Objective Social isolation and loneliness are associated with increased mortality and higher health care spending in older adults. Hearing loss is a common condition in older adults and impairs communication and social interactions. The objective of this review is to summarize the current state of the literature exploring the association between hearing loss and social isolation and/or loneliness. Data Sources PubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library. Review Methods Articles were screened for inclusion by 2 independent reviewers, with a third reviewer for adjudication. English-language studies of older adults with hearing loss that used a validated measure of social isolation or loneliness were included. A modified Newcastle-Ottawa Scale was used to assess the quality of the studies included in the review. Results Of the 2495 identified studies, 14 were included in the review. Most of the studies (12/14) were cross-sectional. Despite the heterogeneity of assessment methods for hearing status (self-report or objective audiometry), loneliness, and social isolation, most multivariable-adjusted studies found that hearing loss was associated with higher risk of loneliness and social isolation. Several studies found an effect modification of gender such that among women, hearing loss was more strongly associated with loneliness and social isolation than among men. Conclusions Our findings that hearing loss is associated with loneliness and social isolation have important implications for the cognitive and psychosocial health of older adults. Future studies should investigate whether treating hearing loss can decrease loneliness and social isolation in older adults.

Age-related hearing loss is a highly prevalent chronic condition in older adults, but hearing loss is rarely accounted for in patient-provider communication studies. This systematic review synthesizes current evidence on the impact of age-related hearing loss on patient-provider communication in hospitalized older adults. Five databases were queried to identify original research that examined patient-provider communication in older adults with hearing loss in an inpatient setting. Of 1053 studies, 13 were included in the final review. All studies reported an adverse effect of hearing loss on patient-provider communication. Among studies that evaluated an intervention to improve communication in older adults with hearing loss, simple interventions such as low-cost voice amplifiers were found to improve communication. An understanding of the effect of hearing loss on patient-provider communication and strategies to mitigate the impact are needed in order to provide safe, quality, patient-centered care to older adults with hearing loss.

Objectives Hearing loss is common in older adults and limits communication. We investigated the independent association between functional hearing loss and social engagement in a nationally representative sample of older adults. Methods Using data from the 2015 Medicare Current Beneficiaries Survey, we modeled the cross-sectional association between self-reported hearing ability and limitation in social activity over the past month using multivariable logistic regression. Results The majority of the study population was female (54.8%) and non-Hispanic white (74.3%). Participants (40.4%) reported “a little trouble” hearing and 7.4% reported “a lot of trouble” hearing. Those who reported any trouble hearing had higher odds of limited social engagement in the past month. After adjustment for demographic, clinical, and functional covariates, those who reported “a lot of trouble” hearing had 37% higher odds of limited social activity in the past month compared to those with normal hearing. Discussion These results suggest that hearing loss may be an important risk factor for limited social engagement and downstream negative health consequences, independent of other disability and health conditions.

OBJECTIVES Investigate the cross-sectional association between hearing loss (HL), hearing aid use, and depressive symptoms in community-dwelling older adults. METHOD The analytic sample consisted of 3188 participants (age range 71-94 years) in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). Multivariable logistic regression was used to evaluate the association of audiometric hearing status and self-reported hearing aid use with depressive symptoms (11-item Center for Epidemiologic Studies Depression Scale). RESULTS 4.6% of participants had depressive symptoms. 40% had mild HL and 27% had moderate or greater HL. In multivariable-adjusted models, mild HL was associated with 1.90 times higher odds (95% Confidence Interval, [CI] 1.20-3.01) and moderate or greater HL with 2.42 times higher odds (95% CI 1.44-4.07) of depressive symptoms compared to normal hearing. Each 10dB increase in HL was associated with 1.30 higher odds of depressive symptoms (95% CI 1.14-1.49). Hearing aid use was not associated with depressive symptoms among those with mild (Odds Ratio [OR] 0.94, 95% CI 0.35-2.54) or moderate or greater (OR 1.12, 95% CI 0.60-2.11) HL. DISCUSSION Older adults with HL have higher odds of depressive symptoms compared to adults with normal hearing. Future studies are needed to assess whether hearing care is protective against depressive symptoms in older adults.