Demographic factors impact the rate of hearing decline across the adult lifespan

Abstract

Little is known about the natural history of hearing loss in adults, despite it being an important public health problem. The purpose of this study is to describe the rate of hearing change per year over the adult lifespan. The 1436 participants are from the MUSC Longitudinal Cohort Study of Age-related Hearing Loss (1988-present). Outcomes are audiometric thresholds at 250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz, averaged across right and left ears, and pure-tone average (PTA). Demographic factors are sex (female/male), race, which is categorized as white or racial Minority, and baseline age group (18-39, 40–59, 60–69, 70+ years). Linear mixed regression models are used to estimate the effect of age (per year) on the rate of threshold and PTA change. Participants’ mean age is 63.1 (SD 14.9) years, 57.7% are female, and 17.8% are racial Minority (17.1% were Black or African American). In sex-race-adjusted models, rates of threshold change are 0.42 to 1.44 dB across thresholds. Rates of change differ by sex at most individual thresholds, but not PTA. Females (versus males) showed higher rates of threshold change in higher frequencies but less decline per year in lower frequencies. Black/African American (versus white) participants have lower rates of threshold and PTA change per year. Hearing thresholds decline across the adult lifespan, with older (versus younger) baseline age groups showing higher rates of decline per year. Declines to hearing occur across the adult lifespan, and the rate of decline varies by sex, race, and baseline age. Hearing loss is a common health condition, yet little is known about how hearing changes over time. In this study of 1436 individuals from across the adult lifespan, declines in hearing occurred throughout adulthood. The rate of decline per year varied by sex, in that females experienced more decline in higher pitches but less decline in lower pitches. The rate of decline per year varied by race, in that Black/African American (versus white) participants showed lower rates of hearing decline per year. The rate of decline per year also varied by age, in that older (versus younger) baseline age groups had higher rates of hearing decline per year. This study contributes to understanding of the natural history of hearing loss and could be used to better understand how to focus efforts to prevent and/or manage hearing loss across populations. Dillard et al. evaluate changes in hearing over the adult lifespan. Females show higher rates of threshold change in higher frequencies but less decline per year in lower frequencies compared to males.