The Association Between Hearing Loss and Depression in a Large Electronic Health Record System.

Objective: Hearing loss (HL) is associated with depression, but existing datasets are limited by the type of data available for both hearing and mental health conditions. The purpose of this study is to determine if there is an association between HL and depressive disorders within a large bi-institutional electronic health record (EHR) system containing more granular diagnostic information.

Study design: Cross-sectional epidemiologic study.

Setting: Two academic medical centers.

Methods: Audiometric data was collected from patients ≥18 years old between 2020 to mid-2023 (n = 29,772). The exposure was HL defined as the 4-frequency pure-tone average (PTA), speech reception threshold (SRT), and word recognition score (WRS). The outcomes were depression, categorized as either: (1) major depressive disorder, defined by International Classification of Diseases, 10th Revision (ICD-10) code; (2) persistent mood disorder, defined by ICD-10 code; or (3) antidepressant medication use, defined by medication lists. Odds ratios were computed from logistic regressions between HL and each of the outcome variables, controlling for age, sex, cardiovascular risks, and site.

Results: The mean age (standard deviation) was 60.5 (18.2) years, and 17,736 participants (59.6%) were female. Controlling for covariates, for every 10-dB worsening in hearing by PTA, the odds of major depressive disorder increased by 1.04 times (95% confidence interval [CI] = 1.01-1.07, P = .015). Similarly, for every 10 dB worsening in hearing by PTA or SRT, the odds of antidepressant medication use increased by 1.04 times (95% CI = 1.01-1.06, P = .004). Odds ratios for persistent mood disorder were nonsignificant.

Conclusion: In a large academic EHR, HL is associated with major depressive disorder and antidepressant medication use.