Noise During Cognitive Tests and Older Adults’ Cognitive Performance: Evidence From India

TL;DR

This study finds that noise during cognitive tests affects older adults' performance, especially in India, and suggests that test conditions should be optimized.

Contribution

The study provides evidence that acute noise during testing impacts cognitive scores independently of chronic noise exposure.

Findings

High noise levels during testing were linked to lower general cognitive performance and domain-specific scores.

The effects of noise were not explained by chronic noise-related factors like depression or sleep quality.

Hearing abilities had a curvilinear relationship with noise effects, strongest for those with normal hearing or severe loss.

Abstract

Existing evidence suggests that chronic noise exposure elevates the risk of cognitive impairment among older adults. However, noise during cognitive testing may be associated with chronic noise exposure and could impact cognitive testing, leading to bias in analyses of the chronic noise-cognition association. The risk of such biases may be larger in developing regions, where creating optimal test conditions may be more challenging. Using data from the second wave of the Longitudinal Aging Study in India - Diagnostic Assessment of Dementia (n = 3,507), we examined the associations between interviewer-rated noise during assessment and cognitive functioning. We assessed whether the associations were explained by potential mediators linked to chronic noise exposure and cognition (e.g., depression, sleep quality) and whether they were moderated by hearing abilities. High noise levels during testing were significantly associated with lower general cognitive performance scores (b = -.309; p < .001) and lower scores in several cognitive domains, including executive functioning, language, visuospatial, and memory (b = -.280, -.398, -.156, and -.254; p < .05). Associations remained after accounting for potential mediators of chronic noise-cognition associations, suggesting observed effects may be due to acute impacts of noise during assessment rather than chronic noise exposures. Moreover, the moderating effects of hearing abilities were curvilinear, with stronger associations for respondents with normal hearing range and severe hearing loss. These findings suggest that testing conditions, including noise, may factor into older adults’ cognitive assessment results. Further research is needed to better understand the implications of noise during cognitive tests.