Combined effect of self-reported hearing problems and level of social activities on the risk of disability in Japanese older adults: A population-based longitudinal study

BACKGROUND: We used longitudinal cohort data to investigate whether hearing problems and low levels of social activity lead to a higher incidence of disability among community-dwelling older adults. METHODS: Participants were 4576 older adults (47.8% male, mean age 75.9 years) who met the study inclusion criteria. Longitudinal data on the incidence of disability were monitored monthly. Disability was defined as Japanese long-term care insurance certification for personal support or care for 2 years following the baseline assessment. Hearing problems were measured using the Hearing Handicap Inventory for the Elderly and for Adults - Screening version. Participants completed a questionnaire that included five questions on daily social activities. RESULTS: In the adjusted model that included potential covariates, participants with co-occurring hearing problems and low participation rates in social activities were at higher risk of developing a disability than participants without hearing problems and low levels of social activity (hazard ratio [HR] = 2.13, 95% confidence interval [CI]: 1.31-3.45). The second highest risk of developing a disability was found for those with low levels of social activity alone (HR = 1.98, 95% CI: 1.26-3.11), and the third highest for those with hearing problems alone (HR = 1.38, 95% CI: 1.07-1.77). CONCLUSIONS: Hearing problems and a lack of social activity were independent risk factors for developing a disability. Co-occurring hearing problems and low levels of participation in social activities represented the largest risk factor for disability.