Abstract
Age-related hearing loss (ARHL) is a kind of symmetrical and slow sensorineural hearing loss, which is a common condition in older adults. The characteristic of ARHL is hearing loss beginning in the high-frequency region and spreading toward low-frequency with age. Previous studies have linked it to anxiety, suggesting that brain structure may be involved in compensatory plasticity after partial hearing deprivation. However, the neural mechanisms of underlying ARHL-related anxiety remain unclear. The purpose of this cross-sectional study was to explore the interactions among high-frequency hearing loss and anxiety as well as brain structure in older adults. Sixty-seven ARHL patients and 68 normal hearing (NH) controls participated in this study, and the inclusion criterion of ARHL group was four-frequency (0.5, 1, 2, and 4 kHz) pure tone average (PTA) > 25 decibels hearing level of the better hearing ear. All participants performed three-dimensional T1-weighted magnetic resonance imaging (MRI), pure tone audiometry tests, anxiety and depression scales. Our results found gray matter volume (GMV) decreased in 20 brain regions in the ARHL group compared with the NH group, and a positive correlation existed between high-frequency pure tone audiometry (H-PT) and anxiety scores in the ARHL group. Among 20 brain regions, we also found the GMVs of the middle cingulate cortex (MCC), and the hippocampal/parahippocampal (H-P) regions were associated with H-PT and anxiety scores in all participants separately. However, the depressive symptoms indicated no relationship with hearing assessment or GMVs. Our findings revealed that the crucial role of MCC and H-P in a link of anxiety and hearing loss in older adults.
Highlights
Age-related hearing loss (ARHL), referred to as presbycusis, is a kind of symmetrical and slow sensorineural hearing loss that occurs with age, which is a common condition in older adults (Lin et al, 2011)
The pure tone average (PTA) of patients with ARHL was significantly higher than the normal hearing (NH) group (p < 0.001)
Our study showed that there was a close positive relationship between high-frequency hearing loss and anxiety scores in ARHL group
Summary
Age-related hearing loss (ARHL), referred to as presbycusis, is a kind of symmetrical and slow sensorineural hearing loss that occurs with age, which is a common condition in older adults (Lin et al, 2011). Age-related hearing loss has been reported to link a range of negative emotional outcomes, including depression based on the longitudinal studies (Brewster et al, 2018; Cosh et al, 2018), social isolation (Mick et al, 2014), and anxiety (Mehta et al, 2003b; Jayakody et al, 2018a,b) which are all cross-sectional studies. Compared with normal hearing controls, older adults with self-reported hearing loss were found to be more likely to have anxiety symptoms in a cross-sectional study (Mehta et al, 2003b). ARHL patients with moderately severe hearing loss had a more significant anxiety symptom compared with mild hearing loss (Jayakody et al, 2018a). Untreated hearing loss has been linked to the risk of anxiety, and the risk of anxiety may increase with pure tone audiometry thresholds elevated in the patients with ARHL (Jayakody et al, 2018b)
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