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Hearing impairment and diverse health outcomes

An umbrella review of meta-analyses of observational studies

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Summary

Background

Globally, it is estimated that approximately 1.3 billion people live with some form of hearing impairment. Major causes of hearing loss include infection/disease, age-related factors, and occupational factors. Numerous systematic reviews and meta-analyses have attempted to synthesise literature on these topics. To date there has not been a systematic evaluation of the relationships between hearing impairment and diverse physical, mental, and social outcomes.

Objective

We performed an umbrella review of systematic reviews of observational studies with meta-analyses for any physical disease, biomarkers of disease, mental health or cognitive outcomes, and/or modifiable risk factors associated with hearing impairment.

Methods

For each meta-analytic association, random effects summary effect size, 95% confidence intervals, heterogeneity, evidence for small-study effect, excess significance bias and 95% prediction intervals were calculated, and risk of bias was assessed via the AMSTAR2 tool. These were used to grade significant evidence (p < 0.05) from I to IV, using the recommendations from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria.

Results

From 3747 studies, 21 were included covering 54 outcomes. Overall, 44/54 outcomes (82%) yielded significant results. Of the highest quality evidence, age-related hearing loss and non-specific hearing impairment were negatively associated with several types of cognitive impairments; pediatric bilateral hearing loss was negatively associated with quality of life, sensorineural hearing loss was positively associated with rheumatoid arthritis and tinnitus was positively associated with temporomandibular disorders.

Conclusion and relevance

Results show moderate quality evidence for associations between several types of hearing impairments and cognitive difficulties, quality of life and systemic diseases such as rheumatoid arthritis. Practitioners and public health policies should note these findings when developing relevant healthcare policies.

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Authors and Affiliations

  1. Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Young Street, CB1 2LZ, Cambridge, UK

    Mike Trott, Guillermo F. Lopez-Sanchez & Shahina Pardhan

  2. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, CB1 1PT, Cambridge, UK

    Mike Trott &  Lee Smith

  3. College of Mathematics and Statistics, Shenzhen University, Shenzhen, Guangdong Province, China

    Tao Xiao

  4. Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy

    Nicola Veronese

  5. ICREA, Pg. Lluis Companys 23, Barcelona, Spain

    Ai Koyanagi

  6. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain

    Ai Koyanagi & Louis Jacob

  7. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France

    Louis Jacob

  8. Anglia Ruskin University, CB1 1PT, Cambridge, UK

    Yvonne Barnett

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Correspondence to Lee Smith.

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Conflict of interest

M. Trott, L. Smith, T. Xiao, N. Veronese, A. Koyanagi, L. Jacob, G. F. Lopez-Sanchez, Y. Barnett and S. Pardhan have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. Transparency statement: the lead author confirms that the manuscript is an honest, accurate, and transparent account of the study being reported. No important aspects of the study have been omitted.

Ethical standards

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case. Because this is a systematic review, ethical approval was not required.

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Full details of AMSTAR2 results

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Trott, M., Smith, L., Xiao, T. et al. Hearing impairment and diverse health outcomes. Wien Klin Wochenschr 133, 1028–1041 (2021). https://doi.org/10.1007/s00508-021-01893-0

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