Hearing impairment and incident disability and all-cause mortality in older British community-dwelling men

Ann E M Liljas,Sheena E Ramsay,Peter H Whincup,S Goya Wannamethee,Livia A Carvalho,Steve Iliffe,Lucy T Lennon,Olia Papacosta,Kate Walters

doi:10.1093/ageing/afw080

Ann E M Liljas, Sheena E Ramsay + Show 7 more

Open Access

https://doi.org/10.1093/ageing/afw080

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Abstract

Background and objective: hearing impairment is common in older adults and has been implicated in the risk of disability and mortality. We examined the association between hearing impairment and risk of incident disability and all-cause mortality.Design and setting: prospective cohort of community-dwelling older men aged 63–85 followed up for disability over 2 years and for all-cause mortality for 10 years in the British Regional Heart Study.Methods: data were collected on self-reported hearing impairment including hearing aid use, and disability assessed as mobility limitations (problems walking/taking stairs), difficulties with activities of daily living (ADL) and instrumental ADL (IADL). Mortality data were obtained from the National Health Service register.Results: among 3,981 men, 1,074 (27%) reported hearing impairment. Compared with men with no hearing impairment, men who could hear and used a hearing aid, and men who could not hear despite a hearing aid had increased risks of IADL difficulties (age-adjusted OR 1.86, 95% CI 1.29–2.70; OR 2.74, 95% CI 1.53–4.93, respectively). The associations remained after further adjustment for covariates including social class, lifestyle factors, co-morbidities and social engagement. Associations of hearing impairment with incident mobility limitations, incident ADL difficulties and all-cause mortality were attenuated on adjustment for covariates.Conclusion: this study suggests that hearing problems in later life could increase the risk of having difficulties performing IADLs, which include more complex everyday tasks such as shopping and light housework. However, further studies are needed to determine the associations observed including the underlying pathways.

Highlights

Hearing impairment increases with age and has been associated with chronic conditions including cardiovascular disease (CVD) and poor quality of life [1, 2]
Men who could not hear, irrespective of using hearing aid, had greater risks of developing problems performing activities of daily living (ADL) compared with men with no hearing impairment
The association was attenuated after further adjustment among men who used an aid but remained in those who could not hear and did not use hearing aid even after further adjustment for social engagement

Summary

Introduction

Hearing impairment increases with age and has been associated with chronic conditions including cardiovascular disease (CVD) and poor quality of life [1, 2]. Demographic changes mean that people are living longer with chronic diseases and associated physical limitations affecting independent living and overall well-being [3]. Earlier studies have shown an association between hearing impairment and mobility limitations [5] including increased risks of subsequent mobility limitations among older adults with hearing impairment [6, 7]. Previous research has shown an association between hearing impairment and incident ADL deficits in hospital-based samples of older people [8, 9]. It has been suggested that hearing impairment increases the risk of all-cause mortality [2], but some studies have shown no association after adjustment for demographic factors, physical functioning and cognition [12, 13]

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