Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

Alice M Saperstein; Bibi A Subhan; Justin S Golub; Alice Medalia

doi:10.1016/j.jagp.2023.11.002

Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

Am J Geriatr Psychiatry. 2024 Apr;32(4):489-496. doi: 10.1016/j.jagp.2023.11.002. Epub 2023 Nov 11.

Authors

Alice M Saperstein¹, Bibi A Subhan², Justin S Golub³, Alice Medalia⁴

Affiliations

¹ New York State Psychiatric Institute, Department of Psychiatry (AMS, AM), Columbia University Vagelos College of Physicians and Surgeons, and New York-Presbyterian, New York, NY. Electronic address: Alice.Saperstein@nyspi.columbia.edu.
² New York State Psychiatric Institute, Department of Psychiatry (BAS), Columbia University Vagelos College of Physicians and Surgeons, New York, NY.
³ Department of Otolaryngology-Head & Neck Surgery (JSG), Columbia University Vagelos College of Physicians and Surgeons, and New York-Presbyterian, New York, NY.
⁴ New York State Psychiatric Institute, Department of Psychiatry (AMS, AM), Columbia University Vagelos College of Physicians and Surgeons, and New York-Presbyterian, New York, NY.

PMID: 38030420
PMCID: PMC10950537 (available on 2025-04-01)
DOI: 10.1016/j.jagp.2023.11.002

Abstract

Objective: The severity and impact of hearing deficits among adults with schizophrenia spectrum disorders may become increasingly relevant with advancing age. This study evaluated hearing ability and associated psychosocial functioning among older adults aged 50-70.

Design: Cross-sectional analysis.

Setting: Four outpatient psychiatry clinics in New York City.

Participants: Individuals aged 50-70 years with diagnoses of schizophrenia or schizoaffective disorder.

Measurements: Unaided pure tone air conduction audiometry conducted using a portable audiometry system determined the pure tone average (PTA) hearing threshold across four frequencies: 500, 1k, 2k, and 4k Hz. Better ear PTA defined the hearing threshold. Audiometry data retrieved from the U.S. National Health and Nutrition Examination Survey aided interpretation of sample hearing loss rates. Standard measures evaluated psychiatric symptoms, perceived impact of hearing impairment, loneliness, and quality of life.

Results: Among audiometry completers (N = 40), 35% (n = 14) demonstrated subclinical hearing loss (16-25 dB) and 35% (n = 14) had mild or worse hearing loss (≥26 dB). Rates were higher than expected based on age-based population data. Those who perceived hearing handicap rated it moderate (12.2%) or severe (7.3%); those who perceived tinnitus rated the impact as mild to moderate (12.2%) or catastrophic (2.4%). Neither psychiatric symptoms nor interviewer-rated quality of life was associated with hearing ability. Greater loneliness was significantly correlated with worse audiologic performance (r = 0.475, p <0.01) and greater perceived hearing handicap (r = 0.480, p <0.01).

Conclusion: Identifying the need for hearing loss treatment among aging adults with schizophrenia spectrum disorders is important given the potential implications for social functioning, cognitive, and mental health.

Keywords: Schizophrenia; audiometry; hearing loss; loneliness.

MeSH terms

Aged
Audiometry, Pure-Tone
Cross-Sectional Studies
Hearing Loss* / complications
Hearing Loss* / diagnosis
Hearing Loss* / epidemiology
Humans
Nutrition Surveys
Psychosocial Functioning
Quality of Life
Schizophrenia* / complications
Schizophrenia* / epidemiology

Grants and funding

P50 MH115843/MH/NIMH NIH HHS/United States