title: Hearing Impairment and Undiagnosed Disease: The Potential Role of Clinical Recommendations.
abstract: The objective of this study was to use cross-sectional, nationally representative data to examine the relationship between self-reported hearing impairment and undetected diabetes, hypertension, hypercholesterolemia, and chronic kidney disease.
  
  
  
  We analyzed the National Health and Nutrition Examination Survey for the years 2007-2012 for individuals 40 years of age and older without previously diagnosed cardiovascular disease. Analyses were conducted examining hearing impairment and undiagnosed disease.
  
  
  
  The unweighted sample size was 9,786, representing 123,444,066 Americans. Hearing impairment was reported in 10.2% of the individuals. In unadjusted analyses, there was no significant difference between adults with hearing impairment and adults with typical hearing for undiagnosed diabetes, hypertension, or hypercholesterolemia. A higher proportion of adults with hearing impairment than adults with typical hearing had undiagnosed chronic kidney disease (20.1% vs. 10.7%; p = .0001). In models adjusting for demographics and health care utilization, hearing impairment was associated with a higher likelihood of having undiagnosed chronic kidney disease (odds ratio = 1.53, 95% CI [1.23, 1.91]).
  
  
  
  Individuals with hearing impairment are more likely to have undiagnosed chronic kidney disease. Hearing impairment may affect disclosure of important signs and symptoms as well as the comprehension of medical conversations for chronic disease management. General practitioners can play a critical role in improving medical communication by responding with sensitivity to the signs of hearing impairment in their patients.
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Marlow
authors.affiliation: Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: John
authors.initials: J
authors.lastname: Malaty
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville.
authors.forename: Ara
authors.initials: A
authors.lastname: Jo
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Tanner
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville.
authors.forename: Valery M
authors.initials: VM
authors.lastname: Beau de Rochars
authors.affiliation: Department of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Carek
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, GainesvilleDepartment of Community Health and Family Medicine, University of Florida, Gainesville.
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D003951:Diagnostic Errors; D005260:Female; D034381:Hearing Loss / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D057566:Self Report; D014481:United States / Q000453:epidemiology