Is Hearing Loss Associated with Poorer Health in Older Adults Who Might Benefit from Hearing Screening?
Bibliographic record
Abstract
OBJECTIVES: Hearing screening programs may benefit adults with unacknowledged or unaddressed hearing loss, but there is limited evidence regarding whether such programs are effective at improving health outcomes. The objective was to determine if poorer audiometric hearing thresholds are associated with poorer cognition, social isolation, burden of physical or mental health, inactivity due to poor physical or mental health, depression, and overnight hospitalizations among older American adults with unacknowledged or unaddressed hearing loss. DESIGN: The authors performed a cross-sectional population-based analysis of older American adults with normal hearing or unacknowledged or unaddressed hearing loss. Data was obtained from the 1999 to 2010 cycles of the National Health and Nutrition Examination Survey. Participants with a pure-tone average (PTA in the better hearing ear of thresholds at 0.5, 1, 2, and 4 kHz) > 25 dB HL who self-reported their hearing ability to be "good" or "excellent" were categorized as having "unacknowledged" hearing loss. Those who had a PTA > 25 dB HL and who self-reported hearing problems but had never had a hearing test or worn a hearing aid were categorized as having "unaddressed" hearing loss. Multivariate regression was performed to account for confounding due to demographic and health variables. RESULTS: A 10 dB increase in PTA was associated with a 52% increased odds of social isolation among 60- to 69-year-olds in multivariate analyses (p = 0.001). The average Digit Symbol Substitution Test score dropped by 2.14 points per 10 dB increase in PTA (p = 0.03), a magnitude equivalent to the drop expected for 3.9 years of chronological aging. PTA was not associated significantly with falls, hospitalizations, burden of physical or mental health, or depression, or social isolation among those ages 70 years or older in these samples. CONCLUSION: Unacknowledged or unaddressed hearing loss was associated with a significantly increased risk of social isolation among 60- to 69-year-olds but not those 70 years or older. It was also associated with lower cognitive scores on the Digit Symbol Substitution Test among 60- to 69-year-olds. This study differs from prior studies by focusing specifically on older adults who have unacknowledged or unaddressed hearing loss because they are the most likely to benefit from pure-tone hearing screening. The finding of associations between hearing loss and measures of social isolation and cognition in these specific samples extends previous findings on unrestricted samples of older adults including those who had already acknowledged hearing problems. Future randomized controlled trials measuring the effectiveness of adult hearing screening programs should measure whether interventions have an effect on these measures in those who have unacknowledged or unaddressed pure-tone hearing loss.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".