Clinical depression has been referred to as the “common cold” of mental illness. Statistical figures on the incidence of depression are staggering. It is estimated that 1 out of every 5 Americans will experience an episode of depression at some point in their lives. The total number of individuals suffering from depression in the United States currently exceeds the 18-million mark.
Not surprisingly, the elderly comprise one of the largest segments of the clinically depressed population, particularly among those living in institutional settings. Given the prevalence of hearing loss, its interactive nature, and the myriad problems it is known to produce, it is reasonable to assume that the role of hearing may well be an exacerbating factor or even a contributing cause of depression in the elderly population.
Most of the studies examining the relationship between hearing loss and depression do so within the context of quality of life, which is a multidimensional concept encompassing the social, affective, physical, and cognitive domains. If the hearing loss is longstanding, we can expect that most individuals will experience some degree of emotional and social isolation, which in turn may affect quality of life, mental health, and general wellness. An assortment of earlier studies have provided evidence of an association between hearing loss and depression, but correlations are not consistent, and in fact conflict when the role of hearing loss magnitude is taken into account.2-6 Most of the evidence presented seems to suggest that emotional disturbance of more than a transitory nature occurs with hearing loss, and that it is reduced when treatment is rendered.2,4,7,8
In addition to depression, there is a significant correlation between uncorrected hearing loss and cognitive decline. Of particular interest are the studies that have examined the relationship between changes in sensory function (vision and hearing) with age and reduced intellectual and cognitive function.9,10 Sensory function is seen as a strong predictor of cognitive function in elderly people. The model presented by a number of authors suggests that age-related differences in cognitive function are so strongly related to sensory function that age in itself plays a relatively subordinate role. If this is indeed the case, it is a very strong argument for early detection and fitting of hearing aids.11 As we have seen in research with Alzheimer’s patients, hearing loss exacerbates difficulties with speech comprehension, as the necessary cognitive reserves required for compensatory strategies are not available.10 The more auditory information that is made available, the greater the likelihood that an impaired cognitive system will be able to process it effectively.
There are a number of excellent resources available where readers can gain further information, including the following organizations:
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Acknowledgements
The author would like to acknowledge Nicole Hemsley, Director of the Amsterdam Free Library, for her valuable assistance in securing journal articles and reference material.
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Carl R. Chiasson, AuD, is a second-generation audiologist and hearing instrument specialist who is a staff audiologist at a HearUSA practice located in Kingston, NY. CORRESPONDENCE can be addressed to Dr Chiasson at: carl_r_aud@yahoo.com. |
References
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