Trajectory of depressive symptom before and after incident hearing loss: A 24-year population-based longitudinal cohort study

BACKGROUND: Although hearing loss (HL) is a known risk factor for depressive symptoms, how depressive symptoms progress after its onset remains insufficiently explored. This study aimed to explore whether incident HL is associated with an acute increase and a sustained progress in depressive symptoms, after accounting for pre-HL depressive trajectories. METHODS: Using longitudinal data from the Health and Retirement Study (1998-2022), depressive symptoms were assessed biennially using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D). Linear mixed-effects models were employed to estimate acute changes at the time of HL onset and the annual rate of change in depressive symptoms post-HL, while adjusting for pre-HL trajectories and baseline covariates. RESULTS: Among 11,099 participants (mean age 64.8 years), 3024 developed incident HL over a mean follow-up of 15.7 years. Prior to HL onset, the annual increase in depressive symptoms did not differ significantly between those who developed HL and those who remained free of HL. Following HL onset, a significant acute increase in depressive symptoms was observed (β = 0.234; 95 % CI: 0.184 to 0.283). Additionally, there was a sustained acceleration in the annual rate of increase in depressive symptoms post-HL (β = 0.013/year; 95 % CI: 0.005 to 0.022). CONCLUSIONS: Incident HL is associated with an immediate increase and a long-term progress in depressive symptoms, independent of pre-onset trajectories. These findings highlight HL as a preventable risk factor for late-life depressive symptoms and underscore the importance of early detection and intervention for hearing to mitigate depressive symptom risk in aging populations.