Association of Hearing Impairment and Mortality in Older Adults

Dane J Genther, Joshua Betz, Sheila Pratt, Steven B Kritchevsky, Kathryn R Martin, Tamara B Harris, Elizabeth Helzner, Suzanne Satterfield, Qian-Li Xue, Kristine Yaffe, Eleanor M Simonsick, Frank R Lin, for the Health ABC Study

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102 Citations (Scopus)


BACKGROUND: Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults.

METHODS: Prospective observational data from 1,958 adults ≥70 years of age from the Health, Aging, and Body Composition Study were analyzed using Cox proportional hazards regression. Participants were followed for 8 years after audiometric examination. Mortality was adjudicated by obtaining death certificates. Hearing was defined as the pure-tone average of hearing thresholds in decibels re: hearing level (dB HL) at frequencies from 0.5 to 4kHz. HI was defined as pure-tone average >25 dB HL in the better ear.

RESULTS: Of the 1,146 participants with HI, 492 (42.9%) died compared with 255 (31.4%) of the 812 with normal hearing (odds ratio = 1.64, 95% CI: 1.36-1.98). After adjustment for demographics and cardiovascular risk factors, HI was associated with a 20% increased mortality risk compared with normal hearing (hazard ratio = 1.20, 95% CI: 1.03-1.41). Confirmatory analyses treating HI as a continuous predictor yielded similar results, demonstrating a nonlinear increase in mortality risk with increasing HI (hazard ratio = 1.14, 95% CI: 1.00-1.29 per 10 dB of threshold elevation up to 35 dB HL).

CONCLUSIONS: HI in older adults is associated with increased mortality, independent of demographics and cardiovascular risk factors. Further research is necessary to understand the basis of this association and whether these pathways might be amenable to hearing rehabilitation.

Original languageEnglish
Pages (from-to)85-90
Number of pages6
JournalThe Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Issue number1
Early online date14 Jul 2014
Publication statusPublished - Jan 2015

Bibliographical note

© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

This research was supported by National Institute on Aging (NIA)
(N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106); NIA grant
(R01-AG028050); and National Institute of Nursing Research (NINR)
grant (R01-NR012459). This study was further supported in part by
National Institutes of Health (NIH) grant (T32DC000027), NIA grant
(K24AG031155), National Institute on Deafness and Other Communication
Disorders (NIDCD) grant (K23DC011279), Intramural Research Program
of the National Institute on Aging, Triological Society and American
College of Surgeons through the Clinician Scientist Award, and Eleanor
Schwartz Charitable Foundation. S.P. was supported with resources and
the use of facilities at the VA Pittsburgh Healthcare System, Pittsburgh,
PA; however, the contents do not represent the views of the Department
of Veterans Affairs or the United States Government. The sponsors had no
role in the design and conduct of the study; in the collection, analysis, and
interpretation of the data; or in the preparation of the manuscript.


  • epidemiology
  • longevity
  • outcomes
  • public health
  • successful aging


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