The Mediating Role of Depression in the Association Between Hearing Impairment and Functional Disability Among Middle-Aged and Older Adults in China

BACKGROUND AND OBJECTIVES: This study aims to explore the association between hearing impairment (HI) and functional disability and to examine whether depression mediates this association. RESEARCH DESIGN AND METHODS: In the study, 11 335 individuals aged 45 years and older were analyzed from the China Health and Retirement Longitudinal Study. The study used logistic regression and Karlson/Holm/Breen’s method to examine the correlation between HI, depression, and functional disability. Functional disability was assessed using activities of daily living and instrumental activities of daily living. RESULTS: HI was significantly associated with activities of daily living disability (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.21–1.49) and instrumental activities of daily living disability (OR = 1.57, 95% CI = 1.46–1.68). The mediated effect of depression accounted for 22.80% and 15.17% of the total effect of HI on activities of daily living and instrumental activities of daily living disability, respectively. Additionally, depression partially mediated the effects of HI on specific activities of daily living and instrumental activities of daily living tasks, including bathing (33.23%), toileting (27.50%), doing chores (37.36%), preparing meals (28.04%), shopping (25.81%), taking care of finances (11.82%), and taking medicine (12.71%). DISCUSSION AND IMPLICATIONS: HI increased the likelihood of functional disability partially through depression in middle-aged and older adults, suggesting that emphasizing the mental wellness of these people with HI is necessary to prevent impairments in physical function.