The left high-frequency average hearing threshold showed a marginally significant negative predictive effect on the total MoCA score ( β = −0.08, p = 0.066), whereas the effect of the right ear was not significant (β = −0.07, p = 0.101).
In contrast, the indirect effect through the ABR pathway did not reach statistical significance (−0.030, 95% CI: −0.080 to 0.010), suggesting that central auditory conduction may not be the primary pathway through which noise affects cognition in this study population, or that more sensitive neurophysiological indicators may be required.