OLDER ADULTS WITH HEARING LOSS AND THE INCREASED RISK FOR PSYCHOSOCIAL CONDITIONS

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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Associations of Hearing Loss and Depressive Symptoms With Incident Disability in Older Adults: Health, Aging, and Body Composition Study

The Journals of Gerontology Series A ◽

10.1093/gerona/gly251 ◽

2018 ◽

Vol 75 (3) ◽

pp. 531-536 ◽

Cited By ~ 7

Author(s):

Nicole M Armstrong ◽

Jennifer A Deal ◽

Joshua Betz ◽

Stephen Kritchevsky ◽

Sheila Pratt ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Body Composition ◽

Depressive Symptoms ◽

Mobility Disability ◽

Body Composition Study ◽

Increased Risk ◽

Health Aging ◽

Composition Study ◽

Adl Disability

Abstract Background Depressive symptoms and hearing loss (HL) are independently associated with increased risk of incident disability; whether the increased risk is additive is unclear. Methods Cox Proportional Hazards models were used to assess joint associations of HL (normal, mild, moderate/severe) and late-life depressive symptoms (defined by a score of ≥8 on the 10-item Center for Epidemiologic Studies-Depression scale) with onset of mobility disability (a lot of difficulty or inability to walk ¼ mile and/or climb 10 steps) and any disability in activities of daily living (ADL), among 2,196 participants of the Health, Aging and Body Composition Study, a cohort of well-functioning older adults aged 70–79 years. Models were adjusted for age, race, sex, education, diabetes, hypertension, and body mass index. Results Relative to participants with normal hearing and without depressive symptoms, participants without depressive symptoms who had mild or moderate/severe HL had increased risk of incident mobility and ADL disability (hazard ratio [HR] for mobility disability, mild HL:1.34, 95% confidence interval [CI]: 1.09, 1.64 and HR for mobility disability, moderate/severe HL: 1.37, 95% CI: 1.08, 1.75 and HR for ADL disability, mild HL: 1.32, 95% CI: 1.08, 1.63, and HR for ADL disability, moderate/severe HL: 1.42, 95% CI: 1.11, 1.82). Among participants with depressive symptoms, mild HL (HR: 1.71, 95% CI: 1.09, 2.70) was associated with increased risk of incident mobility disability. Conclusions Independent of depressive symptoms, risk of incident disability was greater in older adults with HL, regardless of severity. Further research into HL interventions may delay disability onset.

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Fall-related Injuries Mediate the Relationship between Self-Reported Hearing Loss and Mortality in Middle-Aged and Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab123 ◽

2021 ◽

Author(s):

Dongjuan Xu ◽

Melissa D Newell ◽

Alexander L Francis

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Structural Equation ◽

Equation Modeling ◽

Middle Aged ◽

Risk Of Death ◽

Risk Of Injury ◽

Increased Risk ◽

The Relationship ◽

Hearing Problems

Abstract Background Hearing loss is associated with a greater risk of death in older adults. This relationship has been attributed to an increased risk of injury, particularly due to falling, in individuals with hearing loss. However, the link between hearing loss and mortality across the lifespan is less clear. Methods We used structural equation modeling and mediation analysis to investigate the relationship between hearing loss, falling, injury, and mortality across the adult lifespan in public-use data from the National Health Interview Survey and the National Death Index. We examined 1) the association between self-reported hearing problems and later mortality, 2) the associations between self-reported hearing problems and the risk of injury and degree and type of injury, 3) the mediating role of falling and injury in the association between self-reported hearing problems and mortality, and 4) whether these relationships differ in young (18-39), middle-aged (40-59) and older (60+) age groups. Results In all three age ranges, those reporting hearing problems were more likely to fall, were more likely to sustain an injury, and were more likely to sustain a serious injury, than those not reporting hearing problems. While there was no significant association between hearing loss and mortality in the youngest category, there was for middle-aged and older participants and for both fall-related injury was a significant mediator in this relationship. Conclusions Fall-related injury mediates the relationship between hearing loss and mortality for middle-aged as well as older adults, suggesting a need for further research into mechanisms and remediation.

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Examining the Combined Estimated Effects of Hearing Impairment and Depression on Cognitive Decline and Dementia

Innovation in Aging ◽

10.1093/geroni/igab046.1848 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 480-480

Author(s):

Danielle Powell ◽

Willa Brenowitz ◽

Kristine Yaffe ◽

Frank Lin ◽

Alden Gross ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Depressive Symptoms ◽

Cognitive Decline ◽

Cox Proportional Hazards ◽

Hearing Impaired ◽

Cognitive Test ◽

Late Life Depression ◽

Incident Dementia ◽

Increased Risk

Abstract Late-life depression is a comorbidity which may co-occur in older adults with hearing loss- each as prevalent and independent modifiable risk factors for dementia. We used data from 1,820 participants (74 ± 2.8 years, 38% Black race) from the Health Aging and Body Composition Study to test if the hearing loss-dementia/cognitive decline (Modified Mini Mental State Exam[3MS] and Digit Symbol Substitution[DSST]) relationship differed in hearing impaired participants who also had depressive symptoms. Depressive symptoms were defined as CES-D 10 ≥10) at one or more visits from years 1-5. Algorithmic incident dementia defined using medication use, hospitalizations and cognitive test scores. Audiometric hearing loss was measured at year 5 and categorized as normal/mild vs ≥moderate loss. In linear mixed models adjusted for demographic and clinical covariates, presence of both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS (-0.30, 95% CI:-0.78, -0.19) and DSST (-0.35,95% CI:-0.67, -0.03) over 10 years of follow-up. Both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio (HR):2.91, 95%CI: 1.59, 5.33) of incident dementia in multivariable-adjusted Cox proportional hazards models. Comorbid conditions among hearing impaired older adults should be considered and may aid in dementia prevention and management strategies.

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Characteristics and Health Outcomes Associated With Hearing Loss and Hearing Aid Use Among Older Adults

Journal of Aging and Health ◽

10.1177/0898264319848866 ◽

2019 ◽

Vol 32 (7-8) ◽

pp. 724-734 ◽

Cited By ~ 2

Author(s):

Timothy S. Wells ◽

Lorraine D. Nickels ◽

Steven R. Rush ◽

Shirley A. Musich ◽

Lizi Wu ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Hearing Loss ◽

Health Outcomes ◽

Hearing Aid ◽

Mobility Limitations ◽

Self Rated Health ◽

Hearing Aid Use ◽

Psychosocial Conditions ◽

Study Designs

Background: This study recruited older adults to explore physical and psychosocial conditions and other health outcomes associated with hearing loss (HL) and hearing aid use. Method: Survey data were used to categorize 20,244 participants into five groups: no HL, unaided mild HL, aided mild HL, unaided severe HL, and aided severe HL. Results: Individuals with unaided severe HL were more likely to report poor-fair self-rated health and were less likely to leave the home, or exercise 4 to 7 days per week, while there were no such associations for those with aided mild or severe HL. In addition, those with aided hearing were less likely to report depression, low social support, or mobility limitations. Discussion: In several instances, hearing aid use reduced associations between HL and negative psychosocial and physical characteristics, and health outcomes. More research using longitudinal study designs is needed to better understand the true implications of these findings.

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HEARING LOSS AND SOCIAL ISOLATION: THE ROLE OF NEIGHBORHOOD SOCIAL COHESION AND DISORDER

Innovation in Aging ◽

10.1093/geroni/igz038.3462 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S954-S954

Author(s):

Sol Baik ◽

Amanda Lehning

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Social Isolation ◽

Social Cohesion ◽

Protective Factor ◽

Community Dwelling ◽

Random Coefficient ◽

Neighborhood Social Cohesion ◽

Increased Risk ◽

Socially Isolated

Abstract Social isolation is a critical public health issue that socially isolated individuals are at increased risk for mortality and deteriorated health. Those who acquire hearing loss in later life experience difficulties with communication, potentially leading to social isolation. However, less is known about the social consequences of age-related hearing loss, and few studies have assessed the influence of environmental factors on hearing loss and social isolation. The aims of this study are to examine: (1) the association between hearing loss and social isolation of older adults over time, and (2) the moderating effects of perceived neighborhood social cohesion and disorder on this relationship. We analyzed 2,080 community-dwelling Medicare beneficiaries aged 65 or above from Round 1 to 3 of National Health and Aging Trends Study. We conducted random coefficient models, entering hearing loss as a random coefficient. Older adults with hearing loss were less socially isolated than those without hearing loss. However, the effect of hearing loss on social isolation varied depending on perceived neighborhood social cohesion. Older adults with hearing loss who reported high neighborhood cohesion had significantly lower social isolation compared to those without hearing loss, while those with hearing loss who perceived low social cohesion had significantly higher social isolation. Our findings suggest neighborhood social cohesion can serve as a potential protective factor for older adults with hearing loss. This poster will propose neighborhood-level interventions that could supplement other services for those with hearing loss, such as assistive devices that are rarely covered by health insurance.

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Age-Related Hearing Loss, Late-Life Depression, and Risk for Incident Dementia in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa242 ◽

2020 ◽

Cited By ~ 1

Author(s):

Katharine K Brewster ◽

Mei-Chen Hu ◽

Sigal Zilcha-Mano ◽

Alexandra Stein ◽

Patrick J Brown ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Depression Scale ◽

Late Life ◽

Mediation Effect ◽

Late Life Depression ◽

Data Set ◽

Age Related ◽

Increased Risk ◽

Over Time

Abstract Background Hearing loss (HL), late-life depression, and dementia are 3 prevalent and disabling conditions in older adults, but the interrelationships between these disorders remain poorly understood. Methods N = 8529 participants ≥60 years who were free of cognitive impairment at baseline were analyzed from National Alzheimer’s Coordinating Center Uniform Data Set. Participants had either No HL, Untreated HL, or Treated HL. Primary outcomes included depression (15-item Geriatric Depression Scale ≥5) and conversion to dementia. A longitudinal logistic model was fit to examine the association between HL and changes in depressive symptoms across time. Two Cox proportional hazards models were used to examine HL and the development of dementia: Model A included only baseline variables and Model B included time-varying depression to evaluate for the direct effect of changes in depression on dementia over time. Results Treated HL (vs no HL) had increased risk for depression (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.04–1.54, p = .02) and conversion to dementia (hazard ratio [HR] = 1.29, 95% CI = 1.03–1.62, p = .03). Baseline depression was a strong independent predictor of conversion to dementia (HR = 2.32, 95% CI = 1.77–3.05, p < .0001). Development/persistence of depression over time was also associated with dementia (HR = 1.89, 95% CI = 1.47–2.42, p < .0001), but only accounted for 6% of the direct hearing–dementia relationship (Model A logHR = 0.26 [SE = 0.12] to Model B logHR = 0.24 [SE = 0.12]) suggesting no significant mediation effect of depression. Conclusions Both HL and depression are independent risk factors for eventual conversion to dementia. Further understanding the mechanisms linking these later-life disorders may identify targets for early interventions to alter the clinical trajectories of at-risk individuals.

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The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

Perspectives on Gerontology ◽

10.1044/gero20.2.49 ◽

2015 ◽

Vol 20 (2) ◽

pp. 49-57 ◽

Cited By ~ 1

Author(s):

Yvonne Rogalski ◽

Amy Rominger

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Reading Aloud ◽

Cognitive Testing ◽

Professional Collaboration ◽

Cognitive Screening ◽

Speech Language Pathologist ◽

Text Passage ◽

The Impact ◽

Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

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