Age-Related Hearing Loss: A cross-sectional study of healthy older Australians.

Abstract

Introduction Hearing loss is common in ageing populations, but thorough investigation of factors associated with objective hearing loss in otherwise healthy, community dwelling older individuals is rare. We examined prevalence of age-related hearing loss (ARHL) in healthy, community-dwelling older adults, and determined whether sociodemographic, lifestyle or health factors associate with hearing thresholds. Audiometry assessment was investigated with self-reports of hearing loss and hearing handicap. Methods Australian participants (n=1260) of median age 73 years (IQR 71-76) joined ASPREE-Hearing, a sub-study of the ASPREE (ASPirin in Reducing Events in the Elderly) trial with exclusions including cognitive impairment, cardiovascular disease (CVD), independence-limiting physical disability, and uncontrolled hypertension. ASPREE collected demographics, anthropometrics, lifestyle, and health data. Audiometry measured better ear pure-tone-average (PTA) across four frequencies (0.5-4kHz) to establish hearing thresholds, categorised as normal or mild, moderate and severe hearing loss. Questionnaires collected perceived hearing problems and noise exposure. Results ARHL prevalence by audiometry was 49.7%, affecting men (59%) more than women (41%). A majority (54.5%) self-reported some hearing problems which mostly aligned with objective assessments; 45.6% self-reported a "little trouble" with hearing, while 35% had objective mild hearing loss; (8.3%) reported having a "lot of trouble" hearing while 13% had moderate hearing loss; and (0.6%) reported being "deaf" with 2% demonstrated severe hearing loss. There was a significant association (p<0.001) between self-reported hearing handicap and audiometric measures of hearing loss. In multivariate analysis of health, demographics and lifestyle risk factors only age, gender (men), and education years (<12) remained associated (P<0.05) with hearing loss. Hearing thresholds were not associated with smoking, living situation, alcohol use, hypertension, diabetes, or chronic kidney disease. Conclusion ARHL robustly assessed by audiometry is common among healthy older Australians with men more likely to have abnormal hearing thresholds than women. Hearing loss was associated with fewer years of formal education, but not with a range of chronic conditions or alcohol use. Self-reported hearing loss correlates well with higher PTA hearing threshold levels in this healthy cohort where prevalence was lower than previously reported for the age group >70 years. Hearing health education remains an important public health tool for this age. Targeting hearing in older patient health checks could be beneficial to mitigate the cognitive, social, and mental health consequences of ARHL, even if patients do not report a problem or handicap.