Author(s)
Tyler James Gallagher
Virak Prak
Janet S. Choi
Affiliation(s)
University of Southern California Keck School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the common etiologies and age of onset of hearing loss in this national sample of U.S. older adults, how etiology and onset varies by severity of hearing loss and unilateral/bilateral nature of hearing loss, and the association of etiology and onset of hearing loss with hearing aid use.
Objectives: To examine the etiologies and onset of hearing loss (HL) by audiometric characteristics and their association with hearing aid use in the U.S.
Study Design: Cross-sectional.
Methods: Cohort included adults 70 years or older from 2017-2020 National Health and Nutrition Examination Survey who completed audiometry exam and questionnaires (n=3,174). Participants self-reported etiology and onset of HL and hearing aid use. Audiometry included HL severity and laterality defined by speech frequency pure tone average.
Results: The weighted prevalence of bilateral and unilateral HL was 86.0% [95% CI:82.1-89.2%] and 7.6% [95% CI:5.6-10.1%], respectively. The most common etiologies of bilateral HL were aging (66.9% [95% CI:57.9-74.8%]) and loud long term noise (32.0% [95% CI:25.3-39.4%]). Majority reported onset at 70 or more years (40.6% [95% CI:33.7-47.9%]) followed by 60-69 years (28.4% [95% CI:21.3-36.8%]). Most common etiologies of unilateral HL were aging (79.7% [95% CI:56.4-92.3%]) and loud long term noise (16.7% [95% CI:1.9-68.3%]). While aging was the primary cause of mild (71.0% [95% CI:58.7-80.8%]) and moderate (65.4% [95% CI:55.6-74.1%]) bilateral HL, loud long term noise was the most common cause of bilateral severe to profound HL (47.5% [95% CI:6.7-91.9%]). While aging was the primary cause of mild (76.7% [95% CI:45.2-92.9%]) and moderate (97.0% [95% CI:40.0-99.9%]) unilateral HL, infection was the most common cause of unilateral severe to profound HL (51.4%). In multivariable analysis, individuals with HL due to genetic causes (OR:11.9 [95% CI:1.6-86.1]) were more likely to use hearing aids, and those with ear infections were less likely to use hearing aids (OR:0.1 [95% CI:0.0-0.9]) than those with aging related HL only.
Conclusions: While late onset aging related HL was the most common cause of HL in U.S. older adults, severe HL was more prevalent among individuals reporting potentially preventive etiologies such as noise exposure. Our finding suggests the importance of raising awareness of the risks associated HL and benefits of preventive measures and hearing rehabilitation.