Depression, Hearing Loss, and Treatment with Hearing Aids

By Elizabeth Brassine, Au.D.

Around the beginning of the 21st century, there were a half-dozen landmark studies about the relationship between untreated hearing loss and other health related issues. All which led to the insights about the possible benefit of hearing aids and aural (hearing) rehabilitation.

A review of the literature suggests complex but compelling association between hearing loss and depression. One study was done at the University Of Texas Health Science Center in San Antonio in collaboration with a VA clinic. This study found of 194 hearing impaired participants (half of which were assigned to a waiting list group, therefore not receiving any hearing aid treatment; the other half were fit with hearing aids). Before the study began, 82% of subjects reported adverse effects of the quality of life due to hearing loss and 24% were depressed.

At a four-month follow up, the group that was treated with hearing aids showed significant score improvements for social and emotional function, communication function, cognitive function, and lessening of depression. This field trial established that hearing aids are a successful treatment for reversing social, emotional and communication dysfunctions caused by hearing loss. Additionally it suggested that hearing aids may lead to improvements in cognition and depression. Two years later the study continued to show in 192 of the same participants, the quality of life benefit measures for social and emotional, communication, and depression were sustained.

Another significant study was the 1999 National Council on the Aging (NCOA) report on “The Consequences of Untreated Hearing Loss in Older Persons.” In a large-scale national survey of older Americans, the study quantified the social, psychosocial, and functional effects of hearing loss, with the goal of assessing the effects of hearing loss on quality of life and comparing these effects to those who wear or do not wear hearing aids. This cross-sectional, self- assessment survey was comprised of 2,304 hearing impaired individuals and 2,090 family members. The study concluded:

“Most users of hearing aids reported significant improvements in the quality of their lives since they began to use hearing aids. Half or more reported better relationships at home and improved feelings about themselves. Many also reported improvements in their confidence, independence, relations with children and grandchildren and view about life overall. Along every dimension, family members of the hearing impaired person were even more likely to report improvements. The majority of family respondents reported that use of hearing aids had resulted in improvements in terms of relations at home, feelings about themselves, life overall, and relations with children and grandchildren.”

In 2003, a review was published of all the studies done to date on the negative consequences of uncorrected hearing loss in the International Journal of Audiology. The findings were that uncorrected hearing loss represents an auditory disability involving reduced speech recognition ability, especially in difficult listening environments and reduced ability to detect, identify, and localize sounds. It was stated that this affects the lives of both the hearing impaired person and significant others and that the hearing impaired person may not always be aware of the consequences. It was also stated that uncorrected hearing loss gives rise to a poorer quality of life, related to isolation, reduced social activity, a feeling of being excluded, and increased symptoms of depression. The 14 major risk factors for depression are: alcohol dependence, anxiety, chronic pain, comorbid chronic medical conditions (hearing loss), female gender, hypomania or mania, nonresponsive to effective treatments for medical conditions, obstetric patients, psychosis, personal or family history of depression, recent childbirth, recent stressful events, substance misuse, and unexplained somatic symptoms.

Hearing loss has been associated with a dozen comorbidities, of which four were also significantly associated with the risk of depression-chronic artery disease, alcohol-related illness, anxiety, and stroke.

We think of the obvious effect of hearing loss with regard to communication difficulties. However, your hearing health contributes to your overall well being and quality of life. Statistically, hearing loss is the third most prevalent chronic condition in older Americans after hypertension and arthritis. Aging also brings cognitive processing deficits that interfere with communication and can create distractions that lead to memory loss, falls, and other accidents. If hearing loss is strongly associated with depression, then, are hearing aids a possible method for treating depression in this population?

To hear better, is to live better! Start a better health and wellness conversation today! Better hearing health is possible! Call your audiologist today!

Elizabeth Brassine is a Doctor of Audiology and owner of Hearing Services of McKinney.