Association Between Hearing Impairment and Risk of Hospitalization in Older Adults

Abstract

Objectives: To determine the association between hearing impairment (HI) and risk and duration of hospitalization in community-dwelling older adults in the United States.

Design: Prospective observational study.

Setting: Health, Aging and Body Composition Study.

Participants: Well-functioning community-dwelling white and black Medicare beneficiaries aged 70 to 79 at study enrollment in 1997-98 were followed for a median of 12 years.

Measurements: Incidence, annual rate, and duration of hospitalization were the primary outcomes. Hearing was defined as the pure-tone average (PTA) of hearing thresholds in decibels re: hearing level (dB HL) at octave frequencies from 0.5 to 4.0 kHz. Mild HI was defined as a PTA from 25 to 40 dB HL, and moderate or greater HI was defined as a PTA greater than 40 dB HL.

Results: Of the 2,148 participants included in the analysis, 1,801 (83.5%) experienced one or more hospitalizations, with 7,007 adjudicated hospitalization events occurring during the study period. Eight hundred eighty-two (41.1%) participants had normal hearing, 818 (38.1%) had mild HI, and 448 (20.9%) had moderate or greater HI. After adjusting for demographic characteristics and cardiovascular comorbidities, persons with mild HI experienced a 16% (hazard ratio (HR) = 1.16, 95% confidence interval (CI) = 1.04-1.29) greater risk of incident hospitalization and a 17% (incidence rate ratio (IRR) = 1.17, 95% CI = 1.04-1.32) greater annual rate of hospitalization, and those with moderate or greater HI experienced a 21% (HR = 1.21, 95% CI = 1.06-1.38) greater risk of incident hospitalization and a 19% (IRR = 1.19, 95% CI = 1.04-1.38) greater annual rate of hospitalization than persons with normal hearing. There was no significant association between HI and mean duration of hospitalization.

Conclusion: Hearing-impaired older adults experience a greater incidence and annual rate of hospitalization than those with normal hearing. Investigating whether rehabilitative therapies could affect the risk of hospitalization in older adults requires further study.

Keywords: epidemiology; hearing impairment; hospitalization; older adults.

Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Figures

Figure 1. Kaplan-Meier survivor estimate for the proportion of participants remaining free of incident hospitalization by degree of hearing impairment

Mild and moderate/greater HI, respectively, are defined as a pure-tone average >25–40 dB HL and >40 dB HL of hearing thresholds at octave frequencies from 0.5–4 kHz in the better ear. HI, hearing impairment; dB HL, decibels re: Hearing Level.

Figure 2. Hazard ratio of incident hospitalization by degree of hearing impairment

Hearing is defined as the pure-tone average of hearing thresholds at octave frequencies from 0.5–4 kHz in the better ear. The solid line indicates the hazard ratio, and the dotted lines represent the 95%CI. dB HL, decibels re: Hearing Level.