Influence of hearing impairment on quality of life among older adults: A descriptive study in Sri Lanka

Introduction: Hearing impairment is an important global public health concern. It negatively impacts the communication and quality of life (QoL), particularly among older adults. 
Objectives: To describe the QoL of hearing-impaired adults above 65 years  living in the Regional Directorate of Health Services (RDHS) area, Colombo, Sri Lanka in comparison with normal hearing 
Methods: A community-based descriptive study was conducted in a sample of 36 Grama Niladhari divisions within Colombo District. Hearing impairment was assessed using the Portable Screening Audiometry (PSA) test, with positive cases defined using a validated cutoff as hearing impairment in one or both ears. The interviewer-administered Elderly Quality of Life (EQULI) questionnaire consisting of 30 questions across six different domains was used to evaluate QoL. Comparison of differences in domain scores were assessed for significance using non-parametric tests and regression analysis. 
Results: The prevalence of hearing impairment was 52.6%, with 454 hearing impaired persons. The older adults with normal hearing showed significantly higher domain scores of QoL compared to those with impaired hearing in the domains of mental (mean=71.2; SD=68.7; p=0.01), functional (mean=59.2; SD=56.7; p<0.001), environmental (mean=56.2; SD=53.5; p=0.01) and spiritual (mean=61.2; SD=57.2; p<0.001). Multiple linear regression revealed male sex, high income and hearing aid use were positively associated with high QoL, while age 75 years and above and presence of comorbidities were negatively associated with QoL. 
Conclusions & Recommendations: Establishing community-based hearing screening, subsidising hearing aids, and strengthening family and community supported psychosocial interventions to reduce social isolation could be recommended to ensure better QoL.