Summary: Researchers report age related hearing loss can increase the risk of older adults experiencing symptoms of depression. The study reports those with mild hearing loss were twice as likely to be depressed, and those with server hearing loss were up to four times more likely to suffer depression than those with normal hearing.
Source: Columbia University Irving Medical Center.
A new study found that elderly individuals with age-related hearing loss had more symptoms of depression; the greater the hearing loss, the greater the risk of having depressive symptoms. The findings suggest that treatment of age-related hearing loss, which is underrecognized and undertreated among all elderly, could be one way to head off late-life depression.
The study was published online in JAMA Otolaryngology-Head & Neck Surgery.
“Most people over age 70 have at least mild hearing loss, yet relatively few are diagnosed, much less treated, for this condition,” says lead author Justin S. Golub, MD, MS, assistant professor of otolaryngology-head & neck surgery at Columbia University Vagelos College of Physicians and Surgeons. “Hearing loss is easy to diagnose and treat, and treatment may be even more important if it can help ease or prevent depression.”
Age-related hearing loss is the third-most common chronic condition in older adults. The condition is known to raise the risk of other conditions, such as cognitive impairment and dementia. But there are few large studies asking whether hearing loss may lead to depression in the elderly — particularly in Hispanics, a group in which depression may be underdiagnosed because of language and cultural barriers.
The researchers analyzed health data from 5,239 individuals over age 50 who were enrolled in the Hispanic Community Health Study/Study of Latinos. Each participant had an audiometric hearing test — an objective way to assess hearing loss — and was screened for depression.
The researchers found that individuals with mild hearing loss were almost twice as likely to have clinically significant symptoms of depression than those with normal hearing. Individuals with severe hearing loss had over four times the odds of having depressive symptoms.
The study looked for an association at a single point in time, so it can’t prove that hearing loss causes depressive symptoms. “That would have to be demonstrated in a prospective, randomized trial,” says Golub. “But it’s understandable how hearing loss could contribute to depressive symptoms. People with hearing loss have trouble communicating and tend to become more socially isolated, and social isolation can lead to depression.”
Although the study focused on Hispanics, the results could be applied to anyone with age-related hearing loss, according to the researchers. “In general, older individuals should get their hearing tested and consider treatment, if warranted,” says Golub.
Funding: Drs. Golub and Kim reported receiving travel expenses for education and an industry conference paid for by Cochlear. No other financial or conflicts of interest were reported.
The study was supported by Collaborative and Multidisciplinary Pilot Research Awards from the Columbia University Irving Institute for Clinical and Translational Research and by grants from the National Institute on Aging (K23AG057832 and K24AG045334).
Source: Helen Garey – Columbia University Irving Medical Center
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Original Research: Abstract for “Association of Audiometric Age-Related Hearing Loss With Depressive Symptoms Among Hispanic Individuals” by Justin S. Golub, MD, MS; Katharine K. Brewster, MD; Adam M. Brickman, PhD; Adam J. Ciarleglio, PhD; Ana H. Kim, MD; José A. Luchsinger, MD, MPH; and Bret R. Rutherford, MD in JAMA Otolaryngology – Head & Neck Surgery. Published December 6 2018.
Association of Audiometric Age-Related Hearing Loss With Depressive Symptoms Among Hispanic Individuals
Age-related hearing loss is highly prevalent and has recently been associated with numerous morbid conditions of aging. Late-life depression is also prevalent and can be resistant to available treatments. Preliminary studies examining the association between hearing loss and late-life depression have been limited by subjective hearing measures, small sample sizes, and primarily white populations.
To assess whether a cross-sectional association exists between objective audiometric hearing loss and depressive symptoms in older Hispanic adults.
Design, Setting, and Participants
This cross-sectional study uses 2008-2011 Hispanic Community Health Study/Study of Latinos data collected in Miami, Florida, San Diego, California, Chicago, Illinois, or the Bronx, New York, from 5328 Hispanic adults 50 years or older who had exposure, outcome, and covariate data. Data analyses were conducted from March 2018 to September 2018.
Audiometric hearing loss (pure-tone average).
Main Outcomes and Measures
Center for Epidemiologic Studies Depression Scale, 10-item version (CESD-10) score of 10 or higher, which indicates clinically significant depressive symptoms.
The median age (interquartile range) of the 5328 participants was 58 (53-63) years, and 3283 participants (61.6%) were female. The mean (SD) CESD-10 score was 7.7 (6.4). Of the 5328 included participants, 1751 (32.9%) had clinically significant depressive symptoms. The odds of having these symptoms increased 1.44 (95% CI, 1.27-1.63) times for every 20 dB of hearing loss, adjusting for hearing aid use, age, sex, educational level, study site, geographic background, cardiovascular disease, and antidepressant use. Compared with those for individuals with normal hearing (0 dB), the odds of having clinically significant depressive symptoms was 1.81 (95% CI, 1.48-2.22) times as high in individuals with mild hearing loss (median threshold, 32.5 dB), 2.38 (95% CI, 1.77-3.20) times as high in individuals with moderate hearing loss (median threshold, 47.5 dB), and 4.30 (95% CI, 2.61-7.09) times as high in individuals with severe hearing loss (median threshold, 80 dB).
Conclusions and Relevance
Objective hearing loss appears to be associated with clinically significant depressive symptoms in older Hispanic people, with greater hearing loss seemingly associated with greater odds of having depressive symptoms. Given the high prevalence of untreated hearing loss in older adults, hearing loss may be a potentially modifiable risk factor for late-life depression.