Hearing loss and incident psychosis in later life: the Health In Men Study (HIMS)

OBJECTIVE: To determine if hearing loss is associated with increased risk of incident psychosis in later life.

METHODS: Longitudinal cohort study of a community-representative sample of 38173 men aged 65-85 years at the start of the follow up period of 18 years. We used the Western Australian Data Linkage System to ascertain the presence of hearing loss and of psychotic disorders according to the International Classification of Diseases (ICD versions 8, 9 and 10). We also collected information on concurrent morbidities: cancer and diseases of the cardiovascular, respiratory, digestive and renal systems.

RESULTS: 1442 (3.8%) and 464 (1.2%) men had a recorded diagnosis of hearing loss and psychosis at the start of follow up. After excluding the 464 participants with prevalent psychosis, 37709 men were available for the longitudinal study and, of these, 252 (0.7%) developed a psychotic disorder. Competing risk regression showed that hearing loss was associated incident psychosis (sub-hazard ratio = 2.03, 95%CI=1.24, 3.32; after statistical adjustment for age and concurrent morbidities).

CONCLUSIONS: Hearing loss is associated with double the risk of incident psychosis in older men. Available evidence suggests that this link could be causal, although conclusive evidence is still missing from randomised controlled trials designed to test the effect of correction of hearing loss on the prevalence and incidence of psychosis.