2026 Theses Doctoral

Longitudinal Impacts of Hearing Loss on Trajectories of Emotional Health Among Older Adults in China

Zhang, Zhe

The aging population in China is undergoing an unprecedented demographic transition in
speed and scale, yet age-related hearing loss (ARHL) remains significantly under addressed. This condition not only affects the older adults’ functional communication but also creates emotional health gaps over years. To deepen understanding of how hearing loss interacts with emotional health over the long term, this study investigated the longitudinal impacts of hearing loss on the trajectories of depressive symptoms among older adults in China.

Data driven from the China Health and Retirement Longitudinal Study (CHARLS) from Wave 2 (2013) to Wave 5 (2020). The participants were classified into three groups by longitudinal hearing patterns: hearing difficulty group, mixed group, and no hearing difficulty group. To measure the association between hearing trajectories and emotional outcomes, the study applied linear mixed-effects models with a hierarchical model-building strategy and logistic regression.

Results show that the consistent hearing difficulty group reached the threshold of clinical depression over time. This study also reveals significant disparities where rural residents face a higher risk of both hearing loss and depression. Conversely, active social engagement and higher self-rated health were identified as protective factors. These findings suggest future policy and intervention implementations by both the medical model of deafness and a socially supportive framework. In addition, this study suggests a new method to identify ARHL with a hearing pattern-based approach, to capture the progressive and dynamic nature of ARHL.