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

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: Declines to hearing occur across the adult lifespan, and the rate of decline varies by sex, race, and baseline age.

Fig. 1. Average rates of audiometric threshold and PTA change (dB) per year, stratified by sex.

Results are presented as Beta coefficients with corresponding 95% confidence intervals (error bars) for female (blue circles; n = 828) and male (green squares; n = 608) participants. Estimates are adjusted for race. *p < 0.05; significance determined by including age*sex interaction term in models. PTA pure-tone average, calculated from frequencies 500, 1000, 2000 and 4000 Hz averaged across right and left ears.

Fig. 2. Average rates of audiometric threshold and PTA change (dB) per year, stratified by race.

Results are presented as Beta coefficients with corresponding 95% confidence intervals (error bars) for white (blue circles; n = 1180) and Black/African American (green squares; n = 246) participants. Estimates are adjusted for sex. *p < 0.05; significance determined by including age*race interaction term in models. Participants who were not white or Black/African American race (categorized as other race) were excluded from these analyses given the small sample size (n = 10; see Table 1). PTA: pure-tone average, calculated from frequencies 500, 1000, 2000 and 4000 Hz averaged across right and left ears. AA: African American.

Fig. 3. Average rates of audiometric threshold and PTA change (dB) per year, stratified by baseline age group (years).

Results are presented as Beta coefficients with corresponding 95% confidence intervals (error bars) for participants aged 18–39 (blue circles; n = 154), 40-59 (orange squares; n = 231), 60-69 (green triangles; n = 547) and 70+ (grey Xs; n = 504) years at the baseline examination. Estimates are adjusted for sex and race. *p < 0.05; significance determined by including age*baseline age interaction term in models. PTA: pure-tone average, calculated from frequencies 500, 1000, 2000 and 4000 Hz averaged across right and left ears.