Abstract
PurposeThe adverse impact of hearing loss (HL) extends beyond auditory impairment and may affect the individuals' psychosocial wellbeing. We aimed to examine whether there exists a causal psychosocial pathway between HL and depression in later life, via socioeconomic factors and quality of life, and whether hearing aids usage alleviates depressive symptoms over time.MethodsWe examined the longitudinal relationship between HL and depressive symptoms (CES-D) applying dynamic cross-lagged mediation path models. We used the full dataset of participants aged 50–89 years (74,908 person-years), from all eight Waves of the English Longitudinal Study of Ageing (ELSA). Their quality of life (CASP-19) and their wealth were examined as the mediator and moderator of this relationship, respectively. Subgroup analyses investigated differences among those with hearing aids within different models of subjectively and objectively identified HL. All models were adjusted for age, sex, retirement status and social engagement.ResultsSocioeconomic position (SEP) influenced the strength of the relationship between HL and depression, which was stronger in the lowest versus the highest wealth quintiles. The use of hearing aids was beneficial for alleviating depressive symptoms. Those in the lowest wealth quintiles experienced a lower risk for depression after the use of hearing aids compared to those in the highest wealth quintiles.ConclusionHL poses a substantial risk for depressive symptoms in older adults, especially those who experience socioeconomic inequalities. The early detection of HL and provision of hearing aids may not only promote better-hearing health but could also enhance the psychosocial wellbeing of older adults, particularly those in a lower SEP.
Highlights
According to global estimates, over 1.3 billion people live today with some degree of hearing loss(HL) [1], and onethird of people above 65 years old are affected by disabling HL [2]
The participants’ non-modifiable demographic factors, and prevalence of HL and elevated depressive symptoms in eight Waves of the English Longitudinal Study of Ageing (ELSA) are provided in Table 1 of the supplementary material
This study examined the psychosocial mechanisms that help explain the prospective relationship between HL and depression in older adults, which was previously unknown
Summary
Over 1.3 billion people live today with some degree of hearing loss(HL) [1], and onethird of people above 65 years old are affected by disabling HL [2]. HL is the leading cause of morbidity among older adults in England [3, 4]. It is a highly underdiagnosed [5] and untreated chronic health condition [6, 7], which is quite alarming, as HL’s adverse impact extends beyond auditory impairment and may affect the individuals' mental wellbeing and their full participation in society [2, 8]. Despite the fact that studies consistently show that HL has a tremendous impact on quality of life [11,12,13], little is understood about the specific mechanisms involved in the relationship between HL and the multidimensional concept of quality of life [11, 13,14,15]
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