Abstract
BACKGROUND: This study examines how different types of age-related hearing loss─ unilateral (UHL) and bilateral (BHL) ─are associated with perceived stress and health-related quality of life (HRQoL) in elderly people. METHODS: A cross-sectional analysis was conducted using data for 1,665 participants aged 70 to 84 years from the 2022-2023 Korean Frailty and Aging Cohort Study. Participants were categorized into three groups based on hearing status: reference (normal to mild HL, n = 1163), UHL (n = 215), and BHL (n = 287), defined as a pure tone average of > 40 dB. Perceived stress was assessed using the 10-item Perceived Stress Scale, which evaluates perceived helplessness and self-efficacy. HRQoL was measured using the 12-item Short Form Health Survey, which includes physical (PCS) and mental (MCS) component summaries. Multiple logistic regression analyses were performed, adjusting for age, sex, education, marital status, occupation, household income, mobile phone use, hearing aid use, mobility, comorbidities, smoking status, alcohol consumption, physical activity, loneliness, and social networks. RESULTS: Participants with BHL had significantly higher perceived stress (odds ratio: 2.493, 95% CI: 1.778-3.494), reflected in greater helplessness (1.692, 1.232-2.324) and lower self-efficacy (2.270, 1.653-3.115). UHL was not significantly associated with increased perceived stress (1.244, 0.839-1.846). In the HRQoL domains, UHL and BHL were associated with higher odds of both PCS impairment (UHL: 2.516, 1.663-3.806; BHL: 1.762, 1.198-2.591) and MCS impairment (UHL: 1.695, 1.176-2.443; BHL 2.539, 1.833-3.517). CONCLUSION: BHL was associated with increased perceived stress and poorer HRQoL, whereas UHL did not differ significantly from the reference group in perceived stress but was associated with poorer physical and mental HRQoL. These findings highlight the importance of early identification and intervention for hearing loss to improve health-related outcomes in elderly people.