Assessing the associations between hearing, health, and physical activity across the adult lifespan

Adults with hearing loss are at a greater risk of additional chronic health conditions and poorer psychosocial wellbeing than those without. Many of these conditions (e.g., dementia, diabetes, depression) are potentially modifiable via interventions that target health behaviours such as physical activity. Adults with hearing loss are an under researched population who face additional barriers to engaging in protective health behaviours like physical activity. However, there is a paucity of research assessing how behavioural interventions could mitigate the onset of these conditions in individuals with hearing loss across the adult lifespan. 

This thesis is comprised of two aims. First, the thesis aims to assess the associations between hearing and different health domains in a cohort of adults from 18-87 years, including an exploration of the potential mediating pathways between hearing and memory problems (Chapter 2), an investigation of the impact of the mode of cognitive assessment delivery on cognitive performance (Chapter 3), and an assessment of the associations between hearing and health domains using behavioural measures (Chapter 4). Second, the thesis aims to further explore the relationship between hearing loss and physical activity in middle- and older- adults. First a longitudinal analysis from the English Longitudinal Study of Ageing was conducted to explore the possibility of reverse causality (Chapter 5), followed by a systematic review of existing behavioural interventions to increase physical activity in this population (Chapter 6), and a qualitative evaluation of the barriers and facilitators to physical activity using semi-structured interviews (Chapter 7).

This thesis highlights that a holistic approach to hearing healthcare is necessary to improve health outcomes for adults with hearing loss across the lifespan. Novel findings suggest that behavioural interventions to improve physical activity should be tailored to the needs of adults with hearing loss, as they experience several hearing loss specific barriers to physical activity. Addressing the lack of physical activity in middle- and older- adults with hearing loss may be critical to support healthy ageing and longevity.