Gait and Hearing Performance in Cognitively Unimpaired Adults: A Sex-Stratifyed Analysis.

Objectives

Hearing loss may contribute to mobility decline, but its relationship with gait in cognitively unimpaired adults and whether it differs by sex is unclear.

Methods

In this cross-sectional study, cognitively unimpaired adults aged 50-80 years from the DataCOG study were included. Gait was assessed using the instrumented Timed Up and Go test, and pure-tone audiometry (better-ear PTA exposure). Three prespecified composite gait outcomes (global duration, turning, walking duration) were modeled unadjusted, age/sex-adjusted, and sex-stratified, with HC3-robust linear regression. The a priori criterion was Holm-adjusted p < 0.05 across the three composites per model; sensitivity analyses added education, comorbidities/cognition, high-frequency PTA, and a WHO 20 dB HL threshold. Sex-stratified analyses were also performed.

Results

A total of 172 participants were included (119 women; mean age 63.9 ± 8.1 years) all with complete exposure, outcome, age, sex, and education data. Unadjusted, worse hearing was associated with poorer performance on all three composites (Holm p ≤ 0.015). Adjusted for age and sex, global duration was borderline (Holm p = 0.050) and turning/walking duration no longer met the Holm-adjusted threshold (Holm p = 0.064, 0.131). Sex-stratified, age-adjusted estimates were larger in men (n = 53) than women (n = 119), but neither sex reached the Holm-adjusted threshold (men, Holm p = 0.054; women, Holm p ≥ 0.459).

Conclusions

Worse peripheral hearing was associated with poorer unadjusted gait performance. Adjustment and multiplicity correction attenuated this to borderline or non-significant, and apparent sex differences did not reach the prespecified threshold. These findings are hypothesis-generating and warrant confirmation. LEVEL OF EVIDENCE: 3