Hearing Impairment and Other Health Conditions in Older Adults: Chance Associations or Opportunities for Prevention?

Abstract

The prevalence of hearing impairment, as well as many other medical conditions, increases with age. Epidemiological evidence also suggests that the prevalence of hearing impairment, cardiovascular disease, and possibly dementia have declined during the 20th century. Differences in disease occurrence by birth year indicate that modifiable risk factors contribute to these diseases and that exposure to these risk factors changed over time. This article discusses the co-occurrence of chronic conditions at older ages, along with their shared risk factors and similar temporal trends. Recognition of these patterns is important for audiologists and other health care professionals who treat these complex patients, as well as for researchers investigating the underlying causes of these diseases. Various lines of evidence linking hearing impairment to other conditions and medication use point to the need for hearing health care to be better integrated with the broader health care system.Learning Outcomes: As a result of this activity, the participant will be able to (1) list at least three health conditions that may be more common in older people with hearing impairments and (2) identify findings from at least two studies that suggest that hearing impairment in older adults is at least partly preventable.

Sensory-specific impairment among older people. An investigation using both sensory thresholds and subjective measures across the five senses

“…At odds with a bulk of evidence that report a lower sensitivity with increasing age (e.g., smell: [ 5 , 6 , 51 ], vision [ 27 , 52 ], taste: [ 53 , 54 ], touch: [ 8 ], audition: [ 55 ]), no significant correlations were found between age and objective measures of smell, vision, taste, and touch. Only auditory thresholds significantly changed with age in our sample.…”

Hearing in Middle Age

“…These contradictory findings might perhaps be due to differences in un-modelled confounding factors associated with male sex in the different populations across studies. That male sex is not a consistent risk factor might suggest that the excess risks to hearing associated with male sex are modifiable (Cruickshanks et al 2012). Evidence for the modifiability of excess risk associated with male sex include the observation that in the US Health Aging and Body Composition Study, sex differences disappeared after multivariable adjustment which included lifestyle factors (such as smoking and work-related noise exposure) (Helzner et al 2005).…”

Long-term Assessment of Systemic Inflammation and the Cumulative Incidence of Age-related Hearing Impairment in the Epidemiology of Hearing Loss Study

“…Participants less than 60 years at the baseline examination were moving through the peak risk period over the course of this study. Because higher levels of systemic inflammation are associated with older age, and hearing impairment often co-occurs with other negative health conditions such as diabetes, CVD, and hypertension (8), selection bias may have disproportionally affected associations in the older age stratum making it difficult to detect risk factor associations. Despite the results of this study, prior studies have demonstrated that inflammation may have negative consequences even in the oldest old (17).…”

“…The etiology of age-related hearing impairment, which is no doubt multifactorial, is still being determined. Increasingly, relationships of cardiovascular disease (CVD) and its antecedents as possible risk factors for hearing impairment have been examined (3)(4)(5)(6)(7)(8). The prevalence of both hearing impairment and CVD is increased in older adults and these conditions often co-occur, suggesting that there may be some common underlying pathological factors at work.…”