Hearing Status, Social Engagement, and Longitudinal Changes in Cognition: Results From the Mexican Health and Aging Study

Objectives: This study explored the mediation and moderation effects of social engagement on the relationship between hearing status and cognitive function among Mexican adults aged ≥ 50 years across a six-year period (2015–2021). Methods: Data were drawn from the nationally representative Mexican Health and Aging Study (MHAS). Social engagement was calculated by summing the number of social activities and frequencies undertaken in the past year. A global measure of cognitive function was derived by summing z-scores of verbal memory, orientation, verbal fluency, visual scanning, figure copy, and figure recall. Multilevel generalized models with lagged predictors were used to assess the mediation and moderation effects of social engagement on the association between self-reported hearing status and cognitive function over time. Results: There were 10,561 people in the analytic sample. Greater social engagement was independently associated with better cognitive function over time. Better hearing status was associated with higher cognitive functioning in the following survey wave. Fair or better hearing was significantly associated with increased social engagement. The association was attenuated when covariates were adjusted. The association between hearing difficulty and cognitive function varied across levels of social engagement. Discussion: The mediation and moderation effects of social engagement on the association between hearing difficulty and cognitive function were affected by the population’s socioeconomic status among middle-aged and older adults in Mexico. Future research should investigate other unknown mediators between hearing difficulty and cognitive health of middle-aged and older adults in low- and middle-income countries.