The Association Between Self-Perceived Auditory Disability and Psychosocial Health in a Longitudinal Cohort Study

OBJECTIVES: Hearing loss affects millions of people worldwide and is linked to psychosocial consequences such as loneliness, depression, and anxiety. Self-reported hearing problems may offer unique insights into emotional and social functioning beyond what audiometric tests reveal. Evidence on the association between self-perceived auditory functioning and psychosocial health in adults remains scarce. This study seeks to explore this relationship. DESIGN: This study used baseline and follow-up data from the Netherlands Longitudinal Study on Hearing, a prospective cohort study with adults aged 18 to 70 years at enrollment. Self-perceived auditory disability was assessed using the Amsterdam Inventory for Auditory Disability and Handicap (AIADH), while psychosocial outcomes were measured using validated questionnaires assessing loneliness, distress, depression, anxiety, and somatization. The associations between self-perceived auditory disability and psychosocial outcomes were analyzed using linear mixed-effects models and generalized estimating equations, accounting for repeated measurements, potential effect modifiers, and confounders. RESULTS: A total of 2897 participants (63% female; mean age at baseline 48.1 years) contributed data across up to four measurement rounds. Higher self-perceived auditory disability (AIADH) was consistently associated with worse psychosocial outcomes across all domains, showing graded associations. Compared with participants reporting little or no auditory disability (AIADH 0 to 6), those in the highest AIADH quartile (38 to 84) reported significantly higher loneliness scores (scale 0 to 11; B = 1.30; 95% confidence interval [CI]: 0.98 to 1.61), including both social loneliness (scale 0 to 5; B = 0.69; 95% CI: 0.52 to 0.87) and emotional loneliness (scale 0 to 6; B = 0.61; 95% CI: 0.41 to 0.82). Psychological distress (scale 0 to 32) increased progressively with higher AIADH scores, with participants in the highest quartile reporting on average 3.96 points higher distress levels than those in the lowest quartile (95% CI: 3.34 to 4.58). Higher AIADH scores were also associated with higher mean levels of depressive symptoms (scale 0 to 12; ratio of means [RoM] up to 4.50; 95% CI: 3.02 to 6.67), anxiety symptoms (scale 0 to 24; RoM up to 3.13; 95% CI: 2.36 to 4.15), and somatization symptoms (scale 0 to 32; RoM = 1.58; 95% CI: 1.46 to 1.71). Effect modification was observed in specific analyses by age, hearing device use, tinnitus, and age of onset of hearing loss. All associations remained statistically significant after adjustment for objective speech-in-noise performance. CONCLUSIONS: These findings highlight the broad psychosocial impact of self-reported hearing difficulties, emphasizing that hearing loss affects not only communication but also mental well-being. Incorporating self-reported hearing assessments into audiological evaluations and providing psychosocial support when indicated alongside hearing interventions may improve overall well-being.