Social participation trajectories and self-reported hearing impairment among Chinese older adults: Evidence from the Chinese longitudinal healthy longevity study over 10 years

Social participation is an important aspect of healthy aging, yet its association with hearing impairment among older adults remains insufficiently explored. This study aimed to examine the social participation trajectories of Chinese older adults and their association with hearing impairment over 10 years. The study extracted 2154 Chinese older adults from the China Longitudinal Healthy Living Survey conducted between 2008 and 2018. The social participation and hearing impairment data used in this study were self-reported. We identified social participation trajectories using a group-based trajectory model and explored their association with hearing impairment using Cox hazard proportional regression. Subgroup analysis and interaction tests were further used to examine the potential influence of categorical covariates on the relationship between social participation trajectories and hearing impairment. We also performed 3 sensitivity analyses to determine the robustness of the results. Three social participation trajectory groups were identified: low-activity (N = 488, 22.66%), moderate-activity (N = 1298, 60.26%), and high-activity (N = 368, 17.08%). The median age of the participants was 73.00 (P25: 69.00, P75: 80.00) years. We documented that the incidence of hearing impairment was 20.84% during ten years of follow-up. After adjusting for covariates, we found that compared with the low-activity group, the hazard ratio of the moderate-activity was 0.54 (95% confidence intervals: 0.40-0.73), whereas that of the high-activity group was 0.17 (95% confidence intervals: 0.09-0.32). Interaction analyses showed that family annual income was a significant moderator (P for interaction <.05). The results of our study remained robust in 3 sensitivity analyses. Social participation in older adults can be classified into 3 distinct trajectory groups. Compared with the low-activity social participation trajectory, older Chinese adults in the moderate-activity and high-activity groups were associated with a lower risk of hearing impairment. Community-based strategies need to be developed to encourage older adults to maintain their social participation, which may help support hearing health.