Association of Self-Recognition of Hearing Loss With Hospitalizations in Older Adults in the United States

Sarah Bessen; Wuyang Zhang; Frank R Lin; Emmanuel E Garcia Morales; Nicholas S Reed

doi:10.1097/MLR.0000000000002133

Association of Self-Recognition of Hearing Loss With Hospitalizations in Older Adults in the United States

Med Care. 2025 Jan 23. doi: 10.1097/MLR.0000000000002133. Online ahead of print.

Authors

Sarah Bessen^{1

2}, Wuyang Zhang^{1

3}, Frank R Lin^{1

2

3}, Emmanuel E Garcia Morales^{1

2}, Nicholas S Reed^{1

2

4}

Affiliations

¹ Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD.
² Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
⁴ Optimal Aging Institute, NYU Grossman School of Medicine, New York, NY.

PMID: 39846991
DOI: 10.1097/MLR.0000000000002133

Abstract

Background: Hearing loss is highly prevalent and associated with increased health care utilization. Recognition of hearing loss may play an important role in self-advocacy in difficult communication situations and prevent negative outcomes.

Objectives: To investigate the associations between self-recognition of hearing loss and hospitalization outcomes.

Research design and subjects: This is a cross-sectional analysis of 1766 participants from the National Health and Aging Trends Study.

Exposures and outcomes: The exposure, recognition of hearing loss, was constructed using participants' self-reported functional hearing difficulty, audiometric hearing loss, and self-reported hearing aid use. Primary outcomes included self-reported hospital stay occurrence and number of hospital stays within the last year. Regression models were adjusted for demographic, socioeconomic, and health characteristics and further stratified by severity of hearing loss.

Results: Among 1766 participants with hearing loss, those with unrecognized hearing loss [60.1% (n=1062)] had higher but statistically insignificant odds of any hospitalization [odds ratio (OR)=1.32; 95% CI: 0.96, 1.81] or higher count of hospitalizations [incident rate ratio (IRR)=1.13; 95% CI: 0.85, 1.51] compared with those with recognized hearing loss (39.9%, n=704). Among participants with mild hearing loss, those with unrecognized hearing loss demonstrated significantly higher odds of any hospitalization occurrence (OR=2.50; 95% CI: 1.26-4.97) and a higher count of hospitalizations (IRR=2.00, 95% CI: 1.00-4.01) than those with recognized hearing loss. There were no significant differences in hospitalization outcomes among participants with moderate or greater hearing loss.

Conclusions: In a nationally representative sample of older adults, individuals with unrecognized hearing loss compared with those with self-recognized hearing loss may be at increased odds of adverse hospitalization outcomes.