Spousal Presence and Modifiable Factors of Cognitive Impairment among Older Adults with Hearing Loss: Cross-sectional Study using Machine Learning Approach

Purpose Age-related hearing loss (ARHL) is a major risk factor for cognitive decline [1] Spousal presence may influence emotional and instrumental support mechanisms related to cognitive vulnerability [2,3], but its moderating role has not been fully examined.This study aimed to (1) to identify modifiable risk factors for cognitive impairment among older adults with ARHL using a machine learning approach, and (2) to examine how risk factors for cognitive impairment operate within older adults with ARHL, according to spousal presence.Method A cross-sectional secondary analysis was conducted using 2023 National Survey of Older Koreans data.A total of 1,495 adults aged ≥65 years with subjective hearing difficulty were included after excluding those with diagnosed dementia or missing cognitive assessment.Cognitive impairment was defined as Korean MMSE