Associations of Hearing Loss and Depressive Symptoms With Incident Disability in Older Adults: Health, Aging, and Body Composition Study.

ABSTRACT

BACKGROUND: Depressive symptoms and hearing loss (HL) are independently associated with increased risk of incident disability; whether the increased risk is additive is unclear. METHODS: Cox Proportional Hazards models were used to assess joint associations of HL (normal, mild, moderate/severe) and late-life depressive symptoms (defined by a score of ≥8 on the 10-item Center for Epidemiologic Studies-Depression scale) with onset of mobility disability (a lot of difficulty or inability to walk » mile and/or climb 10 steps) and any disability in activities of daily living (ADL), among 2,196 participants of the Health, Aging and Body Composition Study, a cohort of well-functioning older adults aged 70-79 years. Models were adjusted for age, race, sex, education, diabetes, hypertension, and body mass index. RESULTS: Relative to participants with normal hearing and without depressive symptoms, participants without depressive symptoms who had mild or moderate/severe HL had increased risk of incident mobility and ADL disability (hazard ratio [HR] for mobility disability, mild HL1.34, 95% confidence interval [CI] 1.09, 1.64 and HR for mobility disability, moderate/severe HL 1.37, 95% CI 1.08, 1.75 and HR for ADL disability, mild HL 1.32, 95% CI 1.08, 1.63, and HR for ADL disability, moderate/severe HL 1.42, 95% CI 1.11, 1.82). Among participants with depressive symptoms, mild HL (HR 1.71, 95% CI 1.09, 2.70) was associated with increased risk of incident mobility disability. CONCLUSIONS: Independent of depressive symptoms, risk of incident disability was greater in older adults with HL, regardless of severity. Further research into HL interventions may delay disability onset.