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Bidirectional Association Between Depression and Hearing Loss: Evidence From the China Health and Retirement Longitudinal Study

The relationship between depression and age-related hearing loss (ARHL) is not fully understood. This study tested the bidirectional associations between clinically significant depressive symptoms (CSDSs) and ARHL in middle-aged and older adults using data from the China Health and Retirement Longitudinal Study. Among 3,418 participants free of baseline ARHL, baseline CSDS was associated with an increased odds of incident ARHL (odds ratio [OR]: 1.51). Cognitive decline, BMI, and arthritis partially mediated the longitudinal CSDS–ARHL association and explained 24% of the variance in the total effect. Among 4,921 participants without baseline CSDS, baseline ARHL was associated with an increased odds of incident CSDS (OR: 1.37). The bidirectional associations remained significant after adjustments for baseline demographic factors, comorbidities, and other health-related covariates. Depression may contribute to the development of ARHL, and vice versa. Interventions in depression, cognitive decline, and arthritis may delay the onset of ARHL and break the vicious circle between them.