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. 2023 Jul 3;6(7):e2326320.
doi: 10.1001/jamanetworkopen.2023.26320.

Prevalence of Hearing Loss and Hearing Aid Use Among US Medicare Beneficiaries Aged 71 Years and Older

Nicholas S Reed  1   2   3 , Emmanuel E Garcia-Morales  1   3 , Clarice Myers  2   3 , Alison R Huang  1   3 , Joshua R Ehrlich  4   5 , Olivia J Killeen  3 , Julie E Hoover-Fong  6 , Frank R Lin  1   2   3 , Michelle L Arnold  7 , Esther S Oh  3   8 , Jennifer A Schrack  1 , Jennifer A Deal  1   2   3
Affiliations

Prevalence of Hearing Loss and Hearing Aid Use Among US Medicare Beneficiaries Aged 71 Years and Older

Nicholas S Reed et al. JAMA Netw Open. .

Abstract

Importance: National prevalence estimates are needed to guide and benchmark initiatives to address hearing loss. However, current estimates are not based on samples that include representation of the oldest old US individuals (ie, aged ≥80 years), who are most at-risk of having hearing loss.

Objective: To estimate the prevalence of hearing loss and hearing aid use by age and demographic covariates in a large, nationally representative sample of adults aged 71 years and older.

Design, setting, and participants: In this cohort study, prevalence estimates of hearing loss by age, gender, race and ethnicity, education, and income were computed using data from the 2021 National Health Aging and Trends Study. Survey weights were applied to produce nationally representative estimates to the US older population. Data were collected from June to November 2021 and were analyzed from November to December 2022.

Main outcomes and measures: Criterion-standard audiometric measures of hearing loss and self-reported hearing aid use.

Results: In this nationally representative sample of 2803 participants (weighted estimate, 33.1 million individuals) aged 71 years or older, 38.3% (95% CI, 35.5%-41.1%) were aged 71 to 74 years, 36.0% (95% CI, 33.1%-38.8%) were aged 75 to 79 years, 13.8% (95% CI, 12.6%-14.9%) were aged 80 to 84 years, 7.9% (95% CI, 7.2%-8.6%) were aged 85 to 89 years, and 4.0% (95% CI, 3.5%-4.6%) were aged 90 years or older; 53.5% (95% CI, 50.9%-56.1%) were female and 46.5% (95% CI, 43.9%-49.1%) were male; and 7.5% (95% CI, 6.2%-8.7%) were Black, 6.5% (95% CI, 4.4%-8.7%) were Hispanic, and 82.7% (95% CI, 79.7%-85.6%) were White. An estimated 65.3% of adults 71 years and older (weighted estimate, 21.5 million individuals) had at least some degree of hearing loss (mild, 37.0% [95% CI, 34.7%-39.4%]; moderate, 24.1% [95% CI, 21.9%-26.4%]; and severe, 4.2% [95% CI, 3.3%-5.3%]). The prevalence was higher among White, male, lower-income, and lower education attainment subpopulations and increased with age, such that 96.2% (95% CI, 93.9%-98.6%) of adults aged 90 years and older had hearing loss. Among those with hearing loss, only 29.2% (weighted estimate, 6.4 million individuals) used hearing aids, with lower estimates among Black and Hispanic individuals and low-income individuals.

Conclusions and relevance: These findings suggest that bilateral hearing loss is nearly ubiquitous among older US individuals, prevalence and severity increase with age, and hearing aid use is low. Deeper consideration of discrete severity measures of hearing loss in this population, rather than binary hearing loss terminology, is warranted.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Reed reported being an advisory board member of Neosensory outside the submitted work. Dr Hoover-Fong reported providing consulting services to pharmaceutical companies and serving as the institutional principal investigator for clinical trials from pharmaceutical companies outside the submitted work; these arrangements have been reviewed and approved by her institution. Dr Lin reported receiving personal fees from Frequency Therapeutics and Apple, Inc, outside the submitted work, and being the director of a public health research center funded in part by a philanthropic gift from Cochlear, Ltd, to the Johns Hopkins Bloomberg School of Public Health. Dr Arnold reported receiving grants from the National Institute on Aging, the National Institute on Deafness and Other Communication Disorders, and University of South Florida Morsani College of Medicine outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Prevalence Estimates of 2060 Adults Aged 71 Years and Older in the US With Hearing Loss by Age and Severity
Data are from the 2021 National Health Aging Trends Study and are weighted according to study guidelines. Hearing loss severity is defined based on a 4-frequency (0.5, 1.0, 2.0, and 4.0 kHz) pure tone average threshold (no hearing loss, ≤25 decibel hearing level [dBHL]; mild, 26-40 dBHL; moderate, 41-60 dBHL; and severe or greater, >60 dBHL).
See this image and copyright information in PMC

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