Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
National Health Commission (NHC) Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.
Int J Geriatr Psychiatry. 2022 Jun;37(6). doi: 10.1002/gps.5729.
To evaluate whether social isolation and loneliness mediates the relationship between hearing loss and depression symptoms in older adults in China.
A cross-sectional analysis was conducted of 3769 participants (aged≥60 years) in Shandong province of China. Hearing loss was assessed using Pure-Tone Audiometry test, depression symptoms using 15-item Geriatric Depression Scale, loneliness through UCLA Loneliness Scale and social isolation using Lubben Social Network Scale. Regression and bootstrap analyses were performed to test both direct associations of hearing loss and depression symptoms, and whether the mediating role of social isolation and loneliness.
Overall, 44% of older adults had hearing loss, which was generally mild (30%) rather than moderate (10%), severe (3%) or profound (0.6%). Increasing levels of hearing loss was associated with increasing levels of social isolation and depressions. Hearing loss was also associated with loneliness, but here a threshold effect was apparent and no trend for increasing loneliness with increasing hearing loss. Models that included social isolation and loneliness showed an amelioration in the association of hearing loss and depression, although it remained significant at all levels of hearing loss. Overall, 8% of the total effect of hearing loss on depression symptoms was explained by the mediated effect through social isolation and 42% by loneliness.
Psychosocial factors such as social isolation and loneliness might explain the association between hearing loss and depression. Interventions that address older adults' social isolation and loneliness may ameliorate depression in older adults with hearing loss.
评估在中国老年人中，社会隔离和孤独是否在听力损失与抑郁症状之间起中介作用。
对中国山东省的 3769 名（年龄≥60 岁）参与者进行了横断面分析。使用纯音测听试验评估听力损失，使用 15 项老年抑郁量表评估抑郁症状，使用 UCLA 孤独量表评估孤独感，使用 Lubben 社会网络量表评估社会隔离。回归和 bootstrap 分析用于测试听力损失和抑郁症状的直接关联，以及社会隔离和孤独感的中介作用。
总体而言，44%的老年人有听力损失，听力损失通常较轻（30%），而非中度（10%）、重度（3%）或极重度（0.6%）。听力损失程度的增加与社会隔离和抑郁程度的增加有关。听力损失也与孤独感有关，但存在一个阈值效应，即随着听力损失的增加，孤独感并没有增加的趋势。纳入社会隔离和孤独感的模型显示，听力损失与抑郁之间的关联有所改善，但在所有听力损失水平下仍具有统计学意义。总体而言，听力损失对抑郁症状总效应的 8%通过社会隔离的中介效应来解释，42%通过孤独感来解释。
社会隔离和孤独等心理社会因素可能解释了听力损失与抑郁之间的关系。针对老年人社会隔离和孤独感的干预措施可能会改善听力损失老年人的抑郁症状。
