EXAMINATION OF THE IMPACT OF HEARING IMPAIRMENT ON THE ASSOCIATION BETWEEN LONELINESS AND THE INCIDENCE OF DISABILITY

K. Tomida¹, S. Lee¹, K. Makino¹, K. Harada¹, O. Katayama¹, M. Morikawa¹, R. Yamaguchi¹, C. Nishijima¹, K. Fujii¹, Y. Misu¹, H. Shimada¹

¹National Center for Geriatrics and Gerontology, Department of Preventive Gerontology, Oobu, Japan

Background: Loneliness is thought to have a negative impact on physical and mental health and to be a factor in the incidence of disability, but the association between loneliness and disability remains uncertain. In recent years, age-related hearing impairment has been known to increase discrimination in the daily lives of older adults, and the association between loneliness and the incidence of disability may be impacted by the presence or absence of hearing impairment.

Purpose: The aim of this study was to examine the association between loneliness and the incidence of disability among older adults stratified by hearing impairment.

Methods: A total of 4,739 community-dwelling people aged≥65 years (mean age [SD] 73.8 [5.5] years; female: 2,622 [55.3%]) met the inclusion criteria for the present study. Hearing impairment was defined as a score > 8 on the Hearing Handicap Inventory for the Elderly Screening or as the use of hearing aids or cochlear implants. The University of California, Los Angeles Loneliness Scale (version 3) was used to measure loneliness. The incidence of disability as an outcome was determined according to public long-term care insurance, and participants were followed up monthly for 2 years after the baseline assessment to monitor the incidence of long-term care conditions. Age, sex, Body Mass Index (BMI), heart disease, diabetes, eye disease, educational history, number of medications, walking speed, exercise habits, smoking history, drinking habits, current work status, living alone, and cognitive function were also assessed as a potential confounding factor.

Results: Among the 4,739 who met the inclusion criteria, 3,792 [79.9%] were without hearing impairment and 947 [20.1%] were hearing impaired. The percentage of those with loneliness was 1,215 [32.0%] without hearing impairment and 441 [46.6%] with hearing impairment (p<0.001). After 2 years, the number of persons with disability was 172 [4.5%] without hearing impairment and 79 [8.3%] with hearing impairment (p<0.001). The Kaplan-Meier survival curves for loneliness and incidence of new disability, stratified by hearing impairment status, showed significant differences for both groups with/without hearing impairment by log-rank test (p<0.05). Cox proportional hazards regression analysis showed no significant association between loneliness and incidence of disability (HR: 1.10, 95% CI: 0.80-1.53) in a model adjusted for potential confounding factors among community-dwelling older adults without hearing impairment. On the other hand, among community-dwelling older adults with hearing impairment, a model adjusted for potential confounding factors showed a significant association between loneliness and incidence of disability (HR: 1.71, 95% CI: 1.04-2.80).

Conclusions: A 2-year longitudinal analysis of 4,739 community-dwelling older adults, stratified by hearing impairment status, found that the association between loneliness and incidence of disability was related to hearing impairment status, with a risk of disability 1.7 times higher among hearing-impaired participants with loneliness than among hearing-impaired participants those with no loneliness.

Implications: Loneliness may hasten the future incidence of disability in older adults with hearing impairment, and there is a growing need for appropriate hearing impairment and loneliness management for older adults in order to prevent the incidence of disability.

Funding acknowledgements: This work was supported by the Grant-in-Aid for Scientific Research Activity start-up (21K21183).

Keywords:
Hearing impairment
Loneliness
Disability

Topics:
Older people
Mental health
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: National Center for Geriatrics and Gerontology

Committee: ethics committee of National Center for Geriatrics and Gerontology

Ethics number: 1440-3