Age-related hearing difficulties can include problems with signal audibility and central auditory processing.

Studies have demonstrated associations between audibility and dementia risk.

To our knowledge, limited data exist to determine whether audibility, central processing, or both drive these associations.

We determine the associations between signal sensitivity, central auditory processing, and dementia and Alzheimer dementia (AD) risk.

This follow-up observational study of a sample from the prospective Adult Changes in Thought study of dementia risk was conducted at Kaiser Permanente Washington, a western Washington health care delivery system, and included 280 volunteer participants without dementia who were evaluated from October 2003 to February 2006 with follow-up through September 2018. Analyses began in 2019 and continued through 2021.