Prevalence of self-reported hearing difficulty on the Revised Hearing Handicap Inventory and associated factors

Abstract

Background: Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors.

Methods: This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI).

Results: There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty.

Conclusions: The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.

Keywords: Audiology; Cohort study; Demographics; Hearing loss; Patient reported outcome measures; Self-report.

Fig. 1

Prevalence estimates of RHHI self-reported hearing difficulty and audiometric hearing loss by age. Descriptive results are presented for the entire sample and stratified by sex and race. Solid lines indicate the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and dashed lines indicate the prevalence of audiometric hearing loss (pure-tone average [PTA] of thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 > 25 dB HL in the worse ear)

Fig. 2

Scatterplot showing age and PTA relationships for participants with and without RHHI self-reported hearing difficulty. Relationships of age and PTA (pure-tone average of thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 > 25 dB HL in the worse ear) are shown for participants without (left panel; purple) and with (middle panel; green) RHHI self-reported hearing difficulty and both overlayed (right panel). Datapoints are fit to a linear regression line, and 95% confidence intervals are shown by shading