Project Summary Our project focuses on the high prevalence of Alzheimer's disease and related dementias (ADRD) among the Hispanic population in the United States. In 2014 ADRD affected nearly half a million Hispanic adults aged 65+ (12% of Hispanics in this age group), and this number is expected to double by 2030. Because ADRD has limited effective interventions, we are mainly concerned with two significant risk factors: low language acculturation and hearing loss. Low language acculturation affects over 60 million Hispanics, hindering their participation in cognitively stimulating activities and potentially accelerating cognitive decline. Hearing loss has recently been identified as a modifiable risk factor for ADRD. Hearing loss is associated with cognitive function and structural brain outcomes that may be early indicators of ADRD. Notably, hearing aids have proven to slow cognitive decline among older at higher risk for ADRD. Despite this, few Hispanic adults with hearing loss use hearing aids. Our research aims to investigate the potential effect modification of low language acculturation on the association between hearing loss, and cognitive function in Hispanic adults. Using data from two studies of Hispanic adults—the Hispanic Community and Health Study/Study of Latinos (HCHS/SOL), and the Northern Manhattan Study of Metabolism and Mind— we have three specific aims: Aim 1. Examine whether the association between hearing loss and cognitive decline over approximately six years among Hispanic adults in the U.S. differs by levels of language acculturation. Aim 2. Investigate the association between hearing loss and brain health markers on MRI scans and whether language acculturation moderates these associations. Aim 3. Explore the link between hearing loss and Alzheimer's disease pathology markers in a different sample from the NOMEM study and assess the role of language acculturation. Our research will inform public health efforts and raise awareness about interventions that can mitigate the effects of hearing loss and cognitive decline in the Hispanic community. It will have a significant impact on healthcare providers, community organizations, and families, helping them address communication barriers and improve access to necessary support systems.