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Life sciences · Journal article
The Lancet. Healthy Longevity
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Background. Hearing loss is associated with poorer health, depression, cognitive decline, and perhaps, with increased mortality risk. Whether hearing aids ameliorate this association is not well understood. We conducted a meta-analysis with a replication study to examine associations between hearing loss, current use of hearing aids, and mortality.Methods. Hearing threshold data, all-cause mortality, and cardiovascular disease (CVD)-related mortality (available across datasets) were analysed using individual participant data (IPD) meta-analysis of three combined population-based studies: Blue Mountains Hearing Study (BMHS, Australia, 1997-2007), Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS, Iceland, 2002-06), and National Health and Nutrition Examination Survey (NHANES, USA, 1999-2006). The Nord-Trøndelag Hearing Loss Study (NTHLS, Norway, 1996-98) was chosen for replication. An IPD meta-analysis of the combined consortium datasets for BMHS (n=2689), AGES-RS (n=5171), and NHANES (n=5992) was performed using Cox regression to estimate hazard ratios and 95% CIs, after adjusting for age, sex, education, BMI, smoking, angina or heart attack, diabetes, hypertension, stroke, and noise-exposure history; NTHLS data were analysed similarly. Hearing loss was defined by better ear pure-tone average categories endorsed by the Global Burden of Disease Hearing Loss Expert Group and WHO.Findings. The IPD meta-analysis included 13 851 participants, with a mean age of 61·8 (SD 18·5; men 6228 [45·0%], women 7622 [55·0%]). Mild (1·19 [95% CI 1·10-1·29]), moderate (1·55 [1·42-1·70]), and moderately severe or worse (1·56 [1·38-1·76]) hearing loss were associated with increasing all-cause mortality risk. Mild (1·18 [95% CI 1·02-1·37]), moderate (1·43 [1·22-1·67]), and moderately severe or worse (1·30 [1·05-1·60]) hearing loss were also associated with increased CVD-related mortality risk. Current use of hearing aids was associated with reduced all-cause mortality risk [0·91 (95% CI 0·83-0·99)] and reduced CVD-related mortality [0·85 (0·73-0·99)]. The NTHLS replication study of 50 277 adults (men 23 532 [46·8%], women 26 745 [53·2%]) corroborated these findings.Interpretation. The IPD meta-analysis and Norwegian NTHLS confirmed that increasing severity of hearing loss is significantly associated with higher mortality risk. Use of hearing aids was associated with reduced mortality risk. The potential link between hearing-aid use, other forms of hearing rehabilitation, and increased life expectancy in adults is an important area for future research investigation.Funding. Macquarie University; National Institute on Deafness and Other Communication Disorders, National Institutes of Health; Icelandic Heart Association (Hjartavernd); National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; and Norwegian Institute of Public Health.