Hearing Loss Associated with More Hospitalizations & Poorer Health in Older Adults

By Editor, on June 18th, 2013

Hearing Loss Associated with Poorer Health & More Hospitalizations in Older Adults A new study by researchers at Johns Hopkins, analyzing data from 1,140 men and women aged 70 and older with hearing loss and 529 with normal hearing, found that those with hearing deficits were significantly more likely to have experienced hospitalizations, prolonged periods of physical illness or injury, and extended episodes of stress, depression or bad mood than those with normal hearing.

The new study was published on June 11, 2013 in JAMA, the journal of the American Medical Association.

According to background information published with the study, “Hearing loss (HL) is a chronic condition that affects nearly 2 of every 3 adults aged 70 years or older in the United States.” “Hearing loss has broader implications for older adults, being independently associated with poorer cognitive and physical functioning,” the Johns Hopkins authors wrote.

As many as 27 million Americans over age 50, including two-thirds of men and women aged 70 years and older, suffer from some form of hearing loss, according to Frank R. Lin, M.D., Ph.D., the study’s principal author, who is an assistant professor at the Johns Hopkins University School of Medicine and the university’s Bloomberg School of Public Health.

The association of hearing loss with health care use and other health economic outcomes, had previously not been studied, according to the study authors. The findings of the new study “are believed to be the first to show the broader, economic and long-term effects of hearing loss on general health,” according to a Johns Hopkins news release about the study.

The Study; Method

For the study, Frank R. Lin, M.D., Ph.D. and Dane J. Genther, M.D. of Johns Hopkins University School of Medicine, Baltimore, and colleagues, analyzed data from 1,140 men and women aged 70 and older with hearing loss who participated in the 2005-2006 and 2009-2010 National Health and Nutrition Examination Survey (NHANES), an ongoing national study designed to assess the health and functional status of non-institutionalized individuals in the U.S. They compared the data on the 1,140 men and women with hearing loss to similar data gathered as part of the NHANES study from 529 older men and women with normal hearing.

All study participants had volunteered to have their hearing tested over a four-year period, as part of the larger, ongoing NHANES study.

The purpose of the analysis was to investigate the extent of association between hearing loss and hospitalization and other physical and mental disease in a nationally representative study of adults 70 years of age or older.

In the study, hearing was defined using World Health Organization criteria, and measured using air-conduction pure-tone audiometry, according to established NHANES protocols. “For the test, study volunteers individually listened to a range of soft and loud sounds, from 0 decibels to 100 decibels, in a soundproof room,” the Johns Hopkins release explains. “Hearing specialists define such a [hearing] deficit as recognizing only those sounds louder than 25 decibels.”

The researchers gathered data on hospitalizations during the previous 12 months and on diseases experienced during the previous 30 days through computer-assisted or interviewer-administered questionnaires.

Findings

The authors found that the older adults with hearing loss were 32 percent more likely to have been admitted to a hospital, 36 percent more likely to have prolonged stretches of illness or injury (lasting more than 10 days), and 57 percent more likely to have deep episodes of stress, depression or bad mood (for more than 10 days) than the 529 older adults with normal hearing, according to the Johns Hopkins release about the study.

The authors found that compared with the 529 individuals with normal hearing, the 1,140 individuals with hearing loss were “more likely to have a positive history for cardiovascular risk factors, have a history of hospitalization in the past year (18.7 percent vs. 23.8 percent), and have more hospitalizations (1.27 vs. 1.52),” a news release issued by JAMA stated.

“Fully adjusted models accounting for demographic and cardiovascular risk factors demonstrated that HL [hearing loss] (per 25 dB) was significantly associated with any hospitalization, number of hospitalizations, more than 10 days of self-reported poor physical health, and more than 10 days of self-reported poor mental health,” the researchers concluded.

They called for additional research “to investigate the basis of these observed associations and whether hearing rehabilitative therapies could help reduce hospitalizations and improve self-reported health in older adults with HL [hearing loss].”

Implications

“Hearing loss may have a profoundly detrimental effect on older people’s physical and mental well-being, and even health care resources,” said senior study investigator Frank Lin, M.D., Ph.D., who is an assistant professor at the Johns Hopkins University School of Medicine and the university’s Bloomberg School of Public Health.

“Our results underscore why hearing loss should not be considered an inconsequential part of aging, but an important issue for public health,” Dr. Lin said.

“Health policymakers really have to consider hearing loss and its broader health impact when making decisions, particularly for older people,” said Dane Genther, M.D., lead study investigator and a Johns Hopkins resident in otolaryngology – head and neck surgery.

“Genther supports expanded Medicare and Medicaid reimbursement for hearing-related health care services, wider installation of hearing loops in various facilities, and more accessible and affordable approaches for treating hearing loss,” according to the Johns Hopkins release about the study.

According to the Johns Hopkins release, Dr. Lin, the study’s principal author, says that “social isolation resulting from hearing loss may explain the physical and mental declines — as well as the cognitive deficits — that afflict older adults.” “This, in turn, may lead to more illness and hospitalization,” says Dr. Lin.

Dr. Lin and his team are working on further research to see if treating hearing loss with counseling and hearing aids can reduce people’s risk of cognitive decline and dementia, according to the Johns Hopkins release.

Funding support for the newly published study and the NHANES study was provided by grants from the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the Eleanor Schwartz Charitable Foundation, and a Triological Society and American College of Surgeons Clinician-Scientist Award, according to Johns Hopkins.