Mental Health Inequalities among Adults with Hearing Loss: Findings from the English Longitudinal Study of Ageing (ELSA)

Objectives: To examine the relationship between mental health and hearing loss among older adults at various socioeconomic strata. Design: Retrospective cohort study from up to seven waves of data collection covering a period of fourteen years of the English Longitudinal Study of Ageing (ELSA), which is a unique and rich resource of information on the health, social, wellbeing and economic circumstances of the English population aged 50 and older. Methods: Hearing loss was defined as >35dB HL at 3.0 kHz (better-hearing ear). Cross-sectional associations between self-reported and objective (available only in wave 7) hearing measures and depression were examined using multinomial-logistic regression (n=8,529). The longitudinal association between self-reported hearing at Wave 1 (2002/03) and diagnosis of depression up to Wave 7 (2014/15) was modelled using Cox proportional hazards regression. Results: The prevalence of depression among adults with hearing loss increased with time in each net financial wealth quintile in waves 1 to 7. In men, the increase of depression was tripled from wave 1 to wave 7 in the lowest wealth group, whereas in men in the higher wealth groups and in women across all wealth groups, the prevalence approximately doubled. Conclusions: Hearing impairment increases the risk for depression at least twice in the full sample and three times in lower wealth groups. These findings are consistent with the hypothesis that early detection of hearing loss could help delay the onset of depression, or that hearing loss is likely to be driving people to depression, particularly in lower wealth groups.