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Hearing loss, loneliness and social isolation

Hearing loss is common in older adults and typically impairs communication and social interactions.  In Australia at least 1 in 3 adults over 60 have a hearing loss.   A growing body of research has linked untreated age-related hearing loss to depression, functional decline, cognitive (mental) decline and dementia1,2.    A scientific literature review published in 2020 also found that hearing loss is associated with a higher risk of loneliness and social isolation3.  This finding has important implications for the cognitive and psychological health of all older adults.

Social isolation can be seen as a state of having minimal contact with others.  It reflects the size of your network of friends, family and social contacts and how often you meet up with these people. Loneliness is related to social isolation but is a little different.  It is a subjective feeling of having a lower level of social contact than you desire.  It arises when our social needs are not met by the quantity and quality of our social relationships.   Sadly, both conditions are common in older adults with approximately one quarter experiencing social isolation4.

Research clearly shows that social isolation and loneliness can have detrimental effects on our health.   These include depression, poor sleep, accelerated cognitive (mental) decline, reduced brain function, high blood pressure, heart disease, and impaired immunity5,6,  In addition, social isolation Increases the risk of premature death from every cause for every race7.   The effect is similar in magnitude to that of obesity and smoking.

A large number of high quality studies have examined hearing loss and social isolation and/or loneliness.   They found that older adults with hearing loss were more likely to be socially isolated and to report loneliness compared to those with normal hearing.    One study found that those with a high level of self-perceived hearing difficulty had over twice the odds of loneliness compared to others8. Older women with hearing loss were more likely to report social isolation than men in some of the studies3.  This may be because women have been found to rely more on verbal communication to establish and maintain social relationships.

So why might hearing loss lead to social isolation and loneliness?  Age related hearing loss makes conversation more difficult to follow.  This can lead to frustration and may result in the one avoiding potentially embarrassing situations particularly in social settings, groups or noisy places.   In addition, the effort involved in listening may also lead to depleted reserves for social activity and interactions.   Hence, it might just feel easier to sit at home on the couch.  Unfortunately, this doesn’t have great long term effects.   Emerging research indicates that reduced social engagement due to hearing loss may in turn lead to cognitive (mental) decline 3.

But there is an answer – a pair of well fitted hearing aids!    Technology has come ahead in leaps and bounds in the last few years.  Modern hearing aids enhance the clarity of speech, even in group situations and reduce the fatigue and embarrassment associated with hearing difficulty.    Hearing aids are a proactive step you can take in optimizing your mental and psychological health.

 Tips for meeting new friends and engaging with others

References

  1. Lin FR, Yaffe K, Xia, J. et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med.  2013;173(4):293-299.
  2. Deal JA, Reed NS, Kravetz AD, et al. Incident hearing loss and comorbidity: a longitudinal administrative claims study. JAMA Otolaryngol Head Neck Surg. 2018;145(1):36-43.
  3. Shukla A, Harper M, Pedersen E, et al. Hearing loss, loneliness, and social isolation: a systematic review. J Otolaryngol-Head N. 2020;162(5): 622-633.
  4. Cudjoe TK, Roth DL, Szanton SL, et al. The epidemiology of social isolation: national health and aging trends study. J Gerontol B Psychol Sci Soc Sci. 2018;75(1):107-113.
  5. Hawkley LC & Capitanio, JP. Perceived social isolation, evolutionary fitness and health outcomes: a lifespan approach.  Philos Trans R Soc Lond B Biol Sci. 2015:370(1669).
  6. Shanker A, Hamer M, McMunn A, et al. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English longitudinal study of ageing. Psychosom Med. 2013;75(2):161-170.
  7. Alcaraz K, Eddens KS, Blasé JL, et al. Social isolation and mortality in US black and white men and women. Am J Epidemiol. 2019;188(1):102-109.
  8. Tomioka K, Ikeda H, Hanaie K, et al. The hearing handicap inventory for elderly-screening (HHIE-S) versus a single question: reliability, validity, and relations with quality of life measures in the elderly community, Japan. Qual Life Res. 2013;22(5):1151-1159.