Further strengths of the study are repeated audiometric assessment of hearing loss, documentation of device use (both objectively and subjectively), and assessment of many other risk factors for cognitive decline (e.g., biomarkers [the APOE 4 allele], social isolation, loneliness, education, mood, activity, quality of life, diet, and medical health), most of which were not included in the studies of Mosnier and colleagues, or in many other studies, and which will facilitate the analysis of the interactions of these factors and the device on cognitive outcomes. Here, APOE is linked to Mental deterioration.