Prevalence and predictors of self-reported hearing aid use and benefit in Norway: the HUNT study

Abstract

Background: Knowledge on hearing aid use and benefit is important to ensure appropriate and effective treatment. We aimed to assess prevalence and predictors of hearing aid use and benefit in Norway, as well as possible birth cohort changes.

Methods: We analyzed two large cross-sectional, population-based hearing surveys of 63,182 adults in 1996-1998 and 2017-2019 (the HUNT study). We used multivariable regression models to examine independent predictors of hearing aid use and benefit, including demography, hearing-related variables, known risk factors for hearing loss and birth cohort.

Results: The nationally weighted hearing aid use in the adult population increased from 4.2% in 1997 to 5.8% in 2018. The use among individuals with disabling hearing loss (≥ 35 dB HL) increased from 46.3% to 64.4%. Most users reported some (47%) or great (48%) help from their hearing aids. In addition to the level of hearing loss and birth cohort, factors associated with hearing aid use included lower age, tinnitus, childhood-onset hearing loss, higher education, marriage, having children, being exposed to occupational noise or impulse noise, recurrent ear infections, and head injury. In addition to the level of hearing loss, factors related to hearing aid benefit included younger age, female gender, and higher income. Being bothered by tinnitus reduced the benefit.

Conclusion: Our study shows an increase in self-reported hearing aid usage over time in Norway, with lower adoption rates and perceived benefits observed among the elderly. The results suggest that having a spouse and children positively influences the adoption of hearing aids. These findings emphasize the necessity of customized strategies to address demographic disparities and the need for innovative enhancements in hearing rehabilitation programs.

Keywords: Ageing; Hearing loss: tinnitus; Marital status; Socioeconomics; Treatment.

Fig. 1

Estimated use of hearing aids in Norway after weighting on age- and sex for different degrees of hearing loss (WHO) based on self-reported use in HUNT2 and HUNT4 and population figures for Norway in 1997 and 2018. Shown are absolute numbers (bars) and proportions (lines). Number of adult inhabitants in Norway in 1997: 3.2 million and in 2028: 4.0 million

Fig. 2

The distribution of different levels of hearing aid benefit for different degrees of hearing loss (WHO). Shown are absolute numbers (bars) and proportions (lines). Sample of hearing aid users in HUNT4 (n = 1,732)

Fig. 3

Predicted prevalence values of self-reported use of hearing aids and disabling hearing loss (PTA4 ≥ 35 dB HL) in HUNT2 and HUNT4. Prevalence values are probabilities predicted with 95% confidence intervals using the margins command in Stata from a logistic regression model including sex, age cohort and interaction between age and cohort

Fig. 4

Associations between various explanatory variables and hearing aid use presented as adjusted odds ratio (OR) with 95% confidence intervals for all independent variables in the logistic regression model. For continuous variables the OR are for one-unit change with the unit shown in parentheses. Pooled sample from HUNT2 and HUNT4 (observations = 75,190, participants = 63,182)

Fig. 5

Associations between various explanatory variables and hearing aid benefit presented as adjusted odds ratio (OR) with 95% confidence intervals for all independent variables in the ordinal logistic regression model. For continuous variables the OR are for one-unit change with the unit shown in parentheses. Sample of hearing aid users in HUNT4 (participants = 1,732)

Fig. 6

Predicted proportions of different levels of hearing aid benefit as a function of age. Proportions are predicted with 95% confidence intervals using the margins command in Stata from an ordinal logistic model including all independent variables. Sample of hearing aid users in HUNT4 (participants = 1,732)