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中国健康与养老追踪调查中听力损失与抑郁之间的关联。

The association between hearing loss and depression in the China health and retirement longitudinal study.

作者信息

Zhang Yanju, He Xiaofang, Liu Yibo, Tian Chunhong, Yang Hui, Zhang Lin

机构信息

The Second Clinical Medical College of Guizhou University of Traditional Chinese Medicine, Guiyang, China.

Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China.

出版信息

Sci Rep. 2025 Jul 1;15(1):20537. doi: 10.1038/s41598-025-05749-9.


DOI:10.1038/s41598-025-05749-9
PMID:40595946
Abstract

Hearing loss (HL) is a common health issue among older adults worldwide, and its incidence is expected to increase as the population ages. A study has shown that among the estimated 500 million people with hearing impairments worldwide, 28 million Americans suffer from hearing disabilities, and the highest number of individuals with hearing impairments is found in the 45-to-64 years old age group. Depression is a significant public health concern for middle-aged and older adults. In 2015, researchers used data from over 100,000 participants that were collected by the UK Biobank to perform a cross-sectional study and reported that the association between hearing impairment and depression was more pronounced among younger participants (aged 40-49 years) and among those with milder forms of depression. These findings suggest that the impact of hearing impairment on mental health may begin to emerge in middle age. Hearing loss may lead to more obstacles for middle-aged individuals in terms of work and social interactions, thereby increasing the risk of depression. Early intervention for hearing impairment is particularly important for middle-aged people, as it can help identify early risk factors and provide more effective interventions to improve mental health and quality of life. Therefore, building on the existing literature that predominantly focused on older adults, this study involved analysing data from the China Health and Retirement Longitudinal Study(CHARLS) database, expanding the age range to 45 years, to investigate the relationship between self-reported hearing loss and depression among middle-aged and older adults. This research used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), including data from 5207 individuals aged 45 years and older. Hearing status was self-reported by the participants, whereas depression was assessed with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). A multivariable logistic regression model was used to investigate the association between self-reported hearing loss and depression, controlling for sociodemographic variables that are associated with depression in middle-aged and older populations. This study involved the use of a multinomial logistic regression model to analyse the relationship between self-reported hearing loss and depression among middle-aged and older adults, with adjustments made for potential confounding variables. The analysis revealed significant relationships between depression and factors such as hearing status, sex, place of residence, self-rated health, chronic diseases, disabilities with respect to activities of daily living (ADLs), and satisfaction with life. Specifically, individuals with self-reported hearing loss, female individuals, individuals residing in rural areas, individuals with poor self-rated health, individuals with chronic diseases, and individuals with disabilities related to ADLs were more likely to experience depression. In the unadjusted model that was used to analyse the relationship between self-reported hearing loss and depression among middle-aged and older adults, both fair hearing (unadjusted OR = 1.556, 95% CI 1.377-1.758) and poor hearing (unadjusted OR = 2.001, 95% CI 1.630-2.457) were significantly associated with the prevalence of depression. After controlling for various covariates, including sex, age, residential status, education level, marital status, health status, physical disability, chronic diseases, activities of daily living (ADLs), and satisfaction with life, our study revealed that both fair hearing (adjusted OR = 1.235, 95% CI: 1.078, 1.415) and poor hearing (adjusted OR = 1.335, 95% CI: 1.063, 1.677) remained significantly correlated with the prevalence of depression among middle-aged and older adults. Previous research has focused primarily on older adults. Therefore, the present study expanded the age range to include individuals as young as 45 years old. The results show that fair hearing and poor hearing are significantly associated with the prevalence of depression among middle-aged and older adults. These findings suggest that self-reported hearing loss is a risk factor for depression in this population in China. The association between self-reported hearing loss and depression is not limited to older adults but also includes middle-aged individuals.

摘要

听力损失(HL)是全球老年人群中常见的健康问题,并且随着人口老龄化,其发病率预计将会上升。一项研究表明,在全球约5亿听力受损人群中,有2800万美国人患有听力障碍,且听力受损人数最多的是45至64岁年龄组。抑郁症是中老年人群的一个重大公共卫生问题。2015年,研究人员利用英国生物银行收集的超过10万名参与者的数据进行了一项横断面研究,并报告称听力障碍与抑郁症之间的关联在年轻参与者(40 - 49岁)以及抑郁症症状较轻的人群中更为明显。这些发现表明,听力障碍对心理健康的影响可能在中年时期就开始显现。听力损失可能给中年个体在工作和社交互动方面带来更多障碍,从而增加患抑郁症的风险。对听力障碍进行早期干预对中年人尤为重要,因为它有助于识别早期风险因素,并提供更有效的干预措施来改善心理健康和生活质量。因此,基于现有主要关注老年人的文献,本研究分析了中国健康与养老追踪调查(CHARLS)数据库的数据,将年龄范围扩大到45岁,以调查中老年人群中自我报告的听力损失与抑郁症之间的关系。本研究使用了2018年中国健康与养老追踪调查(CHARLS)的数据,包括5207名45岁及以上个体的数据。听力状况由参与者自我报告,而抑郁症则使用10项流行病学研究中心抑郁量表(CES - D - 10)进行评估。使用多变量逻辑回归模型来研究自我报告的听力损失与抑郁症之间的关联,并控制与中老年人群抑郁症相关的社会人口学变量。本研究使用多项逻辑回归模型来分析中老年人群中自我报告的听力损失与抑郁症之间的关系,并对潜在的混杂变量进行了调整。分析揭示了抑郁症与听力状况、性别、居住地点、自我健康评价、慢性病、日常生活活动(ADL)残疾以及生活满意度等因素之间存在显著关系。具体而言,自我报告有听力损失的个体、女性个体、居住在农村地区的个体、自我健康评价差的个体、患有慢性病的个体以及与ADL相关的残疾个体更易患抑郁症。在用于分析中老年人群中自我报告的听力损失与抑郁症之间关系的未调整模型中,听力尚可(未调整OR = 1.556,95% CI 1.377 - 1.758)和听力差(未调整OR = 2.001,95% CI 1.630 - 2.457)均与抑郁症患病率显著相关。在控制了各种协变量后,包括性别、年龄、居住状况、教育水平、婚姻状况、健康状况、身体残疾、慢性病、日常生活活动(ADL)以及生活满意度,我们的研究表明,听力尚可(调整后OR = 1.235,95% CI:1.078,1.415)和听力差(调整后OR = 1.335,95% CI:1.063,1.677)在中老年人群中仍与抑郁症患病率显著相关。以往的研究主要集中在老年人身上。因此,本研究扩大了年龄范围,将年龄小至45岁的个体纳入其中。结果表明,听力尚可和听力差与中老年人群抑郁症患病率显著相关。这些发现表明,自我报告的听力损失是中国该人群中抑郁症的一个风险因素。自我报告的听力损失与抑郁症之间的关联不仅限于老年人,还包括中年个体。

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本文引用的文献

[1]
Association between age-related hearing loss and depression: A systematic review and meta-analysis.

PLoS One. 2025-1-3

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Front Neurol. 2024-10-21

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