The Influence of Social Interaction and Physical Health on the Association Between Hearing and Depression With Age and Gender

Abstract

Recent epidemiological data suggest the relation between hearing difficulty and depression is more evident in younger and middle-aged populations than in older adults. There are also suggestions that the relation may be more evident in specific subgroups; that is, other factors may influence a relationship between hearing and depression in different subgroups. Using cross-sectional data from the UK Biobank on 134,357 community-dwelling people and structural equation modelling, this study examined the potential mediating influence of social isolation and unemployment and the confounding influence of physical illness and cardiovascular conditions on the relation between a latent hearing variable and both a latent depressive episodes variable and a latent depressive symptoms variable. The models were stratified by age (40s, 50s, and 60s) and gender and further controlled for physical illness and professional support in associations involving social isolation and unemployment. The latent hearing variable was primarily defined by reported hearing difficulty in noise. For all subgroups, poor hearing was significantly related to both more depressive episodes and more depressive symptoms. In all models, the direct and generally small association exceeded the indirect associations via physical health and social interaction. Significant (depressive episodes) and near significant (depressive symptoms) higher direct associations were estimated for males in their 40s and 50s than for males in their 60s. There was at each age-group no significant difference in estimated associations across gender. Irrespective of the temporal order of variables, findings suggest that audiological services should facilitate psychosocial counselling.

Keywords: UK Biobank; cardiovascular disease; depression; epidemiology; hearing; physical health; social isolation; unemployment.

Figure 1.

The measurement models for (a) depressive episodes and (b) depressive symptoms. The numbers indicate the correlations between latent variables (circled), and between each latent variable and the measurements (boxed) that define it, and measurement error variances (shown to the right of the measurements).

Figure 2.

Models examining confounding and mediating effects on the direct association between functional hearing and depressive episodes by age and gender (F: female, M: male). Variables in ovals and boxes represent latent variables and single measurements, respectively. Only significant path coefficients are shown. (a) 40–49 years, (b) 50–59 years and (c) 60–69 years.

Figure 3.

Models examining confounding and mediating effects on the direct association between functional hearing and depressive symptoms by age and gender (F: female, M: male). Variables in ovals and boxes represent latent variables and single measurements, respectively. Only significant path coefficients are shown. (a) 40–49 years, (b) 50–59 years and (c) 60–69 years.