High burden of comorbidity and clinical outcomes in people with hearing loss

By Melanie Hinze

Hearing loss is common and associated with high comorbi­dity and substantial increases in potentially preventable adverse outcomes, new research published in eClinicalMedicine suggests.

The retrospective population­ based cohort study included more than 4.7 million adults living in Alberta, Canada, between April 2004 and March 2019. Overall, 78,172 partici­pants had hearing loss at baseline and another 74,594 received a new hearing loss diagnosis during a median of 14.4 years’ follow up, resulting in a total of 3.2% of participants with hearing loss.

Using administrative health data, the study authors assessed the prevalence of 31 comorbi­dities at baseline and clinical outcomes during follow up. Clinical outcomes included death, myocardial infarction, stroke or transient ischaemic attack, depression, dementia, placement in long­-term care, hospitalisation, emergency visits, pressure ulcers, adverse drug events and falls.

Both the total number of comorbidities and the prevalence of each comorbidity were higher among participants with hearing loss than those without and remained more prevalent in those with hearing loss after standardisation for age and sex. The most common comorbidities in participants with hearing loss were hypertension (26.8%), chronic pain (19.7%), obesity (13.2%) and depression (10.8%).

During follow up, participants with hearing loss had higher rates of days in hospital, falls, adverse drug events and emergency visits, compared with those without hearing loss. They also had higher adjusted hazards of death, myocardial infarction, stroke or transient ischaemic attack, depression, heart failure, dementia, pressure ulcers and long-term care placement.

Associate Professor Melville da Cruz, ENT Surgeon at Westmead Public and Westmead Private Hospitals, Sydney, and Associate Professor of Otolaryngology in The University of Sydney’s Department of Surgery, said this research built on already known strong associations between hearing loss, dementia and falls.

‘By using retrospective data from a very large population cohort gleaned from a Canadian universal healthcare database, the authors have shown further associations of hearing loss with significant burdens of a large variety of health comorbidity,’ he said.

‘The age-sex-standardised prevalence of all 31 studied comorbidities was higher among participants with hearing loss than those without,’ he added.

‘These findings are important for all healthcare providers but focus the attention of primary healthcare practitioners on the broad adverse influence of hearing loss on many aspects of patient’s health,’ Associate Professor da Cruz told Medicine Today.

The authors concluded that early intervention and increased investment in hearing loss prevention and care were needed to reduce the high comorbidity and preventable adverse outcomes associated with hearing loss. 

eClinical Medicine 2023; 61: 102068; https://doi.org/10. 1016/j.eclinm.2023.102068.

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