Dataset Information

Socioeconomic and lifestyle factors associated with hearing loss in older adults: a cross-sectional study of the English Longitudinal Study of Ageing (ELSA).

ABSTRACT:

Objectives

Aims were (1) to examine whether socioeconomic position (SEP) is associated with hearing loss (HL) among older adults in England and (2) whether major modifiable lifestyle factors (high body mass index, physical inactivity, tobacco consumption and alcohol intake above the low-risk-level guidelines) are associated with HL after controlling for non-modifiable demographic factors and SEP.

Setting

We used data from the wave 7 of the English Longitudinal Study of Ageing, which is a longitudinal household survey dataset of a representative sample of people aged 50 and older.

Participants

The final analytical sample was 8529 participants aged 50-89 that gave consent to have their hearing acuity objectively measured by a screening audiometry device and did not have any ear infection.

Primary and secondary outcome measures

HL defined as >35 dBHL at 3.0 kHz (better-hearing ear). Those with HL were further subdivided into two categories depending on the number of tones heard at 3.0 kHz.

Results

HL was identified in 32.1% of men and 22.3% of women aged 50-89. Those in a lower SEP were up to two times more likely to have HL; the adjusted odds of HL were higher for those with no qualifications versus those with a degree/higher education (men: OR 1.87, 95%CI 1.47 to 2.38, women: OR 1.53, 95%CI 1.21 to 1.95), those in routine/manual occupations versus those in managerial/professional occupations (men: OR 1.92, 95%CI 1.43 to 2.63, women: OR 1.25, 95%CI 1.03 to 1.54), and those in the lowest versus the highest income and wealth quintiles (men: OR 1.62, 95%CI 1.08 to 2.44, women: OR 1.36, 95%CI 0.85 to 2.16, and men: OR1.72, 95%CI 1.26 to 2.35, women: OR 1.88, 95%CI 1.37 to 2.58, respectively). All regression models showed that socioeconomic and the modifiable lifestyle factors were strongly associated with HL after controlling for age and gender.

Conclusions

Socioeconomic and lifestyle factors are associated with HL among older adults as strongly as core demographic risk factors, such as age and gender. Socioeconomic inequalities and modifiable lifestyle behaviours need to be targeted by the health policy strategies, as an important step in designing interventions for individuals that face hearing health inequalities.

SUBMITTER: Tsimpida D

PROVIDER: S-EPMC6756470 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic and lifestyle factors associated with hearing loss in older adults: a cross-sectional study of the English Longitudinal Study of Ageing (ELSA).

Tsimpida Dialechti D Kontopantelis Evangelos E Ashcroft Darren D Panagioti Maria M

BMJ open 20190917 9

<h4>Objectives</h4>Aims were (1) to examine whether socioeconomic position (SEP) is associated with hearing loss (HL) among older adults in England and (2) whether major modifiable lifestyle factors (high body mass index, physical inactivity, tobacco consumption and alcohol intake above the low-risk-level guidelines) are associated with HL after controlling for non-modifiable demographic factors and SEP.<h4>Setting</h4>We used data from the wave 7 of the English Longitudinal Study of Ageing, whi ...[more]

PMID: 31530617

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Project description:BackgroundHearing loss (HL) is a significant public health concern globally and is estimated to affect over nine million people in England. The aim of this research was to explore the regional patterns and trends of HL in a representative longitudinal prospective cohort study of the English population aged 50 and over.MethodsWe used the full dataset (74,699 person-years) of self-reported hearing data from all eight Waves of the English Longitudinal Study of Ageing (ELSA) (2002-2017). We examined the geographical identifiers of the participants at the Government Office Region (GOR) level and the geographically based Index of Multiple Deprivation (IMD). The primary outcome measure was self-reported HL; it consisted of a merged category of people who rated their hearing as fair or poor on a five-point Likert scale (excellent, very good, good, fair or poor) or responded positively when asked whether they find it difficult to follow a conversation if there is background noise (e.g. noise from a TV, a radio or children playing).ResultsA marked elevation in HL prevalence (10.2%) independent of the age of the participants was observed in England in 2002-2017. The mean HL prevalence increased from 38.50 (95%CI 37.37-39.14) in Wave 1 to 48.66 (95%CI 47.11-49.54) in Wave 8. We identified three critical patterns of findings concerning regional trends: the highest HL prevalence among samples with equal means of age was observed in GORs with the highest prevalence of participants in the most deprived (IMD) quintile, in routine or manual occupations and misusing alcohol. The adjusted HL predictions at the means (APMs) showed marked regional variability and hearing health inequalities between Northern and Southern England that were previously unknown.ConclusionsA sociospatial approach is crucial for planning sustainable models of hearing care based on actual needs and reducing hearing health inequalities. The Clinical Commissioning Groups (CCGs) currently responsible for the NHS audiology services in England should not consider HL an inevitable accompaniment of older age; instead, they should incorporate socio-economic factors and modifiable lifestyle behaviours for HL within their spatial patterning in England.

Project description:BackgroundPain has been suggested to act as a stressor during aging, potentially accelerating declines in health and functioning. Our objective was to examine the longitudinal association between self-reported pain and the development, or worsening, of frailty among older men and women.MethodsThe study population consisted of 5,316 men and women living in private households in England, mean age 64.5 years, participating in the English Longitudinal Study of Ageing (ELSA). Data from Waves 2 and 6 of ELSA were used in this study with 8 years of follow-up. At Wave 2, participants were asked whether they were "often troubled with pain" and for those who reported yes, further information regarding the intensity of their pain (mild, moderate, or severe) was collected. Socioeconomic status (SES) was assessed using information about the current/most recent occupation and also net wealth. A frailty index (FI) was generated, with the presence of frailty defined as an FI >0.35. Among those without frailty at Wave 2, the association between pain at Wave 2 and frailty at Wave 6 was examined using logistic regression. We investigated whether pain predicted change in FI between Waves 2 and 6 using a negative binomial regression model. For both models adjustments were made for age, gender, lifestyle factors, depressive symptoms, and socioeconomic factors.ResultsAt Wave 2, 455 (19.7%) men and 856 (28.7%) women reported they often experienced moderate or severe pain. Of the 5,159 participants who were nonfrail at Wave 2, 328 (6.4%) were frail by Wave 6. The mean FI was 0.11 (standard deviation [SD] = 0.1) at Wave 2 and 0.15 (SD = 0.1) at Wave 6. After adjustment for age, gender, body mass index, lifestyle factors, and depressive symptoms, compared to participants reporting no pain at Wave 2 those reporting moderate (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 2.28, 4.16) or severe pain (OR = 3.78, 95% CI = 2.51, 5.71) were significantly more likely to be frail at Wave 6. This association persisted after further adjustment for either occupational class and/or net wealth level. Compared to those without pain, those with mild, moderate, or severe pain were also more likely to develop worsening frailty, as assessed using the FI, and this association persisted after adjustment for SES. There was no evidence that the association between pain and frailty was influenced by gender.ConclusionPain is associated with an increased risk and intensity of frailty in older men and women. Socioeconomic factors contribute to the occurrence of frailty; though in our study do not explain the relationship between pain and frailty.

Dataset Information

Socioeconomic and lifestyle factors associated with hearing loss in older adults: a cross-sectional study of the English Longitudinal Study of Ageing (ELSA).

Objectives

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Socioeconomic and lifestyle factors associated with hearing loss in older adults: a cross-sectional study of the English Longitudinal Study of Ageing (ELSA).

Similar Datasets

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