{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:41:11Z","timestamp":1780450871827,"version":"3.54.1"},"reference-count":55,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Shanghai Municipal Science and Technology Major Project","award":["2018SHZDZX01"],"award-info":[{"award-number":["2018SHZDZX01"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81773513"],"award-info":[{"award-number":["81773513"]}],"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":["82071200"],"award-info":[{"award-number":["82071200"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perspect Psychol Sci"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>The relationship between age-related hearing loss (ARHL) and cognitive impairment (CI) remains intricate. However, there is no robust evidence from experimental or clinical studies to elucidate their relationship. The key unaddressed questions are (a) whether there is a causal effect of ARHL on CI and (b) whether efficacious treatment of ARHL (such as hearing-aid use) ameliorates CI and dementia-related behavioral symptoms. Because of several methodological and systematic flaws\/challenges, rigorous verification has not been conducted. Addressing these stumbling blocks is essential to unraveling the relationship between ARHL and CI, which motivated us to undertake this review. Here, we discuss the methodological problems from the perspectives of potential confounding bias, assessments of CI and ARHL, hearing-aid use, functional-imaging studies, and animal models based on the latest information and our experiences. We also identify potential solutions for each problem from the viewpoints of clinical epidemiology. We believe that \u201cobjectivity,\u201d specifically the use of more objective behavioral assessments and new computerized technologies, may be the key to improving experimental designs for studying the relationship between ARHL and CI.<\/jats:p>","DOI":"10.1177\/17456916231178554","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T13:15:16Z","timestamp":1688649316000},"page":"137-150","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Stumbling Blocks in the Investigation of the Relationship Between Age-Related Hearing Loss and Cognitive Impairment"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2300-3509","authenticated-orcid":false,"given":"Tetsuya","family":"Asakawa","sequence":"first","affiliation":[{"name":"Institute of Neurology, The Third People\u2019s Hospital of Shenzhen, National Clinical Research Center for Infectious Diseases, Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenxu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Institute of Neurology, Huashan Hospital, Fudan University"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University"},{"name":"National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yirong","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Nursing, The Third People\u2019s Hospital of Shenzhen, National Clinical Research Center for Infectious Diseases,Shenzhen, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Enshi Central Hospital, Enshi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Hong","sequence":"additional","affiliation":[{"name":"Institute of Neurology, Huashan Hospital, Fudan University"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University"},{"name":"National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ding","sequence":"additional","affiliation":[{"name":"Institute of Neurology, Huashan Hospital, Fudan University"},{"name":"National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University"},{"name":"National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"bibr1-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31822229d3"},{"key":"bibr2-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.03.016"},{"key":"bibr3-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.06.036"},{"key":"bibr4-17456916231178554","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.ra.2018-0045"},{"key":"bibr5-17456916231178554","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2019.00097"},{"key":"bibr6-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a033217"},{"key":"bibr7-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1089\/jmf.2021.0084"},{"key":"bibr8-17456916231178554","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.798652"},{"key":"bibr9-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2021.08.020"},{"key":"bibr10-17456916231178554","doi-asserted-by":"publisher","DOI":"10.3389\/fnsys.2010.00008"},{"key":"bibr11-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1007\/s10162-014-0461-0"},{"key":"bibr12-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms12241"},{"key":"bibr13-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1177\/2331216519857267"},{"key":"bibr14-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14308"},{"key":"bibr15-17456916231178554","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.17139"},{"issue":"8","key":"bibr16-17456916231178554","first-page":"28","volume":"20","author":"Haque R.","year":"2012","journal-title":"Annals of Long-Term Care"},{"key":"bibr17-17456916231178554","doi-asserted-by":"publisher","DOI":"10.1121\/1.2998779"},{"key":"bibr18-17456916231178554","volume-title":"Causal inference: What if","author":"Hern\u00e1n M. 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