Hearing impairment and frailty: The hidden psycho-cognitive-social mediating pathway
Bibliographic record
Abstract
Abstract Hearing impairment is highly prevalent problem affecting more than two-third of older adults worldwide. With more evidence to indicate its relationship with frailty, it is imperative to understanding the underlying mediating pathway to inform comprehensive care planning. Based on the biopsychosocial model, the objectives of this study were to: i) identify the relationship between hearing impairment and frailty, and ii) examine the mediating roles of depression, cognitive impairment and social loneliness in the relationship, if any From Dec 2023 to July 2024, a total of 2332 older adults were recruited from 7 geographic districts in Hong Kong. The Hearing Handicap Inventory for the Elderly-Screening version (HHIE-S) was used to assess the hearing impairment. The Edmonton Frail Scale (EFS) measured frailty from a multi-dimensional perspective. The 5-minute Montreal Cognitive Assessment Test (MoCA-5), Geriatric Depression Scale (GDS-15) and UCLA Loneliness Scale (UCLA3) were administered to measure the potential mediators. Structural equation model was conducted to test the hypothesized mediating model. The mean age of the participants was72.2 (SD = 7.1). The prevalence of hearing impairment and frailty were 13% and 16.4% respectively. The SEM result indicated that hearing impairment was directly associated with severe frailty [β = 0.147,95%CI(0.106-0.186)], and its relationship is also mediated through poor cognitive function [β = 0.011,95%CI(0.003-0.021)], social loneliness [β = 0.045,95%CI(0.031-0.061)] and depression [β = 0.034,95%CI(0.023-0.048)]. The indirect effect explained 38% of the total effect. This study recommended a holistic approach to manage late-life hearing impairment, with emphasis on compensatory communication strategies, brain health and social engagement optimization, and mental health support.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".