Association of hearing impairment and mortality in older adults

Dane J. Genther, Joshua Francis Betz, Sheila Pratt, Steven B. Kritchevsky, Kathryn R. Martin, Tamara B. Harris, Elizabeth Helzner, Suzanne Satterfield, Qian Li Xue, Kristine Yaffe, Eleanor Marie Simonsick, Frank Lin

Research output: Contribution to journalArticle

Abstract

Background. Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults. Methods. Prospective observational data from 1,958 adults70 years of age from the Health, Aging, and Body Composition Study were analyzed using Cox proportional hazards regression. Participants were followed for 8 years after audiometric examination. Mortality was adjudicated by obtaining death certificates. Hearing was defined as the pure-tone average of hearing thresholds in decibels re: hearing level (dB HL) at frequencies from 0.5 to 4kHz. HI was defined as pure-tone average >25 dB HL in the better ear. Results. Of the 1,146 participants with HI, 492 (42.9%) died compared with 255 (31.4%) of the 812 with normal hearing (odds ratio = 1.64, 95% CI: 1.36-1.98). After adjustment for demographics and cardiovascular risk factors, HI was associated with a 20% increased mortality risk compared with normal hearing (hazard ratio = 1.20, 95% CI: 1.03-1.41). Confirmatory analyses treating HI as a continuous predictor yielded similar results, demonstrating a nonlinear increase in mortality risk with increasing HI (hazard ratio = 1.14, 95% CI: 1.00-1.29 per 10 dB of threshold elevation up to 35 dB HL). Conclusions. HI in older adults is associated with increased mortality, independent of demographics and cardiovascular risk factors. Further research is necessary to understand the basis of this association and whether these pathways might be amenable to hearing rehabilitation.

Original languageEnglish (US)
Pages (from-to)85-90
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume70
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Hearing Loss
Hearing
Mortality
Demography
Social Isolation
Death Certificates
Body Composition
Ear
Dementia
Rehabilitation
Odds Ratio
Depression
Health
Research

Keywords

  • Epidemiology
  • Longevity
  • Outcomes
  • Public health
  • Successful aging

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Association of hearing impairment and mortality in older adults. / Genther, Dane J.; Betz, Joshua Francis; Pratt, Sheila; Kritchevsky, Steven B.; Martin, Kathryn R.; Harris, Tamara B.; Helzner, Elizabeth; Satterfield, Suzanne; Xue, Qian Li; Yaffe, Kristine; Simonsick, Eleanor Marie; Lin, Frank.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 70, No. 1, 01.01.2015, p. 85-90.

Research output: Contribution to journalArticle

Genther, Dane J. ; Betz, Joshua Francis ; Pratt, Sheila ; Kritchevsky, Steven B. ; Martin, Kathryn R. ; Harris, Tamara B. ; Helzner, Elizabeth ; Satterfield, Suzanne ; Xue, Qian Li ; Yaffe, Kristine ; Simonsick, Eleanor Marie ; Lin, Frank. / Association of hearing impairment and mortality in older adults. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2015 ; Vol. 70, No. 1. pp. 85-90.
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AU - Genther, Dane J.

AU - Betz, Joshua Francis

AU - Pratt, Sheila

AU - Kritchevsky, Steven B.

AU - Martin, Kathryn R.

AU - Harris, Tamara B.

AU - Helzner, Elizabeth

AU - Satterfield, Suzanne

AU - Xue, Qian Li

AU - Yaffe, Kristine

AU - Simonsick, Eleanor Marie

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N2 - Background. Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults. Methods. Prospective observational data from 1,958 adults70 years of age from the Health, Aging, and Body Composition Study were analyzed using Cox proportional hazards regression. Participants were followed for 8 years after audiometric examination. Mortality was adjudicated by obtaining death certificates. Hearing was defined as the pure-tone average of hearing thresholds in decibels re: hearing level (dB HL) at frequencies from 0.5 to 4kHz. HI was defined as pure-tone average >25 dB HL in the better ear. Results. Of the 1,146 participants with HI, 492 (42.9%) died compared with 255 (31.4%) of the 812 with normal hearing (odds ratio = 1.64, 95% CI: 1.36-1.98). After adjustment for demographics and cardiovascular risk factors, HI was associated with a 20% increased mortality risk compared with normal hearing (hazard ratio = 1.20, 95% CI: 1.03-1.41). Confirmatory analyses treating HI as a continuous predictor yielded similar results, demonstrating a nonlinear increase in mortality risk with increasing HI (hazard ratio = 1.14, 95% CI: 1.00-1.29 per 10 dB of threshold elevation up to 35 dB HL). Conclusions. HI in older adults is associated with increased mortality, independent of demographics and cardiovascular risk factors. Further research is necessary to understand the basis of this association and whether these pathways might be amenable to hearing rehabilitation.

AB - Background. Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults. Methods. Prospective observational data from 1,958 adults70 years of age from the Health, Aging, and Body Composition Study were analyzed using Cox proportional hazards regression. Participants were followed for 8 years after audiometric examination. Mortality was adjudicated by obtaining death certificates. Hearing was defined as the pure-tone average of hearing thresholds in decibels re: hearing level (dB HL) at frequencies from 0.5 to 4kHz. HI was defined as pure-tone average >25 dB HL in the better ear. Results. Of the 1,146 participants with HI, 492 (42.9%) died compared with 255 (31.4%) of the 812 with normal hearing (odds ratio = 1.64, 95% CI: 1.36-1.98). After adjustment for demographics and cardiovascular risk factors, HI was associated with a 20% increased mortality risk compared with normal hearing (hazard ratio = 1.20, 95% CI: 1.03-1.41). Confirmatory analyses treating HI as a continuous predictor yielded similar results, demonstrating a nonlinear increase in mortality risk with increasing HI (hazard ratio = 1.14, 95% CI: 1.00-1.29 per 10 dB of threshold elevation up to 35 dB HL). Conclusions. HI in older adults is associated with increased mortality, independent of demographics and cardiovascular risk factors. Further research is necessary to understand the basis of this association and whether these pathways might be amenable to hearing rehabilitation.

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