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NHANES data link hearing impairment to higher depression rates in women

Adults diagnosed with hearing impairment are more likely to be diagnosed with depression, according to a study published in JAMA Otolaryngology — Head & Neck Surgery.

Study findings showed that, although more men reported current hearing impairment, hearing-impaired women are at the greatest risk for a diagnosis of moderate to severe depression.

Chuan-Ming Li, MD, PhD, and colleagues from NIH designed a nationally representative study on depression in hearing-impaired U.S. adults ages 18 years and older. Citing earlier research, they wrote that both “depression and hearing impairment have been associated with personal, societal, and economic burden.”

Chuan-Ming Li

According to Li and colleagues, depression is the leading cause of years of life lived with a disability in high-income countries, while hearing impairment is the second most common cause.

Li and colleagues referred to data from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). Health interviews were conducted in study participants' homes. Health measurements were performed in specially designed and equipped mobile centers. Interviews included data from a phone interview that requested participants to self-report perceived hearing quality. Hearing impairment was defined as “a little trouble hearing or greater difficulty.”

Statistical analysis of NHANES data showed the following:

• Researchers noted self-reported hearing impairment in 21.7% (95% CI, 20.6-22.9) of all study participants, 25.0% (95% CI, 23.3-26.8) for men and 18.7% (95% CI, 17.8-19.6) for women.
• Findings on depression showed that moderate to severe depression existed in 11.4% (95% CI, 10.1-13.0) of study participants reporting hearing impairment. Moderate to severe depression was reported in 5.9% (95% CI, 5.3-6.6) of study participants reporting no hearing impairment.
• Among the hearing impaired, 9.0% (95% CI, 7.5-10.8) of men reported depression.
• Among the hearing impaired, 14.7% (95% CI, 12.7-16.9) of women reported depression.

During multivariate analysis, researchers controlled for demographic features including BMI, smoking, binge drinking, heart health, cancer, diabetes, sleep quality and visual impairment. Results demonstrated the strongest risk factors for depression were being female, living below the national poverty threshold, smoking, binge drinking, vision problems and sleep disorders. Findings did not show a significant correlation between depression and race/ethnicity, BMI, educational level, living alone, uninsured status or hypertension in hearing-impaired study participants.

According to researchers, moderate hearing impairment based on thresholds from the Global Burden of Disease classification was associated with depression among women aged 70 years or older (OR=3.9; 95% CI, 1.3-11.3).

They also reported participants with the worst hearing quality or complete deafness had low rates of depression. Researchers suggested that participants with the poorest hearing quality may have had more exposure to treatment and rehabilitation for hearing damage, a measure of intervention that could have alleviated long-term depressive symptoms.

Disclosure: The study received support from the National Institute on Deafness and Other Communication Disorders, the National Institutes of Health, the National Center for Health Statistics and the Centers for Disease Control and Prevention. See the study for a full list of financial disclosures.