{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:58:33Z","timestamp":1790582313899,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371158"],"award-info":[{"award-number":["82371158"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071050"],"award-info":[{"award-number":["82071050"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World j. otorhinolaryngol.-head neck surg."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cognitive impairment is a major public health challenge. Early identification is crucial, especially in the often\u2010overlooked 60\u201369 age group. This study developed an efficient risk identification tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the US National Health and Nutrition Examination Survey (NHANES), three machine learning algorithms screened for key predictive features. Eight models were combined with a nomogram. Mediation, restricted cubic spline, and dose\u2013response analyses explored the hearing\u2013cognition relationship among older adults in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five key features including race, education, alcohol consumption, pure tone audiometry (PTA), and systemic inflammation response index (SIRI) were identified. The random forest model performed best (area under the curve, AUC\u2009=\u20090.865). Education, race, and PTA were the top three contributors. A significant positive linear relationship existed between PTA and cognitive risk, with each 1\u2009dB HL increase raising the risk by 2%. The nomogram highlighted the highest risk for those with less than ninth\u2010grade education, Hispanic ethnicity, and high PTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A exploratory risk stratification tool is developed. Education, race, and hearing level are key contributing variable. The linear PTA\u2010cognition relationship suggests hearing screening may aid in early risk stratification for cognitive impairment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjo2.70168","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:51:33Z","timestamp":1790581893000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hearing and Cognitive Function in Aged Adults: A Machine Learning and Mediation Analysis of NHANES"],"prefix":"10.1002","author":[{"given":"Jia","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2010 Head and Neck Surgery The Third Affiliated Hospital of Sun Yat\u2010Sen University Guangzhou 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