Skip to main content Accessibility help

Effects of self-reported hearing or vision impairment on depressive symptoms: a population-based longitudinal study

  • J. H. Han (a1) (a2), H. J. Lee (a3) (a4), J. Jung (a1) and E.-C. Park (a4) (a5)

The aims of this study were to investigate the effects of either hearing, vision or dual sensory impairment on depressive symptoms and to identify subgroups that are vulnerable and significantly affected.


Data from the 2006–2014 Korean Longitudinal Study of Aging (KLoSA) were used and a total of 5832 individuals were included in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D10) scale. Sensory impairment was assessed according to the levels of self-reported hearing or vision, which were categorised as either good (excellent, very good or good) or poor (fair or poor). The changes in hearing or vision from records of previous survey were investigated. Changes from good to poor, which indicates new onset, were defined as hearing impairment or vision impairment. Interactions of changes in hearing and vision were considered in the analysis. Dual sensory impairment was indicated when hearing impairment and vision impairment both developed at the same time. Demographic, socioeconomic and health-related factors were considered as potential confounders and were adjusted for in the generalised estimating equation model.


Individuals with hearing impairment demonstrated significantly more severe depressive symptoms [β = 0.434, standard errors (s.e.) = 0.097, p < 0.001] than those who had good hearing. Those with vision impairment also showed significantly elevated depressive symptoms (β = 0.253, s.e. = 0.058, p < 0.001) than those with good vision. When the interactions between hearing and vision were considered, participants with dual sensory impairment showed significantly more severe depressive symptoms (β = 0.768, s.e. = 0.197, p < 0.001) than those with good hearing and vision. The effect of a single and dual sensory impairment on depressive symptoms was significant in both sexes and across age groups, except for vision impairment in male participants.


Hearing, vision and dual sensory impairment are significantly associated with depressive symptoms. Our results suggest that treatment or rehabilitation of either hearing or vision impairment would help prevent depression.

Corresponding author
*Address for correspondence: H.J. Lee, RN, MPH, Department of Public Health, Graduate School, Yonsei University, Seoul, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea. (Email:
Hide All

These are co-corresponding authors.

Hide All
Abrams, TE, Barnett, MJ, Hoth, A, Schultz, S, Kaboli, PJ (2006). The relationship between hearing impairment and depression in older veterans. Journal of the American Geriatrics Society 54, 14751477.
Ambresin, G, Chondros, P, Dowrick, C, Herrman, H, Gunn, JM (2014). Self-rated health and long-term prognosis of depression. Annals of Family Medicine 12, 5765.
Andresen, EM, Malmgren, JA, Carter, WB, Patrick, DL (1994). Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine 10, 7784.
Bernabei, V, Morini, V, Moretti, F, Marchiori, A, Ferrari, B, Dalmonte, E, De Ronchi, D, Rita Atti, A (2011). Vision and hearing impairments are associated with depressive – anxiety syndrome in Italian elderly. Aging & Mental Health 15, 467474.
Boi, R, Racca, L, Cavallero, A, Carpaneto, V, Racca, M, Dall'Acqua, F, Ricchetti, M, Santelli, A, Odetti, P (2012). Hearing loss and depressive symptoms in elderly patients. Geriatrics & Gerontology International 12, 440445.
Brennan, M, Horowitz, A, Su, Y (2005). Dual sensory loss and its impact on everyday competence. The Gerontologist 45, 337346.
Capella-McDonnall, ME (2005). The effects of single and dual sensory loss on symptoms of depression in the elderly. International Journal of Geriatric Psychiatry 20, 855861.
Carlsson, PI, Hjaldahl, J, Magnuson, A, Ternevall, E, Eden, M, Skagerstrand, A, Jonsson, R (2015). Severe to profound hearing impairment: quality of life, psychosocial consequences and audiological rehabilitation. Disability and Rehabilitation 37, 18491856.
Castiglione, A, Benatti, A, Velardita, C, Favaro, D, Padoan, E, Severi, D, Pagliaro, M, Bovo, R, Vallesi, A, Gabelli, C, Martini, A (2016). Aging, cognitive decline and hearing loss: effects of auditory rehabilitation and training with hearing aids and cochlear implants on cognitive function and depression among older adults. Audiology and Neuro-Otology 21 (Suppl. 1), 2128.
Chen, J, Liang, J, Ou, J, Cai, W (2013). Mental health in adults with sudden sensorineural hearing loss: an assessment of depressive symptoms and its correlates. Journal of Psychosomatic Research 75, 7274.
Chia, E, Mitchell, P, Rochtchina, E, Foran, S, Golding, M, Wang, JJ (2006). Association between vision and hearing impairments and their combined effects on quality of life. Archives of Ophthalmology 124, 14651470.
Choi, JS, Betz, J, Li, L, Blake, CR, Sung, YK, Contrera, KJ, Lin, FR (2016). Association of using hearing aids or cochlear implants with changes in depressive symptoms in older adults. JAMA Otolaryngology – Head & Neck Surgery 142, 652657.
Chou, KL (2008). Combined effect of vision and hearing impairment on depression in older adults: evidence from the English longitudinal study of ageing. Journal of Affective Disorders 106, 191196.
Contrera, KJ, Betz, J, Deal, JA, Choi, JS, Ayonayon, HN, Harris, T, Helzner, E, Martin, KR, Mehta, K, Pratt, S, Rubin, SM, Satterfield, S, Yaffe, K, Garcia, M, Simonsick, EM, Lin, FR, Health, ABCS (2016). Association of hearing impairment and emotional vitality in older adults. Journals of Gerontology Series B-Psychological Sciences and Social Sciences 71, 400404.
Crews, JE, Campbell, VA (2004). Vision impairment and hearing loss among community-dwelling older Americans: implications for health and functioning. American Journal of Public Health 94, 823829.
Dalton, DS, Cruickshanks, KJ, Klein, BE, Klein, R, Wiley, TL, Nondahl, DM (2003). The impact of hearing loss on quality of life in older adults. The Gerontologist 43, 661668.
Evans, JR, Fletcher, AE, Wormald, RP (2007). Depression and anxiety in visually impaired older people. Ophthalmology 114, 283288.
Garin, N, Olaya, B, Lara, E, Moneta, MV, Miret, M, Ayuso-Mateos, JL, Haro, JM (2014). Visual impairment and multimorbidity in a representative sample of the Spanish population. BMC Public Health 14, 815.
Giloyan, A, Harutyunyan, T, Petrosyan, V (2015). Visual impairment and depression among socially vulnerable older adults in Armenia. Aging & Mental Health 19, 175181.
Gopinath, B, Wang, JJ, Schneider, J, Burlutsky, G, Snowdon, J, McMahon, CM, Leeder, SR, Mitchell, P (2009). Depressive symptoms in older adults with hearing impairments: the blue mountains study. Journal of the American Geriatrics Society 57, 13061308.
Gopinath, B, Schneider, J, Flood, VM, McMahon, CM, Burlutsky, G, Leeder, SR, Mitchell, P (2014). Association between diet quality with concurrent vision and hearing impairment in older adults. The Journal of Nutrition, Health & Aging 18, 251256.
Hallam, R, Ashton, P, Sherbourne, K, Gailey, L (2006). Acquired profound hearing loss: mental health and other characteristics of a large sample. International Journal of Audiology 45, 715723.
Harada, S, Nishiwaki, Y, Michikawa, T, Kikuchi, Y, Iwasawa, S, Nakano, M, Ishigami, A, Saito, H, Takebayashi, T (2008). Gender difference in the relationships between vision and hearing impairments and negative well-being. Preventive Medicine 47, 433437.
Huang, CQ, Dong, BR, Lu, ZC, Yue, JR, Liu, QX (2010). Chronic diseases and risk for depression in old age: a meta-analysis of published literature. Ageing Research Reviews 9, 131141.
Irwin, M, Artin, KH, Oxman, MN (1999). Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine 159, 17011704.
Ishine, M, Okumiya, K, Matsubayashi, K (2007). A close association between hearing impairment and activities of daily living, depression, and quality of life in community-dwelling older people in Japan. Journal of the American Geriatrics Society 55, 316317.
Ives, DG, Bonino, P, Traven, ND, Kuller, LH (1995). Characteristics and comorbidities of rural older adults with hearing impairment. Journal of the American Geriatrics Society 43, 803806.
Jacka, FN, Pasco, JA, Mykletun, A, Williams, LJ, Hodge, AM, O'Reilly, SL, Nicholson, GC, Kotowicz, MA, Berk, M (2010). Association of western and traditional diets with depression and anxiety in women. The American Journal of Psychiatry 167, 305311.
Jun, HJ, Hwang, SY, Lee, SH, Lee, JE, Song, JJ, Chae, S (2015). The prevalence of hearing loss in South Korea: data from a population-based study. The Laryngoscope 125, 690694.
Kiely, KM, Anstey, KJ, Luszcz, MA (2013). Dual sensory loss and depressive symptoms: the importance of hearing, daily functioning, and activity engagement. Frontiers in Human Neuroscience 7, 837.
Kiely, KM, Gopinath, B, Mitchell, P, Browning, CJ, Anstey, KJ (2012). Evaluating a dichotomized measure of self-reported hearing loss against gold standard audiometry: prevalence estimates and age bias in a pooled national data set. Journal of Aging and Health 24, 439458.
Lee, AT, Tong, MC, Yuen, KC, Tang, PS, Vanhasselt, CA (2010). Hearing impairment and depressive symptoms in an older Chinese population. Journal of Otolaryngology – Head & Neck Surgery 39, 498503.
Lee, DJ, Gómez Marín, O, Lam, BL, Zheng, DD, Arheart, KL, Christ, SL, Caban, AJ (2007). Severity of concurrent visual and hearing impairment and mortality: the 1986–1994 national health interview survey. Journal of Aging and Health 19, 382396.
Li, CM, Zhang, X, Hoffman, HJ, Cotch, MF, Themann, CL, Wilson, MR (2014). Hearing impairment associated with depression in US adults, national health and nutrition examination survey 2005–2010. JAMA Otolaryngology – Head & Neck Surgery 140, 293302.
Lin, FR, Metter, EJ, O'Brien, RJ, Resnick, SM, Zonderman, AB, Ferrucci, L (2011). Hearing loss and incident dementia. Archives of Neurology 68, 214220.
Lin, FR, Yaffe, K, Xia, J, Xue, QL, Harris, TB, Purchase-Helzner, E, Satterfield, S, Ayonayon, HN, Ferrucci, L, Simonsick, EM, Health, ABCSG (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine 173, 293299.
Lin, MY, Gutierrez, PR, Stone, KL, Yaffe, K, Ensrud, KE, Fink, HA, Sarkisian, CA, Coleman, AL, Mangione, CM, Study of Osteoporotic Fractures Research G (2004). Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women. Journal of the American Geriatrics Society 52, 19962002.
Lin, P, Huang, S, Su, K (2010). A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biological Psychiatry 68, 140147.
Loprinzi, PD, Codey, K (2014). Influence of visual acuity on anxiety, panic and depression disorders among young and middle age adults in the United States. Journal of Affective Disorders 167, 811.
Lupsakko, T, Mantyjarvi, M, Kautiainen, H, Sulkava, R (2002). Combined hearing and visual impairment and depression in a population aged 75 years and older. International Journal of Geriatric Psychiatry 17, 808813.
McDonnall, MC (2009). The effects of developing a dual sensory loss on depression in older adults: a longitudinal study. Journal of Aging and Health 21, 11791199.
Mener, DJ, Betz, J, Genther, DJ, Chen, D, Lin, FR (2013). Hearing loss and depression in older adults. Journal of the American Geriatrics Society 61, 16271629.
Meuleners, LB, Hendrie, D, Fraser, ML, Ng, JQ, Morlet, N (2013). The impact of first eye cataract surgery on mental health contacts for depression and/or anxiety: a population-based study using linked data. Acta Ophthalmologica 91, e445e449.
Mikkola, TM, Polku, H, Portegijs, E, Rantakokko, M, Rantanen, T, Viljanen, A (2015). Self-reported hearing status is associated with lower limb physical performance, perceived mobility, and activities of daily living in older community-dwelling men and women. Journal of the American Geriatrics Society 63, 11641169.
Muurinen, SM, Soini, H, Suominen, MH, Saarela, MH, Savikko, NM, Pitkälä, KH (2014). Vision impairment and nutritional status among older assisted living residents. Archives of Gerontology and Geriatrics 58, 384387.
Nachtegaal, J, Smit, JH, Smits, C, Bezemer, PD, van Beek, JH, Festen, JM, Kramer, SE (2009). The association between hearing status and psychosocial health before the age of 70 years: results from an internet-based national survey on hearing. Ear and Hearing 30, 302312.
Nyman, SR, Gosney, MA, Victor, CR (2010). Psychosocial impact of visual impairment in working-age adults. British Journal of Ophthalmology 94, 14271431.
Owsley, C, McGwin, G, Scilley, K, Meek, GC, Seker, D, Dyer, A (2007). Effect of refractive error correction on health-related quality of life and depression in older nursing home residents. Archives of Ophthalmology 125, 14711477.
Pronk, M, Deeg, DJ, Smits, C, van Tilburg, TG, Kuik, DJ, Festen, JM, Kramer, SE (2011). Prospective effects of hearing status on loneliness and depression in older persons: identification of subgroups. International Journal of Audiology 50, 887896.
Radloff, LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385401.
Rim, TH, Nam, JS, Choi, M, Lee, SC, Lee, CS (2014). Prevalence and risk factors of visual impairment and blindness in Korea: the fourth Korea national health and nutrition examination survey in 2008–2010. Acta Ophthalmologica 92, e317e325.
Rovner, BW, Ganguli, M (1998). Depression and disability associated with impaired vision: the MoVies project. Journal of the American Geriatrics Society 46, 617619.
Schneider, JM, Gopinath, B, McMahon, CM, Leeder, SR, Mitchell, P, Wang, JJ (2011). Dual sensory impairment in older age. Journal of Aging and Health 23, 13091324.
Steptoe, A, Shankar, A, Demakakos, P, Wardle, J (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences of the United States of America 110, 57975801.
Tambs, K (2004). Moderate effects of hearing loss on mental health and subjective well-being: results from the Nord-Trondelag Hearing Loss Study. Psychosomatic Medicine 66, 776782.
Tseng, CC, Hu, LY, Liu, ME, Yang, AC, Shen, CC, Tsai, SJ (2016). Risk of depressive disorders following sudden sensorineural hearing loss: a nationwide population-based retrospective cohort study. Journal of Affective Disorders 197, 9499.
Wallhagen, MI, Strawbridge, WJ, Shema, SJ, Kurata, J, Kaplan, GA (2001). Comparative impact of hearing and vision impairment on subsequent functioning. Journal of the American Geriatrics Society 49, 10861092.
Yamada, Y, Vlachova, M, Richter, T, Finne-Soveri, H, Gindin, J, van der Roest, H, Denkinger, MD, Bernabei, R, Onder, G, Topinkova, E (2014). Prevalence and correlates of hearing and visual impairments in European nursing homes: results from the SHELTER study. Journal of the American Medical Directors Association 15, 738743.
Zhang, X, Bullard, KM, Cotch, MF, Wilson, MR, Rovner, BW, McGwin, G Jr., Owsley, C, Barker, L, Crews, JE, Saaddine, JB (2013). Association between depression and functional vision loss in persons 20 years of age or older in the United States, NHANES 2005–2008. JAMA Ophthalmology 131, 573581.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology and Psychiatric Sciences
  • ISSN: 2045-7960
  • EISSN: 2045-7979
  • URL: /core/journals/epidemiology-and-psychiatric-sciences
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed