The Interaction of Multigenerational Home Environments With Hearing Loss, Cognition, and Depression

To investigate whether the interaction between multigenerational homes and hearing loss (HL) is associated with improved cognitive and depression outcomes.

This was a cross-sectional, epidemiologic study. Data was analyzed from the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES) for participants 18-80 years old with audiometric data. HL was measured with the four-frequency pure tone average in the better ear. Multigenerational homes have three or more generations or a skipped generation (i.e., < 18 and 60+). Cognition was measured with the Digital Symbol Substitution Score. Depression was measured with the PHQ-9, both as a continuous score and a clinically significant binary variable. Multivariable regressions controlled for age, gender, and cardiovascular risk.

Six hundred and seventy three individuals had complete data. The mean age was 63.8 years (SD = 2.80 years) and mean HL was 18.4 dB (SD = 11.0 dB). One hundred and eight subjects lived in a multigenerational home. Among those in non-multigenerational homes: for every 10 dB worsening of hearing, the cognitive score was 1.90 points lower (worse cognitive performance). For those in multigenerational homes: for every 10 dB worsening of hearing, the cognitive score was 1.98 points higher (better cognitive performance). There was no statistical significance of the interaction between HL and multigenerational homes on depression.

HL was associated with worse cognition among those in non-multigenerational homes. However, among those in multigenerational homes, HL was associated with better cognition. Future research is needed to investigate the opposite relationship between HL and cognition among those in vs. not in multigenerational homes.