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Depression and Hearing Loss: A Haunting Issue for Older Age Group

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Depression and hearing loss are interconnected conditions affecting the older age group, leading to morbidity.

Written by

Dr. Sabhya. J

Medically reviewed by

Dr. Vipul Chelabhai Prajapati

Published At February 13, 2024
Reviewed AtFebruary 22, 2024

Introduction

When an individual suffers a hearing loss, it compromises the patient’s hearing abilities. Therefore, such patients find necessary communication exhaustive and effortful. The exhaustion makes the affected individual withdraw from social activities with friends, family, or community. The individual gradually becomes socially isolated, causing loneliness and further frustration. Researchers at the National Institute of Deafness and Other Communications Disorders (NIDCD) have stated a link between hearing loss and depression among all age groups, especially women.

What Is Hearing Loss?

Hearing loss is a partial or total loss of hearing. Individuals with hearing loss may be socially disengaged, depressed, or in a bad mood. Hearing loss is a common disorder among the older age group and is the third most frequent chronic health disorder. Worldwide, 1.3 billion people are suffering from hearing loss, and the incidence of the disease might increase with an aging population.

Age-related hearing loss is caused by pathological changes seen in aging. There is a loss of hair cells in the ear's basilar membrane, which causes loss of high-intensity hearing. Therefore, the elderly age group is subject to increasing disability, incident morbidity, frailty, and poorer self-rated health. It causes an increased healthcare and economic burden to the patients.

Hearing loss causes poor psychological outcomes; the older age individuals are less happy and have lower self-efficacy, impaired relationships, and poorer emotional vitality. All these factors can cause the older age group with hearing loss to become depressed. Consequently, the elderly may have a poor quality of life.

Additionally, hearing loss can also cause a range of other poor mental health outcomes, which include anxiety, suicidal tendencies, and poorer cognitive function. However, agoraphobia (a type of anxiety disorder) and social phobia have become more prevalent due to communication barriers. The decline of cognitive function in hearing loss patients is manifested as poorer episodic memory, accelerated cognitive decline, and incident dementia.

Therefore, it can be concluded that hearing loss is an invisible handicap for the elderly, causing severe economic and social toll on patients, families, communities, and countries.

What Is Depression?

Depression is a mood disorder and serious medical illness that alters how an individual feels, thinks, or handles daily activities. Around 120 million people around the world have depression, based on the WHO (World Health Organization) statistics. Patients with depression are often sad, lose interest or pleasure in routine activities, feel guilty, have low self-worth, appear tired, angry, irritable, have sleep changes, or experience problems concentrating during work. An individual who is depressed may have a poor quality of life, impaired social or cognitive function, and reduced workplace performance.

What Is the Association Between Depression and Hearing Loss?

Depression and hearing loss are frequently interconnected. According to a study, 11.4 percent of adults with self-reported hearing impairment had moderate to severe depression, and 19.1 percent of adults had mild depressive symptoms. Both conditions are more prevalent in older adults.

Hearing loss tends to worsen pre-existing depression in patients due to social isolation. If the hearing loss is untreated, the developing depression and isolation may contribute to poor quality of life in patients.

Healthcare professionals should identify the signs and symptoms in hearing loss patients and refer them to mental healthcare institutions, thus improving their quality of life. Assessing and treating depression in hearing loss patients is pertinent to improving mental health and well-being. Currently, there is little knowledge of the methods to treat hearing loss in depression patients.

What Are the Negative Consequences of Hearing Loss?

  • Hearing loss can adversely affect an individual’s career and personal life.

  • Individuals with hearing loss may feel embarrassed to meet new people due to reduced hearing ability.

  • The patients may become frustrated with family members as they have difficulty hearing.

  • Due to frustration arising from an inability to hear, the individual may change personal or social life.

Patients with hearing loss develop depression,

  • When they avoid simple duties.

  • When they try to avoid social situations.

  • When they feel lonely being with family members.

  • Hearing loss patients do not often seek help, which may further exacerbate depressive symptoms.

Despite expressing a desire for mental health treatment, patients with severe hearing loss are often not referred to mental health centers. Consequently, this indicates a more significant requirement for evaluation and referral. It can be achieved by further training audiologists to better diagnose mental health disorders in hearing loss patients.

What Does the Imaging Study in Hearing Loss Patients Reveal?

Neuroimaging studies in hearing loss patients have shown reduced activity in the limbic system (center responsible for emotion and behavior), the frontal cortex (center responsible for emotional reasoning, regulation, and planning), and the auditory cortex in the older age group. These findings indicate the presence of neuronal degeneration with hearing loss and depression.

How Are Patients With Hearing Loss Treated to Overcome Depression?

Treating hearing loss will positively impact the individual's mental health. Maintaining and reactivating social activities is vital to a patient’s recovery. Seeking treatment during the early phase of hearing impairment can yield better results. When hearing loss is untreated, it turns into a chronic stressor, which leads to the manifestation of depression as an additional stressor. The type of treatment depends on the cause and severity of hearing loss:

  • Hearing Aid: It is the most common treatment method for hearing loss. Regularly using hearing aids will reduce depression in hearing loss patients. Nonetheless, a cochlear implant or bone-anchoring hearing aid is advised for those with profound hearing loss. According to studies, depressive symptoms are reduced within three months of hearing aid use.

  • Auditory Training: Aural rehabilitation helps individuals to communicate effectively and reduce the intensity of hearing loss. The audiologist helps patients understand how their hearing ability will improve and recommends effective listening techniques to the patients.

  • Assistive Listening Device: A headset device that receives signals through various means and is connected to speakers or phones.

  • Therapy: Patients benefit from receiving therapy along with interventions for hearing loss.

Conclusion

Hearing loss and depression are co-existing conditions in several patients. The association is more prevalent in older age groups. They may become very depressed, have bad moods, become socially isolated, and develop suicidal tendencies. Training audiologists to diagnose and refer such patients to mental health institutions is crucial.

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Dr. Vipul Chelabhai Prajapati
Dr. Vipul Chelabhai Prajapati

Psychiatry

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