Association Between Hearing Impairment and Risk of Hospitalization in Older Adults

ObjectivesTo determine the association between hearing impairment (HI) and risk and duration of hospitalization in community-dwelling older adults in the United States. DesignProspective observational study. SettingHealth, Aging and Body Composition Study. ParticipantsWell-functioning community-dwelling white and black Medicare beneficiaries aged 70 to 79 at study enrollment in 1997-98 were followed for a median of 12years. MeasurementsIncidence, annual rate, and duration of hospitalization were the primary outcomes. Hearing was defined as the pure-tone average (PTA) of hearing thresholds in decibels re: hearing level (dB HL) at octave frequencies from 0.5 to 4.0kHz. Mild HI was defined as a PTA from 25 to 40dB HL, and moderate or greater HI was defined as a PTA greater than 40dB HL. ResultsOf the 2,148 participants included in the analysis, 1,801 (83.5%) experienced one or more hospitalizations, with 7,007 adjudicated hospitalization events occurring during the study period. Eight hundred eighty-two (41.1%) participants had normal hearing, 818 (38.1%) had mild HI, and 448 (20.9%) had moderate or greater HI. After adjusting for demographic characteristics and cardiovascular comorbidities, persons with mild HI experienced a 16% (hazard ratio (HR)=1.16, 95% confidence interval (CI) =1.04-1.29) greater risk of incident hospitalization and a 17% (incidence rate ratio (IRR)=1.17, 95% CI=1.04-1.32) greater annual rate of hospitalization, and those with moderate or greater HI experienced a 21% (HR=1.21, 95% CI=1.06-1.38) greater risk of incident hospitalization and a 19% (IRR=1.19, 95% CI=1.04-1.38) greater annual rate of hospitalization than persons with normal hearing. There was no significant association between HI and mean duration of hospitalization. ConclusionHearing-impaired older adults experience a greater incidence and annual rate of hospitalization than those with normal hearing. Investigating whether rehabilitative therapies could affect the risk of hospitalization in older adults requires further study.