# The association between hearing impairment and incident depression in older adults: a longitudinal analysis

## TL;DR

Older adults with moderate to severe hearing loss are at higher risk for depression, but this risk is reduced with regular hearing aid use.

## Contribution

This study longitudinally links time-varying hearing measures to incident depression and shows hearing aid use reduces depression risk.

## Key findings

- Moderate to severe hearing loss increases depression risk (adjusted HR: 1.24) in older adults.
- Hearing aid use for ≥6 hours/day reduces depression risk (adjusted HR: 0.65) in those with hearing loss.

## Abstract

Hearing loss (HL) is common in older adults and is associated with several adverse health outcomes. Although previous research has demonstrated a link between hearing impairment and depression, most studies have been cross-sectional or relied on a single baseline measure of hearing. To investigate the association between longitudinal, time-varying audiometric measures of hearing and incident depression in older adults. A secondary aim was to assess whether hearing aid use modifies this association over time in those with moderate to severe HL.

We included 1260 participants who underwent pure-tone audiometry at baseline, 18 months, and 36 months. Depression was defined using the CES-D-10 scale, with a cut-score of ≥8. Cox proportional hazards analyses were used to examine the link between hearing status (normal, mild HL, moderate/severe HL) and depression, adjusted for demographic, lifestyle, and clinical variables.

Over a median follow-up of 7.3 years, participants with moderate to severe HL had a higher risk of incident depression (adjusted HR [aHR]: 1.24; 95% CI, 1.08-1.43, P < 0.01) compared with participants with normal hearing. Hearing aid use (≥6 h self-reported use per day on average) in those with moderate to severe HL was associated with significantly reduced risk of incident depression (aHR: 0.65; 95% CI, 0.49-0.87, P < .01).

Moderate to severe HL is a significant risk factor for incident depression among older adults. Hearing aid use attenuated this risk. Future research should investigate mechanistic pathways linking HL and mood disturbances.