Use of Amplification in Older Adults with Depression: Results Should be Interpreted Cautiously

A July, 2016 JAMA Otolaryngology Head & Neck Surgery article indicates hearing aid and cochlear implant (CI) users experienced significant improvement in their depressive symptoms 6 to 12 months after treatment with their amplification devices.

Janet Choi, MPH and colleagues from Johns Hopkins University, University of Oklahoma College of Medicine and Drexel University conducted an observational study involving 113 participants. The study, which ran from August, 2011 to January, 2014, evaluated depression in study participants, all 50 years of age or older, using the 15-item Geriatric Depression Scale (GDS).

After being fitted with hearing aid(s) or a cochlear implant, a baseline measure of depressive symptoms was obtained using the GDS. The specific model of hearing aid/cochlear implant, fitting arrangement (bilateral or unilateral) and technology employed in the device was not reported. Of the 113 participants completing the study, 50 used a cochlear implant and 63 wore hearing aid(s).


Study Results


Following 6 months of hearing aid/CI use, scores of the Geriatric Depression Scale for the CI users decreased by 31%, while the hearing aid users scores decreased by 28% from their baseline score. At the one year mark, cochlear implant users scores on the GDS decreased by 38% and the hearing aid users dropped by 16% from the baseline GDS score.

Of particular interest, a relatively small number of participants — 8 CI (16%) users and 5 (8%) hearing aid wearers -had GDS scores suggestive of depression at baseline. One year following their intervention, 6 CI users (12%) and 3 hearing aid users (4.8%) still had GDS scores indicative of depression.


Although the decline in depressive symptoms on the 15-item GDS was statistically significant, clinicians must take into consideration the small relative decrease (CI users: 8 reduced to 6, and hearing aid users: 5 reduced to 3) in the GDS scores 12 months post-treatment.  Additionally, both CI and hearing aid recipients with the greatest depressive symptoms (higher scores on the GDS) at baseline tended to have the greatest improvement on the GDS after treatment.


To date, studies that have evaluated the relationship between depression and amplification use in older adults have been inconsistent. Even though these studies have shown inconsistent results, the recent Choi et al study does offer hope that older adults with hearing loss who are suffering from depressive symptoms may see improvement in those symptoms following extended use with amplification.


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