Association between Hearing Loss and Suicide Ideation Among Older Adults

Background and Purpose: As life expectancy increases, older people are more likely to experience hearing loss (HL) as a direct result of the aging process. Several studies have found that HL is highly correlated with a low level of physical and mental health status among older adults. The prevalence of suicidal ideation among older adults has been regarded as a major risk factor affecting their quality of life. However, despite the adverse effect of social exclusion and withdrawal due to HL on suicidal ideation, knowledge on the relationship between these factors in older adults remains still lacking. This study therefore aims to rigorously investigate the association between HL and suicidal ideation among older adults, using a nationally representative data.

Methods: A total of 15,838 older adults (over 50 years), drawn from the 2015-2017 National Survey on Drug Use and Health, comprised the study sample. Suicidal ideation was measured by asking the respondents, “At any time in the past year, did you seriously think about trying to kill yourself?” HL was assessed by asking whether the respondents were deaf or had serious difficulty hearing. Gender, age, race, marital status, educational attainment, poverty, urbanization, employment status, hospitalization, number of chronic diseases, obesity, major depressive episodes (MDE), serious psychological distress (SPD), binge drinking, cigarette, and general health status were identified as covariates.  Due to the complex survey design of NSDUH, survey data analysis procedures were utilized.

Results: Of the Americans over 50 years, 11. 7% reported being deaf or having serious difficulty hearing. The vast majority (95%) had at least one chronic disease (e.g., heart disease, diabetes, asthma, cancer, or high blood pressure) and 17.7% stayed overnight in a hospital in past year. Respondents reported smoking a cigarette (13.7%) and alcohol use (46.6%) during the past year. A large majority of them (74.7%) assessed their health as good. While 7.1% reported serious psychological distress, only a very small proportion (0.28%) of older adults seriously thought about suicide in past year. Multivariate logistic regression analyses revealed that compared with their hearing counterparts, older adults with HL were more likely to seriously think about trying to kill themselves (OR=1.34, p<.05). Gender, hospitalization, MDE, SPD, and general health status were found to be significant predictors for suicidal thoughts among older adults. 

Conclusions and Implications: The study found that older adults with HL are likely to have a high level of suicidal ideation. This result may be attributed to several factors. First, HL is a fundamental factor compromising older adults’ communication ability, which is indispensable to social engagement with friends, families, and communities, eventually making them often think about suicide. Second, HL stigma may constitute a major impediment to accepting one’s hearing loss, engaging in help-seeking behaviors, and participating in social activities, which lead to suicide prevention. Therefore, social workers and healthcare providers should better understand how older adults with HL perceive suicidal ideation within the individual, interpersonal, and social contexts. Future research should examine the mechanisms and risk factors affecting the association between HL and suicidal ideation.