title: Comorbidity in adults with hearing difficulties: which chronic medical conditions are related to hearing impairment?
abstract: OBJECTIVE
  To investigate the occurrence of 27 chronic medical conditions in a cohort of adults with and without hearing impairment, and to examine the association between these conditions and hearing ability.
  
  
  METHODS
  The National Longitudinal Study on Hearing (NL-SH study) is a large prospective study among adults aged 18 to 70 years, conducted via the internet in the Netherlands. Hearing ability was measured with a digits-in-noise test and comorbidity was assessed through self-report.
  
  
  METHODS
  Cross-sectional data of 890 hearing-impaired and 975 normally-hearing adults were analyzed. Both descriptive statistics and multinomial logistic regression analyses were conducted.
  
  
  RESULTS
  Of the NL-SH participants with insufficient or poor hearing ability, 78.5% reported to suffer from at least one additional chronic condition. This proportion was larger than in the normally-hearing group (68.6% with one or more chronic conditions and 37.7% with two or more). After adjustment for age and gender, 'dizziness causing falling', 'diabetes' and 'arthritis types other than osteoarthritis and rheumatic arthritis' were significantly associated with poor hearing ability.
  
  
  CONCLUSIONS
  Our results show that some previously reported associations do not only occur in older age groups, but also in younger cohorts. Comorbidity is relevant in the rehabilitation (multi-disciplinary care) and the clinical encounter.
authors.affiliation: * Department of Otolaryngology-Head and Neck Surgery, section Audiology, VU University Medical Center and EMGO Institute for Health and Care Research , Amsterdam , The Netherlands.
authors.forename: Mariska
authors.initials: M
authors.lastname: Stam
authors.forename: Piet J
authors.initials: PJ
authors.lastname: Kostense
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lemke
authors.forename: Paul
authors.initials: P
authors.lastname: Merkus
authors.forename: Jan H
authors.initials: JH
authors.lastname: Smit
authors.forename: Joost M
authors.initials: JM
authors.lastname: Festen
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009622:Noise / Q000009:adverse effects; D010470:Perceptual Masking; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D013067:Speech Perception; D013069:Speech Reception Threshold Test; D055815:Young Adult
keywords: Comorbidity; adults; diabetes; epidemiology; hearing problems