Association of Hearing Impairment and Mortality in Older Adults

Dane J Genther, Joshua Betz, Sheila Pratt, Steven B Kritchevsky, Kathryn R Martin, Tamara B Harris, Elizabeth Helzner, Suzanne Satterfield, Qian-Li Xue, Kristine Yaffe, Eleanor M Simonsick, Frank R Lin, for the Health ABC Study

Research output: Contribution to journalArticle

49 Citations (Scopus)

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 adults ≥70 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
Pages (from-to)85-90
Number of pages6
JournalThe Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Volume70
Issue number1
Early online date14 Jul 2014
DOIs
Publication statusPublished - Jan 2015

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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

Cite this

Association of Hearing Impairment and Mortality in Older Adults. / Genther, Dane J; Betz, Joshua; Pratt, Sheila; Kritchevsky, Steven B; Martin, Kathryn R; Harris, Tamara B; Helzner, Elizabeth; Satterfield, Suzanne; Xue, Qian-Li; Yaffe, Kristine; Simonsick, Eleanor M; Lin, Frank R; for the Health ABC Study.

In: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, Vol. 70, No. 1, 01.2015, p. 85-90.

Research output: Contribution to journalArticle

Genther, DJ, Betz, J, Pratt, S, Kritchevsky, SB, Martin, KR, Harris, TB, Helzner, E, Satterfield, S, Xue, Q-L, Yaffe, K, Simonsick, EM, Lin, FR & for the Health ABC Study 2015, 'Association of Hearing Impairment and Mortality in Older Adults' The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 70, no. 1, pp. 85-90. https://doi.org/10.1093/gerona/glu094
Genther, Dane J ; Betz, Joshua ; Pratt, Sheila ; Kritchevsky, Steven B ; Martin, Kathryn R ; Harris, Tamara B ; Helzner, Elizabeth ; Satterfield, Suzanne ; Xue, Qian-Li ; Yaffe, Kristine ; Simonsick, Eleanor M ; Lin, Frank R ; for the Health ABC Study. / Association of Hearing Impairment and Mortality in Older Adults. In: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2015 ; Vol. 70, No. 1. pp. 85-90.
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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 adults ≥70 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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author = "Genther, {Dane J} and Joshua Betz and Sheila Pratt and Kritchevsky, {Steven B} and Martin, {Kathryn R} and Harris, {Tamara B} and Elizabeth Helzner and Suzanne Satterfield and Qian-Li Xue and Kristine Yaffe and Simonsick, {Eleanor M} and Lin, {Frank R} and {for the Health ABC Study}",
note = "{\circledC} The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. Funding This research was supported by National Institute on Aging (NIA) (N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106); NIA grant (R01-AG028050); and National Institute of Nursing Research (NINR) grant (R01-NR012459). This study was further supported in part by National Institutes of Health (NIH) grant (T32DC000027), NIA grant (K24AG031155), National Institute on Deafness and Other Communication Disorders (NIDCD) grant (K23DC011279), Intramural Research Program of the National Institute on Aging, Triological Society and American College of Surgeons through the Clinician Scientist Award, and Eleanor Schwartz Charitable Foundation. S.P. was supported with resources and the use of facilities at the VA Pittsburgh Healthcare System, Pittsburgh, PA; however, the contents do not represent the views of the Department of Veterans Affairs or the United States Government. The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation of the manuscript.",
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T1 - Association of Hearing Impairment and Mortality in Older Adults

AU - Genther, Dane J

AU - Betz, Joshua

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 M

AU - Lin, Frank R

AU - for the Health ABC Study

N1 - © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. Funding This research was supported by National Institute on Aging (NIA) (N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106); NIA grant (R01-AG028050); and National Institute of Nursing Research (NINR) grant (R01-NR012459). This study was further supported in part by National Institutes of Health (NIH) grant (T32DC000027), NIA grant (K24AG031155), National Institute on Deafness and Other Communication Disorders (NIDCD) grant (K23DC011279), Intramural Research Program of the National Institute on Aging, Triological Society and American College of Surgeons through the Clinician Scientist Award, and Eleanor Schwartz Charitable Foundation. S.P. was supported with resources and the use of facilities at the VA Pittsburgh Healthcare System, Pittsburgh, PA; however, the contents do not represent the views of the Department of Veterans Affairs or the United States Government. The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation of the manuscript.

PY - 2015/1

Y1 - 2015/1

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 adults ≥70 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 adults ≥70 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.

KW - epidemiology

KW - longevity

KW - outcomes

KW - public health

KW - successful aging

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DO - 10.1093/gerona/glu094

M3 - Article

VL - 70

SP - 85

EP - 90

JO - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

JF - The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

SN - 1079-5006

IS - 1

ER -