title: The association between hearing status and psychosocial health before the age of 70 years: results from an internet-based national survey on hearing.
abstract: OBJECTIVE
  There is a substantial lack of knowledge of the impact of reduced hearing on psychosocial functioning in adults younger than 70 yr. The aim of this study was to examine the association between hearing status and psychosocial health in adults aged between 18 and 70 yr.
  
  
  METHODS
  This was a cross-sectional cohort study. Baseline data of the National Longitudinal Study on Hearing are analyzed using regression models. The cohort consisted of 1511 participants. Hearing status was determined using the National Hearing test, a recently launched speech-in-noise screening test over the Internet. We assessed self-reported psychosocial health using a set of online questionnaires.
  
  
  RESULTS
  Adjusting for confounding variables, significant adverse associations between hearing status and distress, somatization, depression, and loneliness are found. For every decibel signal to noise ratio (dB SNR) reduction of hearing status, both the distress and somatization scores increased by 2% [distress: b = 0.02, 95% confidence interval (CI) = 0.00 to 0.03, p = 0.03; somatization: b = 0.02, 95% CI = 0.01 to 0.04, p < 0.001]. The odds for developing moderate or severe depression increase by 5% for every dB SNR reduction in hearing (odds ratio = 1.05, 95% CI = 1.00 to 1.09, p = 0.03). The odds for developing severe or very severe loneliness significantly increase by 7% for every dB SNR reduction in hearing (odds ratio = 1.07, 95% CI = 1.02 to 1.12, p = 0.004). Different age groups exhibit different associations between hearing status and psychosocial health, with loneliness being an issue particularly in the youngest age group (18 to 30 yr). In the group of middle-aged adults (40 to 50 yr), the number of significant associations is highest.
  
  
  CONCLUSIONS
  Hearing status is negatively associated with higher distress, depression, somatization, and loneliness in young and middle-aged adults. The associations are different in different age groups. The findings underline the need to seriously address the adverse effects of limited hearing among young and middle-aged adults both in future research and in clinical practice.
authors.affiliation: Department of ENT/Audiology, VU University Medical Centre, Amsterdam, The Netherlands. j.nachtegaal@vumc.nl
authors.forename: Janneke
authors.initials: J
authors.lastname: Nachtegaal
authors.forename: Jan H
authors.initials: JH
authors.lastname: Smit
authors.forename: Cas
authors.initials: C
authors.lastname: Smits
authors.forename: Pieter D
authors.initials: PD
authors.lastname: Bezemer
authors.forename: Johannes H M
authors.initials: JH
authors.lastname: van Beek
authors.forename: Joost M
authors.initials: JM
authors.lastname: Festen
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Kramer