Clinical Depression Associated With Hearing Loss in Older Hispanic Populations

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The odds of having clinically significant depressive symptoms increased approximately 45% for every 20-dB increase in hearing loss.
The odds of having clinically significant depressive symptoms increased approximately 45% for every 20-dB increase in hearing loss.

Audiometrically measured hearing loss is independently associated with clinically significant depressive symptoms in older Hispanic people, according to research published in JAMA Otolaryngology–Head & Neck Surgery.

Researchers in this cross-sectional study created a cohort derived from publicly available data, collected from the Hispanic Community Health Study/Study of Latinos from 2008 to 2011, of Hispanic adults ≥50 years of age (N=5328) from 4 US communities (Miami, Florida; San Diego, California; Chicago, Illinois; and the Bronx, New York). Data included audiometry results and depressive symptoms scores of 10 or higher, as evaluated by the Center for Epidemiologic Studies Depression Scale, 10-item version (CESD-10). Making adjustments for potentially confounding variables (eg, demographics, hearing aid use, cardiovascular disease, antidepressant use), investigators assessed associations between hearing loss predictors and depression status using logistic regression modeling.

A third of participants (32.9%) had clinically significant depressive symptoms (CESD-10 score ≥10), which increased 1.44 times (95% CI, 1.27–1.63) for every 20 dB of hearing loss.

Using a fully adjusted model, investigators found the odds of clinically significant depressive symptoms were 1.81 times (95% CI, 1.48–2.22) as high for mild hearing loss (32.5 dB); 2.38 times (95% CI, 1.77–3.20) as high for moderate hearing loss (47.5 dB); 3.12 times (95% CI, 2.12-4.62) as high for moderately severe hearing loss (62.5 dB); and 4.30 times (95% CI, 2.61–7.09) as high for severe hearing loss (80 dB).

When considering antidepressant use as the outcome (instead of a covariate) in sensitivity analyses, the odds of antidepressant use were 1.21 times (95% CI, 1.01–1.44) as high per 20 dB of hearing loss.

This study provides more robust statistical analysis than similar previous studies examining associations in objective audiometric hearing loss, with adjustments for numerous confounders. Increased power with a large data set allows for generalizability to the US population.

Limitations inherent to the cross-sectional design include indeterminable temporal order of the exposure and outcome and that all confounders between hearing loss and depressive symptoms cannot be controlled as well as in a randomized control trial.

Researchers conclude that they found “an association between audiometric age-related HL [hearing loss] and clinically significant depressive symptoms as assessed using the CESD-10 in older Hispanic adults. This association remained when adjusting for potentially confounding covariates.” Opportunities for future studies should focus on longitudinal relationships between the treatment of hearing loss and any resultant effect on late-life depression.

Reference

Golub JS, Brewster KK, Brickman AM, et al. Association of audiometric age-related hearing loss with depressive symptoms among Hispanic individuals [published online December 6, 2018]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2018.3270

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