The association of hearing loss with depressive symptoms and cognitive function among older people: Results from the Brazilian Longitudinal Study of Aging

Objectives: Hearing loss, depression, and cognitive decline are common among older people. We investigated the association of hearing loss with depressive symptoms and cognitive function in a nationally representative sample of people aged 50+ in Brazil. Methods: Data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) included information on self-reported hearing loss, hearing aid use (effective or not effective), depressive symptoms (CES-D-8), and a global cognitive score (composed of immediate and late recall, verbal fluency, orientation and prospective memory) in a sample of 9412 individuals. Multiple linear regression was used to estimate the association of hearing loss and hearing aid use with both depressive symptoms and cognitive performance. The analyses were conducted with 7837 participants with complete data, and then repeated with data from the whole sample after multiple imputation. Results: Compared to those without hearing loss, those with hearing loss were more likely to have a higher number of depressive symptoms (beta: 0.53 (0.40-0.67) p < 0.001) but not worse cognitive performance (beta: -0.01 (-0.03 to 0.19) p = 0.631). Among those with hearing loss, the use of hearing aid was neither associated with cognitive performance (beta: -0.08 (-0.19 to 0.03) p = 0.169) or depressive symptoms (beta: -0.42 (-0.98 to 0.14) p = 0.143); its effective use was associated with less depressive symptoms (ss: -0.62 (-1.23 to -0.01) p = 0.045) but not worse cognitive performance (beta: -0.15 (-0.030 to 0.03) p = 0.057). Sensitivity analyses revealed that hearing loss is associated with a worse performance in two non- amnestic cognitive domains. Conclusions: Hearing loss may negatively affect specific cognitive domains and depressive symptoms among older people, and the use of a hearing aid may mitigate the association with depressive symptoms.