Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

• Published in: The American journal of geriatric psychiatry 2024-04, Vol.32 (4), p.489-496
• Main Authors: Saperstein, Alice M., Subhan, Bibi A., Golub, Justin S., Medalia, Alice
• Format: Article
• Language: English
• Subjects: Aged; audiometry; Audiometry, Pure-Tone; Cross-Sectional Studies; hearing loss; Hearing Loss - complications; Hearing Loss - diagnosis; Hearing Loss - epidemiology; Humans; loneliness; Nutrition Surveys; Psychosocial Functioning; Quality of Life; Schizophrenia; Schizophrenia - complications; Schizophrenia - epidemiology
• ISSN: 1064-7481; 1545-7214; 1545-7214
• DOI: 10.1016/j.jagp.2023.11.002

•What is the primary question addressed by this study?This study evaluated whether older adults with a schizophrenia spectrum diagnosis evidence higher rates of hearing loss relative to historical data from U.S. adults of the same age.•What is the main finding of this study?People with schizophrenia spectrum disorder aged 50–70 evidenced elevated hearing loss rates. Hearing threshold was significantly associated with subjective report of hearing-related impairment and greater experienced loneliness.•What is the meaning of the finding?Evidence of increased prevalence of hearing loss in older adults with schizophrenia, which was associated with greater experienced loneliness, indicates need for routine risk assessment and mitigation, screening, and treatment with the goal of improving well-being and quality of life. The severity and impact of hearing deficits among adults with schizophrenia spectrum disorders may become increasingly relevant with advancing age. This study evaluated hearing ability and associated psychosocial functioning among older adults aged 50–70. Cross-sectional analysis. Four outpatient psychiatry clinics in New York City. Individuals aged 50–70 years with diagnoses of schizophrenia or schizoaffective disorder. Unaided pure tone air conduction audiometry conducted using a portable audiometry system determined the pure tone average (PTA) hearing threshold across four frequencies: 500, 1k, 2k, and 4k Hz. Better ear PTA defined the hearing threshold. Audiometry data retrieved from the U.S. National Health and Nutrition Examination Survey aided interpretation of sample hearing loss rates. Standard measures evaluated psychiatric symptoms, perceived impact of hearing impairment, loneliness, and quality of life. Among audiometry completers (N = 40), 35% (n = 14) demonstrated subclinical hearing loss (16–25 dB) and 35% (n = 14) had mild or worse hearing loss (≥26 dB). Rates were higher than expected based on age-based population data. Those who perceived hearing handicap rated it moderate (12.2%) or severe (7.3%); those who perceived tinnitus rated the impact as mild to moderate (12.2%) or catastrophic (2.4%). Neither psychiatric symptoms nor interviewer-rated quality of life was associated with hearing ability. Greater loneliness was significantly correlated with worse audiologic performance (r = 0.475, p