Echoes of Silence: Hearing Loss and Depression Risk in China's Older Adult Cohort.

BACKGROUND

Hearing loss is a highly prevalent sensory disability in older adults and has been increasingly linked to adverse mental health outcomes. However, longitudinal evidence on its association with depression, particularly in low- and middle-income countries, remains limited.

OBJECTIVE

The objective of this study was to examine the prospective association between baseline self-perceived hearing loss and the onset of depression in older Chinese adults and to explore whether this association varies across demographic and clinical subgroups.

METHOD: In this prospective cohort study, we analyzed data from 2,324 community-dwelling adults aged ≥ 65 years who participated in the Chinese Longitudinal Healthy Longevity Survey. Self-perceived hearing status and depressive symptoms were assessed at baseline and during follow-up. The primary outcome was time to depression onset. Kaplan-Meier survival analysis and Cox proportional hazards models were used to estimate hazard ratios (HRs) for incident depression. Models were progressively adjusted for sociodemographic, lifestyle, and health-related covariates. Stratified and interaction analyses were performed to examine potential effect modifiers.

RESULTS

Baseline self-perceived hearing loss was significantly associated with an increased risk of incident depression (adjusted HR > 1.00, p < .001). This association remained statistically significant after adjusting for measured sociodemographic, lifestyle, and health-related covariates, although residual confounding from unmeasured factors cannot be excluded. Stratified Cox models showed consistent effects across subgroups defined by age, sex, and other clinical characteristics. No statistically significant interactions were detected. Participants with hearing loss had shorter depression-free survival than those with normal hearing.

CONCLUSIONS

This study demonstrates that self-perceived hearing loss is independently associated with an increased risk of depression after adjusting for measured covariates. These findings highlight the importance of considering hearing health in care for older adults, though interpretations should account for the subjective nature of the hearing measure used.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31580260.