Hearing Impairment and Health-Related Quality of Life: The Blue Mountains Hearing Study

Abstract

In Brief Objectives: To assess the association between hearing impairment and health-related quality of life (HRQOL) in an older population, using the self-administered 36-item Short-Form Health Survey (SF-36). Design: Participants of the Blue Mountains Hearing Study (BMHS, N = 2956) attended a comprehensive interview and hearing examination in which both self-reported and measured hearing impairments were assessed. Hearing impairment was defined as the pure-tone average of air-conduction hearing thresholds >25 decibels hearing level (dB HL) for the four frequencies (0.5 to 4.0 kHz) in the better ear. Results: Of the 2431 participants with complete data (mean age, 67.0 yr), 1347 (55.4%) did not have measured hearing loss, whereas 324 (13.3%) had unilateral (285 mild, 22 moderate, 17 severe) and 760 (31.3%) had bilateral hearing impairment (478 mild, 207 moderate, 75 severe). After adjusting for demographic and medical confounders, bilateral hearing impairment was associated with poorer SF-36 scores in both physical and mental domains (fall in physical component score, PCS of 1.4 points, p = 0.025; fall in mental component score, MCS of 1.0 point, p = 0.13), with poorer scores associated with more severe levels of impairment (PCS ptrend = 0.04, MCS ptrend = 0.003). Participants with bilateral hearing impairment who habitually used hearing aids had a slightly better PCS (mean, 43.1; standard error [SE], 0.9) than those with the same impairment who did not have hearing aids or who only used them occasionally (mean, 41.2; SE 0.5), although this finding was not statistically significant (p = 0.055). Persons with self-reported hearing loss had significantly poorer HRQOL than corresponding persons without, but persons with unilateral or high-frequency hearing loss did not have significantly different HRQOL scores than their corresponding counterparts. Conclusions: This study quantifies the associated disease burden of age-related hearing impairment on health-related quality of life in a population-based cohort of older persons. The Blue Mountains Hearing Study (BMHS) is a population-based survey of the frequency and impact of age-related hearing loss in a representative older community. This paper assesses the association between hearing impairment and health-related quality of life (HRQOL), using the self-administered 36-item Short- Form health survey (SF-36). After accounting for demographic and medical conditions, bilateral hearing impairment was associated with poorer SF-36 scores in both the physical and mental domains. Significantly poorer scores were associated with increasing levels of hearing impairment. However, those who habitually used hearing aids had slightly better physical scores than impaired persons who did not have hearing aids, or who only used them occasionally, although this finding was not statistically significant. This study documents the disease burden of age-related hearing impairment on HRQOL and highlights the potential benefit on HRQOL from use of hearing aids by older impaired persons.