Hearing loss associated with depression, causal relationship less clear
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LAS VEGAS – Data gained from existing academic research shows that hearing loss is associated with depression but a causal relationship between the two has yet to be established, according to an expert at BRAINWeek 2022.
“First thing to know is that association does not equal causation, so how do we show that [hearing loss and depression] are causal, because it’s hard to do,” Justin S. Golub, MD, MS, associate professor of otolaryngology at Columbia University Irving Medical Center, said during the presentation.
The answer, Golub offered, is to formulate and complete a series of randomized, controlled trials to garner enough data that works toward either proving or disproving any relationship between association and causation.
Golub cited his own study from 2018, which focused on age-related hearing loss with depressive symptoms in more than 5,300 Hispanic individuals. Results showed that, compared to those with normal hearing, those with mild hearing loss had a 1.8 times greater chance to develop depression, those with moderate hearing loss were 2.4 times more likely to experience depression, and those with severe hearing loss 4.3 times more likely for the same.
Factors of age-related hearing loss likely to lead to depression, Golub said, are split into two main categories: causal and noncausal pathways. Normal course of aging, neurodegenerative factors and microvascular disease are cited as examples of the former, with cognitive impairment, development of tinnitus and reduced socialization both as a result of tinnitus and independent of it cited as examples of the former.
Less likely to logically point to a correlation, he added, was the theory of reverse causation, in the hypothetical instance of an individual who experiences depression isolating themselves by wearing headphones that blast loud music. Subsequent long-term exposure would then cause hearing loss.
Existing data has proven that hearing loss is unquestionably associated with depressive symptoms and might be a cause of depression, that introduction of hearing aids may prevent depression and any associations between the two begin with subclinical hearing loss, Golub stated.
Using the example of the immediate course of action taken when children experience hearing loss as opposed to older adults who experience the same and may not respond quickly, Golub added that whatever the cause or age of the patient, the need for treatment is immediate to stave off potential future negative outcomes.
“Disparities are never right; they are evidence of some inherent bias,” Golub said. “You want to treat children and adults the same.”