after adjusting for covariates.
- Higher levels of NfL, GFAP, and Ptau217 were each associated with worse cognition.
- Age significantly moderated these associations, with stronger biomarker-cognition links observed in adults aged 65 and older.
- No significant interactions were observed between hearing loss and plasma biomarkers.ConclusionsHearing loss and plasma biomarkers reflect distinct, additive pathways of cognitive decline.
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Study details
- Study designcross-sectional
- Participants373
- Evidence strengthLow
How this study scored 59/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 33 of the 56 points we could judge it on, which is 59 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer's disease : JAD) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 373 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40961167) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 33 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 33 of the 56 points we could judge it on is 59 out of 100. |
| Total | 59 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Bekena, S., Singh, R. K., Zhu, Y., Cruchaga, C., Arnold, S. E., Ances, B. M., et al. (2025). Hearing loss, plasma neurodegenerative biomarkers, and cognitive function: Independent and additive effects. Journal of Alzheimer's disease : JAD. https://doi.org/10.1177/13872877251378675
Vancouver
Bekena S, Singh RK, Zhu Y, Cruchaga C, Arnold SE, Ances BM, et al. Hearing loss, plasma neurodegenerative biomarkers, and cognitive function: Independent and additive effects. Journal of Alzheimer's disease : JAD. 2025. doi:10.1177/13872877251378675. PMID: 40961167.
BibTeX
@article{bekena2025-40961167,
author = {Bekena, Semere and Singh, Ramkrishna K and Zhu, Yiqi and Cruchaga, Carlos and Arnold, Steven E and Ances, Beau M and Babulal, Ganesh M},
title = {{Hearing loss, plasma neurodegenerative biomarkers, and cognitive function: Independent and additive effects}},
journal = {Journal of Alzheimer's disease : JAD},
year = {2025},
doi = {10.1177/13872877251378675},
pmid = {40961167},
url = {https://doi.org/10.1177/13872877251378675}
}
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