Hearing Loss Increases Severity Risks for People with Medical Conditions

A recent population-based study conducted by scientists in Alberta, Canada, and published online in The Lancet shows that hearing loss is often accompanied by substantial comorbidity—which is the presence of two or more medical conditions—and is also associated with significantly greater risk for increases in hospitalization rates, long-term care placement, emergency visits, adverse drug events, and falls.

The researchers believe the high health burden warrants increased and better-coordinated investment to improve the care of people with hearing loss. The paper, titled “Associations between hearing loss and clinical outcomes: Population-based cohort study,” appears in the June 29, 2023 eClinicalMedicine edition of The Lancet, and its authors are affiliated with the University of Alberta, University of Calgary, and Alberta Health Services in Calgary.

People with hearing loss are at greater risk for poorer treatment success

Aiming to explore the links between hearing loss and various clinical outcomes, the Canadian research team conducted a retrospective analysis of over 4.7 million adults residing in Alberta between April 2004 and March 2019. Among this population, 152,766 individuals (3.2%) were identified as having hearing loss.

The study revealed that people with hearing loss experienced higher rates of adverse clinical outcomes than those without, including increased days spent in the hospital, higher rates of falls, adverse drug events, and emergency visits.

Furthermore, individuals with hearing loss had a higher risk of:

• Mortality
• Myocardial infarction
• Stroke/transient ischemic attack,
• Depression,
• Heart failure,
• Dementia,
• Pressure ulcers, and
• Placement in long-term care facilities.

In Canada alone, the study suggests that 15,631 individuals with hearing loss required new long-term care placement annually, of which 1023 were attributable to hearing loss. “Corresponding estimates for new dementia were 14,959 and 4350, and for [stroke or transient ischemic attack] the estimates were 11,582 and 2242,” write the authors.

The findings show higher rates of comorbidity among individuals with hearing loss and an increased risk of adverse health outcomes. This increased risk might be exacerbated by communication barriers between health professionals and patients. For example, the increased risk of long-term care placement may suggest that more support for people with hearing impairment is needed to help them remain independent.

Why would HL be associated with excess risk? For outcomes such as adverse drug events, hospitalization and preventable emergency visits, we speculate that communication barriers between health professionals and patients are responsible. The independently increased risk of [long-term care placement] warrants further investigation, since it might suggest that additional supports are required for people with HL to continue living independently despite their disability. The excess risk of falls may be due to increased cognitive load, reduced environmental awareness, or perhaps concomitant proprioceptive/vestibular dysfunction.”

Whatever the reasons, the associations between hearing loss and cardiovascular problems, hospitalization, long-term care placement, emergency visits, adverse drug events, and falls underscore the need for improved care and intervention strategies. The authors advocate for increased research, investment, and coordinated efforts to improve the care and outcomes for people with hearing loss. By addressing the high comorbidity burden and implementing preventive measures, it may be possible to enhance the quality of life for individuals with hearing loss via new strategies for prevention, improved treatment, and rehabilitation.

Funding for the study was supported by the Canadian Institutes of Health Research; David Freeze chair in health services research.