Effect of Recognition of Hearing Loss Among Care Recipients on Caregiver Reported Care Outcomes

BACKGROUND: Hearing loss (HL) is common in older adults, but many do not recognize how it affects communication. This lack of recognition may limit caregivers' ability to provide effective support, since communication is central to caregiving. This study examined whether care recipients' HL recognition is associated with caregiver burden and psychosocial well-being. METHODS: We used the Round 13 (2023) data from NHATS and NSOC, including 1480 caregivers assisting 960 older adults. HL status was classified as: unrecognized HL (audiometric HL without self-reported difficulty), recognized HL (audiometric HL with self-reported difficulty or hearing aid use), and no HL (normal audiometry). Caregiver outcomes included emotional, financial, and physical burden; relationship quality; PHQ-4 well-being; and restrictions in leisure and social activities. We further examined differences by HL severity and hearing aid use. RESULTS: Among caregivers, 47% supported older adults with unrecognized HL, 34% recognized HL, and 19% had no HL. Compared with caregivers of older adults without HL, caregivers of those with unrecognized HL were more likely to report depressive symptoms, including little interest or pleasure in doing things (OR 1.85; 95% CI: 1.19-2.87) and feeling down or depressed (OR 2.07; 95% CI: 1.31-3.25). A trend toward fewer depressive symptoms was observed among caregivers of individuals with managed HL, though it was not statistically significant. No differences were found in caregiving burden, relationship quality, or activity restriction. CONCLUSION: Despite expectations otherwise, associations between HL recognition and caregiver well-being were modest, suggesting current measures may not fully capture the communication challenges shaping caregiving experiences.