Hearing Impairment, Loneliness, Social Isolation, and Cognitive Function: Longitudinal Analysis Using English Longitudinal Study on Ageing

Am J Geriatr Psychiatry. 2019 Dec;27(12):1348-1356. doi: 10.1016/j.jagp.2019.07.010. Epub 2019 Jul 22.


Objective: This study examines the relationships between hearing impairment and cognitive function among older adults, and whether that association is mediated by loneliness and social isolation.

Methods: Data were drawn from English Longitudinal Study of Ageing (ELSA) wave two (2004/2005) until wave seven (2014/2015). The study sample consisted of 8,199 individuals aged 50 years or older. Cognitive function was measured using episodic memory. We performed analysis using a generalized structural equation modeling (GSEM) technique.

Results: GSEM analysis shows that the direct effect of hearing impairment on episodic memory was negative and significant (β = -0.29, p <0.001). Loneliness and social isolation mediated that effect. Hearing impairment was positively associated with loneliness (β = 0.10, p <0.001) and social isolation (β = 0.04, p <0.001). Loneliness (β = -0.08, p <0.001) and social isolation (β = -0.09, p = 0.001) were significantly associated with lower memory scores.

Conclusion: The link between hearing impairment and episodic memory was partly mediated by loneliness and social isolation. Interventions to improve the social networks of older adults with hearing impairment are likely to be beneficial in preventing cognitive decline. Thus, the importance of maintaining social relationships among older adults, especially those with hearing impairment is highlighted.

Keywords: Loneliness; dementia; hearing impairment; social isolation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology*
  • England / epidemiology
  • Female
  • Hearing Loss / epidemiology
  • Hearing Loss / psychology*
  • Humans
  • Loneliness / psychology*
  • Male
  • Memory, Episodic
  • Middle Aged
  • Social Isolation / psychology*