An online study on the impact of socio-economic position and lifestyle factors on auditory function in middle aged adults

Slade, Kate, Sharp, Nez, Lad, Meher, Tsimpida, Dialechti and Nuttall, Helen (2022) An online study on the impact of socio-economic position and lifestyle factors on auditory function in middle aged adults. (doi:10.17605/osf.io/xju76).

Abstract

Hearing loss is frequently accepted as an unavoidable consequence of ageing. However, not everyone will experience age-related hearing loss (ARHL), in fact ~29% of people aged 70+ years are unaffected (Royal National Institute for Deaf People (RNID), 2020). It may be the case that modifiable lifestyle factors and health inequalities lead to an increased likelihood of hearing loss in older age. Hearing loss is not only a challenging sensory deficit; it is related to reduced wellbeing (Rutherford et al., 2018), social isolation (Dawes et al., 2015), and is the largest modifiable risk factor for dementia (Livingston et al., 2020). In addition, a nationally representative study in England identified hearing loss as a causal factor for depression; the socioeconomic position of participants influenced the strength of the relationship between hearing loss and depression, and poorer people had up to double the relative risk for depression compared to their affluent counterparts (Tsimpida et el., 2022). Understanding the factors, notwithstanding ageing, which contribute to hearing difficulty in later life will highlight avenues for intervention and reduce the burden of hearing loss on both the individual, and the health care system. Previous research highlights that lower socioeconomic position (incorporating education, occupation, and income factors), and lifestyle variables (including body mass index, physical inactivity, smoking and alcohol consumption) are associated with poorer hearing acuity, as strongly as age and gender (Tsimpida et al., 2019). The link between SEP, lifestyle factors, and hearing loss is multifaceted (Tsimpida et al., 2021). SEP factors, including education attainment, occupation, and monetary resources, contribute to social and health inequality (Tsimpida et al., 2021). Such factors increase the likelihood of: high-noise exposure occupations (Pierre et al., 2012); financial barriers to audiological treatments (Tsimpida et al., 2019); stress due to financial resources leading to unhealthy eating; and increased smoking and alcohol consumption (Dawes et al., 2014; Tsimpida et al., 2021). Critically, SEP disparities create situations in which prioritising behaviours for hearing health is not an option for a proportion of the population. This research plans to confirm and build upon previous literature to understand how SEP and lifestyle factors impact on speech perception ability in middle age adults. In undertaking this research, we seek to highlight which, if any, factors affect speech in noise perception ability as a precursor to hearing loss in older age. Identifying the factors which can predict this early indicator of potential hearing loss will allow for early implementation of lifestyle interventions to address risk factors, encourage uptake of hearing aids in lower SEP groups, and ultimately reduce hearing health inequalities. Our research question is: to understand the contribution of socioeconomic position (incorporating level of education, occupation, and income) as well as demographic information (including region of residence, ethnicity), and modifiable health-related lifestyle factors (including body mass index, physical activity, smoking status, and alcohol consumption), while controlling for age and gender, on speech perception ability in middle aged adults (45-65 years). To investigate this question, we will recruit participants aged 45-65 years to take part in an online research study wherein they will complete demographic questionnaires on SEP and lifestyle, and a behavioural speech perception in noise task (the digits in noise task (DiN)). We will use multiple linear regression to investigate the impact of our various predictors (SEP, lifestyle factors, age, and gender) on the outcome measure of speech perception. We will use model comparison methods, in which predictor variables are systematically removed from the analysis, to determine which combination of predictors provide the best fit for our data, this indicating which factors contribute to speech perception ability in middle age adults. References Dawes, P., Cruickshanks, K. J., Moore, D. R., Edmondson-Jones, M., McCormack, A., Fortnum, H., & Munro, K. J. (2014). Cigarette smoking, passive smoking, alcohol consumption, and hearing loss. JARO - Journal of the Association for Research in Otolaryngology, 15(4). Dawes, P., Emsley, R., Cruickshanks, K. J., Moore, D. R., Fortnum, H., Edmondson-Jones, M., McCormack, A., & Munro, K. J. (2015). Hearing Loss and Cognition: The Role of Hearing Aids, Social Isolation and Depression. PLoS ONE, 10(3). Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. Pierre, P. V., Fridberger, A., Wikman, A., & Alexanderson, K. (2012). Self-reported hearing difficulties, main income sources, and socio-economic status; A cross-sectional population-based study in Sweden. BMC Public Health, 12(1). Royal National Institute for Deaf People (RNID). (2020). Hearing Matters. https://rnid.org.uk/wp-content/uploads/2020/05/Hearing-Matters-Report.pdf Rutherford, B. R., Brewster, K., Golub, J. S., Kim, A. H., & Roose, S. P. (2018). Sensation and Psychiatry: Linking Age-Related Hearing Loss to Late-Life Depression and Cognitive Decline. The American Journal of Psychiatry, 175(3), 215–224. Tsimpida, D., Kontopantelis, E., Ashcroft, D. M., & Panagioti, M. (2021). Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis. Trends in Hearing (25). Tsimpida, D., Kontopantelis, E., Ashcroft, D., & Panagioti, M. (2019). Socioeconomic and lifestyle factors associated with hearing loss in older adults: A cross-sectional study of the English Longitudinal Study of Ageing (ELSA). BMJ Open, 9(9). Tsimpida, D., Kontopantelis, E., Ashcroft, D. M., & Panagioti, M. (2022). The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA). Social psychiatry and psychiatric epidemiology, 57(2), 353-362.

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Contributors

Author: Dialechti Tsimpida

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