Hearing impairment takes a heavy toll on older adults in SG

Research in a multiethnic cohort of older adults in Singapore has shown that hearing impairment (HI) is terrible for the quality of life (QoL).

A substantial impact on hearing-related quality of life (H-QoL) emerged across the spectrum of severity and laterality of the impairment. For example, compared with participants who had no HI, those who had unilateral mild HI reported a 107-percent reduction in H-QoL (β, 0.63, confidence interval [CI], 0.18– 1.09; p=0.006). This deficit in H-QoL increased to 2,816 percent among participants with bilateral severe HI (β, 16.78, 95 percent CI, 13.25–20.31; p<0.001). [Innov Aging 2023;doi:10.1093/geroni/igad101]

“Although the pattern of the associations between severity and laterality of HI and H-QoL were similar across all three ethnic groups, the magnitude of the associations (ie, percentage change) was greater in Chinese people [than in] Malays and Indians,” the investigators pointed out.

Notably, the impact of unilateral mild HI on H-QoL was significant only for Chinese participants but not for those of Malay and Indian ethnicity (β, 1.12, 95 percent CI, 0.41–1.84; p=0.002).

Additional data showed that bilateral severe HI was associated with a −14.4-percent change in gait speed as compared with no HI, such that participants with bilateral severe HI had a gait speed that was slower by 0.11 m/s (β, −0.11, 95 percent CI, −0.19 to −0.04; p=0.003). This negative effect on gait speed was not observed among participants with less severe HI.

HI was not associated with depressive symptoms, instrumental activities of daily living, sarcopenia, and cognitive impairment. However, there was a trend toward increasing odds of frailty as HI severity and laterality increased.

“Two key overall findings were evident from this work. First, our data reiterate the importance of screening for HI, as even individuals with unilateral HI (particularly those of Chinese ethnicity) may benefit from emotional and social support to improve H-QoL,” the investigators said.

“Second, in the clinical management context, emphasis should be placed on preventing the progression from unilateral to late-stage bilateral HI or ameliorating the effects of hearing loss using interventions like hearing aids, to limit potentially debilitating functional impact,” they continued.

The study population comprised 2,503 older adults (mean age 73.4 years, 55.2 percent women). Of these, 289 (11.6 percent) had no HI, 259 (10.4 percent) had unilateral mild HI, 798 (31.9 percent) had bilateral mild HI, 303 (12.1 percent) had mild HI in one ear and moderate in the other, 515 (20.6 percent) had bilateral moderate HI, 52 (2.1 percent) had no/mild HI in one ear and severe in the other, 155 (6.2 percent) had moderate HI in one ear and severe in the other, and 115 (4.6 percent) had bilateral sever HI. Twenty participants (0.8 percent) used a hearing aid.

All participants had completed the 10-item Hearing Handicap Inventory for the Elderly Screening Version that explores how an individual perceives the social and emotional effects of hearing loss. The questionnaire consists of five social or situational items and five emotional response items, with higher HHIE-S scores (range from 0 to 40) indicating greater detrimental effect of HI on H-QoL.

“Additional studies are needed to determine the effect of HI on incident health outcomes and to better understand the mechanisms underlying the HI-health indicators relationships,” the investigators said.