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Original Investigation
July 2016

Association of Using Hearing Aids or Cochlear Implants With Changes in Depressive Symptoms in Older Adults

Author Affiliations
  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
  • 3University of Oklahoma College of Medicine, Oklahoma City
  • 4Drexel University College of Medicine, Philadelphia, Pennsylvania
  • 5Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University, Baltimore, Maryland
  • 6Department of Epidemiology, The Johns Hopkins University, Baltimore, Maryland
JAMA Otolaryngol Head Neck Surg. 2016;142(7):652-657. doi:10.1001/jamaoto.2016.0700

Importance  Hearing loss is a common health problem in older adults that is strongly associated with the development of depression. Previous cross-sectional studies have reported lower odds of depression among individuals who use hearing aids. However, there have been limited prospective studies investigating the effect of hearing loss treatments on depressive symptoms.

Objective  To investigate the association between treatment with a hearing aid or cochlear implant with depressive symptoms in older adults.

Design, Setting, and Participants  A prospective observational study was conducted of 113 participants 50 years or older who received hearing aids (n = 63) or cochlear implants (n = 50). Participants were recruited from August 1, 2011, to January 31, 2014, at a tertiary care academic center.

Intervention  Hearing aid or cochlear implantation.

Main Outcomes and Measures  Depressive symptoms were evaluated by the 15-item Geriatric Depression Scale (GDS) at baseline and at 6 and 12 months after intervention. The score ranges from 0 to 15, and various scores between 3 and 10 have been used as being suggestive of depression.

Results  The median age of the 113 study participants was 69.6 years (interquartile range, 63.5-77.4 years). At baseline, the mean GDS score for the participants was 41% lower (95% CI, 7%-63%) among those receiving hearing aids (mean score, 1.5; 95% CI, 0.7-3.3) compared with those receiving cochlear implants (mean score, 2.6; 95% CI, 1.3-5.1). Cochlear implant recipients’ GDS scores improved from baseline to 6 months after treatment by 31% (95% CI, 10%-47%) and from baseline to 12 months after treatment by 38% (95% CI, 18%-54%). Hearing aid recipients’ GDS scores improved by 28% (95% CI, 0%-48%) at 6 months after treatment but were not significantly different from baseline at 12 months after treatment (16%; 95% CI, –24% to 43%).

Conclusions and Relevance  There was a significant improvement in depressive symptoms at 6 months after treatment for patients receiving cochlear implants and hearing aids; this improvement persisted to 12 months for those who received cochlear implants. Further research is warranted to assess the long-term effect of hearing rehabilitation on mental health in older adults.