Association between Hearing Loss, Physical Activity, and Sedentary Behavior: A Nationally Representative Cross-Sectional Study in Chile
Camilo Morales, Pablo Martinez-Amezcua, Francisco Félix Caballero, Maria J Oliveros, Pamela Seron, Esther Lopez-Garcia, Humberto Yévenes-BrionesAbstract
Background
Hearing loss is common in midlife and older adults and may constrain communication and participation, potentially shaping physical activity and sedentary time; however, population-based evidence remains inconsistent.
Methods
We analyzed a nationally representative sample of Chilean adults aged ≥40 years from the 2016–2017 Chile National Health Survey (n = 3512). Hearing loss was defined by a “no” response to any of three self-report items. Global Physical Activity Questionnaire outcomes included overall physical activity (high/moderate/low), domain-specific energy expenditure (work, transport, leisure; MET-hours/week), and high sedentary behavior (≥8 h/day). We fitted survey-weighted ordinal, gamma (log link), and logistic regression models; effect modification by sex, age, and sleep quality was tested. Sensitivity analyses used inverse probability–of-exposure weighting with gradient-boosted propensity scores.
Results
The weighted prevalence of hearing loss was 27.9%. Hearing loss was not associated with overall physical activity level (OR, 1.14; 95% CI, 0.90; 1.39) or with domain-specific energy expenditure at work (RR, 0.90; 95% CI, 0.75; 1.08), transport (RR, 1.02; 95% CI, 0.83; 1.25), or leisure (RR, 1.10; 95% CI, 0.86; 1.42). In contrast, hearing loss was associated with high sedentary behavior (OR, 1.81; 95% CI, 1.16; 2.82), with similar estimates after weighting (OR, 1.86; 95% CI, 1.18; 2.94). Subgroup analyses showed no consistent heterogeneity by sex, age, or sleep quality.
Conclusion
In Chilean adults aged ≥40 years, self-reported hearing loss was associated with prolonged sedentary time but not with overall or domain-specific physical activity. These findings support integrating hearing care with strategies to reduce sedentary behavior.