Hearing loss is a prevalent condition among older adults and is associated with adverse health outcomes, including depression. However, evidence on the association between hearing loss, hearing aid (HA) use, and depressive symptoms from large-scale, longitudinal, and diverse populations remains limited. This study analyzed individual-level data from five nationally representative longitudinal cohort studies across 24 countries, including participants aged 50 years or older. Hearing function, HA use, and depressive symptoms were assessed using standardized measures. Generalized estimating equations (GEEs) were used to evaluate the associations between hearing loss, HA use, and depressive symptoms. Multiple sensitivity analyses and cross-lagged panel analyses were conducted to ensure robustness. A total of 285,775 observations were included, with 83,711 reporting hearing loss and 19,748 (23.6%) using HAs. Hearing loss was significantly associated with higher odds of depressive symptoms (OR: 1.53, 95% CI: 1.50-1.57). Among individuals with hearing loss, HA use was associated with reduced odds of depressive symptoms (OR: 0.78, 95% CI: 0.75-0.82). Sensitivity analyses confirmed the robustness of these findings. Bidirectional cross-lagged effects revealed reciprocal associations: hearing loss and depressive symptoms mutually reinforced each other (standardized coefficients: 0.05 and 0.03, p < 0.001), while hearing aid use alleviated depressive symptoms but was itself reduced by depression over time (–0.05 and -0.02, p < 0.001). Hearing loss is independently associated with increased depressive symptoms in older adults, while HA use may reduce this risk. These findings highlight the importance of hearing care interventions to improve mental health outcomes in aging populations.

Authors:
Dongshan Zhu, Shandong University, China
Qi Wang, Shandong University, China
Xiang Li, Shandong University, China
Zhongxuan Wang, Shandong University, China
Chunying Fu, Shandong University, China
Bo Xi, Shandong University, China

About the Presenter(s)
Mr. Xiang Li is currently a Master's candidate at the School of Public Health, Shandong University, specializing in Epidemiology and Health Statistics.

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