Summary: Hearing loss was associated with an increased risk of depression in older adults. Those of lower socioeconomic status were twice as likely to report symptoms of depression. However, using hearing aids helped alleviate symptoms of depression.
Source: University of Manchester
University of Manchester researchers have discovered that hearing loss may act as a cause of depression in older people.
And those in the lowest wealth groups, they found, had up to twice the relative risk of developing depression than those in the highest wealth quintiles, as hearing loss disproportionally affected their quality of life.
Published in Social Psychiatry and Psychiatric Epidemiology, the landmark study goes some way in laying to rest more than 40 years of research on whether hearing loss causes depression.
The data also showed that hearing aids have a stronger effect in alleviating symptoms of depression in poorer socio-economic groups than in wealthy ones.
And improved symptoms of depression were more pronounced among those using their hearing aids ‘most of the time’ than those using them ‘some of the time’.
The researchers analysed longitudinally the entire dataset of participants aged 50–89 years in 8 Waves of the English Longitudinal Study of Ageing (ELSA), from 2002 to 2017, examining 74,908 people.
The findings for the first time revealed that hearing loss affected people according to their socioeconomic position.
Dr Dalia Tsimpida, from The University of Manchester who led the study, said: “Our study shows that hearing loss poses a substantial risk for depressive symptoms in older adults, especially those who experience socioeconomic inequalities.
“We also think that hearing aids could support the most vulnerable people who already lacked life opportunities compared to the most affluent.
“That way they were able to take more control of their lives and keep participating actively in society.”
Dr Tsimpida, a Chartered Psychologist and postdoctoral researcher based in the University’s Division of Medical Education, added: “We think it’s reasonable to identify hearing loss as a causal factor because we used advanced statistical techniques called dynamic cross-lagged path models (CLPMs) to estimate hearing loss and depression’s relationship over time.
“We argue the early detection of hearing loss by primary care professionals in routine assessments may not only promote better hearing health but also prevent or delay the onset of depression.
“Increasing the hearing loss treatment rate could be one effective strategy for risk reduction of depression, given the high prevalence of hearing loss in older age and its low treatment levels.”
Co-author Dr Maria Panagioti said: “The existing evidence on the association between hearing loss and depression was conflicting; our study now adds to this body of knowledge by identifying for the first time the socioeconomic pattern in their relationship.”
“Focusing primarily on the role of the socioeconomic position may satisfactorily explain the causal, temporal and graded relationship between hearing loss and depression over time, which differs according to people’s status in the social hierarchy.
“Our study has important and novel clinical implications, as it adds to the understanding of the interrelationship between hearing loss and depression, and the potential impact of interventions with hearing aids for people’s mental health.”
Dr Tsimpida’s study is co-authored by Professor Evangelos Kontopantelis, Professor Darren Ashcroft, and Dr Maria Panagioti.
Original Research: Open access.
“The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA)” by Dalia Tsimpida et al. Social Psychiatry and Psychiatric Epidemiology
Abstract
The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA)
Purpose
The 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.
Methods
We 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.
Results
Socioeconomic 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.
Conclusion
HL 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.
