PP1015 - Hearing Impairment, Hearing Restrictions, Cognition, and Loneliness: A Study of the Elderly

Abstract:
The hearing loss leads to restricted participation in activities of daily living and social isolation. The relationship between cognition, participation restrictions in social activities and loneliness in elderly with untreated hearing impairment was studied. The results showed that the greater the hearing loss, the higher the self-perception of participation restrictions (social, emotional, and total HHIE score) and the higher the reported loneliness. The older the individual, worse was the performance related to working memory. The increased in the average in the better ear hearing thresholds was associated with the increase in Loneliness and hearing handicap scales.

Summary:
Rationale
The hearing loss leads to restricted participation in activities of daily living and social isolation as well as the greater the loss, the greater the impacts.

Design
The relationship between cognition, participation restrictions in social activities and loneliness in elderly with untreated hearing impairment was studied. This is an observational, cross-sectional study with a convenience sample. Fifty individuals (25 females and 25 males), aged between 61 and 86 years, were selected. They had acquired bilateral symmetrical sensorineural hearing loss of mild and moderate degree associated with aging. Research protocol: basic audiological evaluation, Hearing Handicap Inventory for the Elderly (HHIE), Brazilian Loneliness Scale UCLA-BR, cognitive screening CASI-S, and direct and reverse digit span. Data analysis was conducted using the Statistical Package for Social Science, version 28.0. Multiple linear regression models were developed to investigate the influence of the degree of hearing loss, gender, education level, and CASI-S score on feelings of loneliness and self-perceived participation restrictions in daily activities. The level of statistical significance was set at 5% (p ≤ 0.05).

Results
There was no difference by gender for any variables. The greater the hearing loss, the higher the self-perception of participation restrictions (social, emotional, and total HHIE score) and the higher the reported loneliness. The older the individual, the lower the digit span scores (direct and reverse order). Higher socioeconomic status was associated with higher digit span scores (direct and reverse order), better cognitive performance (higher CASI-S scores), and lower self-perception of participation restrictions on the social scale and total score. The variances in CASI and HHIE scores were able to explain 3.3% and 30.8% of the variance in UCLA-BR scores, respectively. The variance in UCLA-BR scores was able to explain 33.9% of the variance in HHIE scores. For each point increased in the HHIE score there was an increase of 0.42 in the UCLA-BR score; for each point increase in the CASI-S, there was a decrease of 0.74 in the UCLA-BR score. For each point increased in CASI-S, there was a decrease of 0.23 points in HHIE; for each point increased in UCLA-BR score, there was an increase of 1.12 in the HHIE score. For each 1dBHL increased in the average in the better ear hearing thresholds, there was an increase of 0.34 in UCLA-BR score and a 0.24 increase in the HHIE score.

Conclusion
The greater the hearing loss, the higher the reported hearing restrictions and loneliness; the variances in HHIE scores could explain one-third of the UCLA-BR score variance, and the variance in UCLA-BR scores could explain one-third of the HHIE score variance.