Associations Between Hearing Health and Well-Being in Unilateral Hearing Impairment

Objectives: To determine population-based risks of adverse effects on hearing and well-being outcomes associated with unilateral hearing impairment.Design: A group of 40-69-year-old adults (n = 861) who reported being able to hear only in one ear and having speech reception thresholds (SRTs) in noise indicating normal hearing in that ear (SRT_N/?) was selected from the UK Biobank cohort. The UK Biobank participants with SRTs indicating either normal (SRT_N/N, n = 95,514) or symmetrically impaired hearing in both ears (SRT_I/I, n = 17,429) were selected as comparison groups. Self-reported difficulty following conversations in noise, tinnitus presence, feelings depressed, lonely, unhappy, and being in poor health or dissatisfied with health were selected as hearing and well-being outcomes. Logistic regression models were used to evaluate the risks of reporting adverse outcomes associated with SRT_N/? compared to SRT_N/N and SRT_I/I whilst controlling for numerous factors linked to hearing and general health. Results: People with SRT_N/? were significantly more likely to report difficulties following conversations in noise (Odds Ratio = 10.61, 95% Confidence Interval = 8.83 to 12.75), tinnitus (4.04, 3.51 to 4.66), poor health (1.35, 1.15 to 1.58), health dissatisfaction (1.22, 1.00 to 1.47), and loneliness (1.28, 1.08 to 1.51) compared to people with SRT_N/N. Well-being outcomes were similar in the SRT_N/? and SRT_I/I groups. However, difficulties following conversations in noise (5.35, 4.44 to 6.44) and tinnitus presence (2.66, 2.31 to 3.08) were significantly more likely with SRT_N/? than with SRT_I/I. The SRT_N/? was associated with increased risk of self-reported poor health by 18% (Relative Risk = 1.18, 95% Confidence Interval = 1.06 to 1.32) and loneliness by 24% (1.24, 1.07 to 1.43) compared with SRT_N/N. The risk of reporting difficulties following conversations in noise increased by 64% (1.64, 1.58 to 1.71) and tinnitus presence by 84% (1.84, 1.69 to 2.01) compared to SRT_I/I. The effect of SRT_N/? on reporting poor health was similar to that from having other health problems such as hypertension or high cholesterol.Conclusions: The large increases in the risks of reporting adverse hearing-related outcomes associated with unilateral hearing impairment suggest its specific impact on hearing function in everyday situations. The increased risk of loneliness and poor health indicates that one normally functioning ear is also insufficient to protect against the adverse psychosocial impacts of unilateral hearing impairment. This impact was still significant after controlling for various health-related factors and can lead to perception of poor health comparable to that with having medical problems contributing to life-threatening conditions such as heart disease. The findings suggest the need for effective interventions to address the hearing-related problems and their impact on well-being in people with unilateral hearing impairment.