Association of Hearing Impairment with Declines in Physical Functioning and the Risk of Disability in Older Adults

David S. Chen, Joshua Betz, Kristine Yaffe, Hilsa N. Ayonayon, Stephen Kritchevsky, Kathryn R. Martin, Tamara B. Harris, Elizabeth Purchase-Helzner, Suzanne Satterfield, Qian-Li Xue, Sheila Pratt, Eleanor M. Simonsick, Frank R. Lin*, Health ABC study

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

138 Citations (Scopus)


Background: Identifying factors associated with functional declines in older adults is important given the aging of the population. We investigated if hearing impairment is independently associated with objectively measured declines in physical functioning in a community-based sample of older adults.

Methods: Prospective observational study of 2,190 individuals from the Health, Aging, and Body Composition study. Participants were followed annually for up to 11 visits. Hearing was measured with pure-tone audiometry. Physical functioning and gait speed were measured with the Short Physical Performance Battery (SPPB). Incident disability and requirement for nursing care were assessed semiannually through self-report.

Results: In a mixed-effects model, greater hearing impairment was associated with poorer physical functioning. At both Visit 1 and Visit 11, SPPB scores were lower in individuals with mild (10.14 [95% CI 10.04-10.25], p <.01; 7.35 [95% CI 7.12-7.58], p <.05) and moderate or greater hearing impairment (10.04 [95% CI 9.90-10.19], p <.01; 7.00 [95% CI 6.69-7.32], p <.01) than scores in normal hearing individuals (10.36 [95% CI 10.26-10.46]; 7.71 [95% CI 7.49-7.92]). We observed that women with moderate or greater hearing impairment had a 31% increased risk of incident disability (Hazard ratio [HR] = 1.31 [95% CI 1.08-1.60], p <.01) and a 31% increased risk of incident nursing care requirement (HR = 1.31 [95% CI 1.05-1.62], p = .02) compared to women with normal hearing.

Conclusions: Hearing impairment is independently associated with poorer objective physical functioning in older adults, and a 31% increased risk for incident disability and need for nursing care in women.

Original languageEnglish
Pages (from-to)654-661
Number of pages8
JournalThe Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Issue number5
Early online date3 Dec 2014
Publication statusPublished - May 2015

Bibliographical note

Funding sources contributed to design and conduct of the study, management and analysis of the data, as well as the preparation and review of the manuscript. Dr Frank Lin reports being a consultant to Cochlear, serving on the scientific advisory board for Autifony and Pfizer, and being a speaker for Med El and Amplifon. Dr Sheila Pratt was supported with resources and the use of facilities at the VA Pittsburgh Healthcare System, Pittsburgh, PA. However, the contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government.


  • Physical function
  • Physical performance
  • Epidemiology


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