Hearing loss and cognitive function among Chinese older adults: the role of participation in leisure activities

Abstract

Background: Hearing loss, a highly prevalent sensory impairment affecting older adults, is a risk factor for cognition decline. However, there were very limited studies on this association in low-resource countries. This study aimed to assess the association between self-reported hearing loss and cognitive decline, and whether engagement in leisure activities moderated this association among older adults in China. Methods: Data were obtained from two waves of the nationally representative survey of China Longitudinal Healthy Longevity Survey (CLHLS) between 2011/12-2014. Eight thousand eight hundred forty-four individuals aged 65 years old or above with a dichotomized measure of self-reported hearing status were included. Modified Mini-Mental Examination (MMSE) was used to measure global cognition. Fixed-effects models were used to estimate whether leisure activity engagement moderated the association of self-perceived hearing loss with global cognitive change in the overall sample and sex subsamples. Results: Self-reported hearing loss was associated with cognitive impairment, with an odds ratio of 2.48 [1.22, 5.06]. Sex difference in the association of hearing loss and cognitive impairment was not found. Self-reported hearing loss was associated with cognitive decline, with 8% increase in risk compared with those with normal hearing. Frequent engagement in leisure activities moderated the association between hearing loss and cognitive decline for the whole and male samples. Conclusion: Hearing loss was associated with cognitive decline, and leisure activities engagement moderated the association among males rather than females.

Does Hearing Impairment Affect Mental Health Among Chinese Older Adults? Evidence from the Chinese Longitudinal Healthy Longevity Survey

“…This is consistent with the findings of previous studies. 4 , 6 , 16 Furthermore, we obtain robust evidence indicating that hearing impairment produced a negative effect on the depression status of older adults, which is consistent with the findings of Strawbridge et al 17 Keidser and Seeto, 18 and Ye et al 19 However, this finding is not consistent with Hu et al 20 and Zhou et al 21 This inconsistency may be due to various reasons, such as using different measurements of depression status.…”

“…Based on previous studies, 6 , 33 , 34 two types of control variables that were linked to mental health were selected in this study. The first type of control variables described the demographic characteristics, which include age (continuous variable), gender (1 = male; 0 = female), marital status (1 = married; 0 = single, divorced or widowed), and residency area (1 = living in urban areas; 0 = living in rural areas).…”

“…16 Gao et al used the fixed effects regression models and reported that hearing status significantly affected the cognitive function of older adults. 6 In addition, some scholars have explored the effect of hearing impairment on depression status, while they did not reach a consensus. Strawbridge et al used longitudinal data and contended that older adults with hearing impairment were more likely to be depressed when compared with those without hearing impairment.…”

Gender Modifies the Association of Cognition With Age-Related Hearing Impairment in the Health and Retirement Study

“…There were studies that evaluated the sex-specific risk for cognitive impairment for older hearing-impaired people, either by analyzing prospective single-sex cohorts, mixed cohorts, or crosssectional populations (14, 24-26, 50-52). Among the existing evidence, some did not find the association between hearing and cognition differing by sex (14,50), while some reported impaired hearing posed a higher risk for cognitive decline in a specific sex group (25,51,52). We postulate that in these controversial findings, there may be confounding factors beyond sex dichotomy.…”

Hearing Loss and Cognition: What We Know and Where We Need to Go

“…A previous meta-analysis ( Loughrey et al, 2018 ) found the odds of cognitive impairment for those with age related hearing loss was 1.22 (95% CI: 1.09, 1.36) and odds of dementia was 1.28 (95% CI: 1.02, 1.59) times higher than those with normal hearing. Prior work has noted an association between hearing loss and declines in global cognitive function, executive function, processing speed, and memory ( Lin et al, 2011 ; Loughrey et al, 2018 ; Alattar et al, 2020 ; Gao et al, 2020 ; Brewster et al, 2021 ). However, what constitutes hearing ability or cognitive impairment often differs across studies.…”