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. 2025 Aug;26(4):467-476.
doi: 10.1007/s10162-025-00993-2. Epub 2025 May 19.

Generational Differences in Audiometric and Self-Reported Hearing and Hearing Aid Use

Lauren K Dillard  1 , Lois J Matthews  2 , Judy R Dubno  2
Affiliations

Generational Differences in Audiometric and Self-Reported Hearing and Hearing Aid Use

Lauren K Dillard et al. J Assoc Res Otolaryngol. 2025 Aug.

Abstract

Purpose: Birth cohort differences capture secular trends in population health. We aimed to determine birth cohort differences, defined by generation, in hearing-related outcomes.

Methods: Participants were from a community-based cohort study. Generation was classified according to birth year: Greatest (1901-1924), Silent (1925-1945), Baby Boom (1946-1964), Generation X (1965-1980), or Millennial (1981-1996) and Gen Z (1997-2012). Primary outcomes were audiometric hearing loss, defined as a worse ear pure-tone average (PTA) of thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 kHz > 25 dB HL, and self-reported hearing difficulty, defined as a score ≥ 6 on the Revised Hearing Handicap Inventory (RHHI). Analyses focused on hearing aid use included only participants with audiometric hearing loss. We used multivariable adjusted logistic regression models to evaluate associations between generation and each outcome. Models were stratified to sex when there was evidence of effect modification.

Results: This cross-sectional study included 1554 participants (mean age 63.7 [SD 14.4] years; 56.8% female, 20.0% racial Minority). The prevalence of audiometric hearing loss, self-reported hearing difficulty, and hearing aid use (among participants with audiometric hearing loss) was 48.9%, 48.8%, and 22.0%, respectively. Generation was associated with audiometric hearing loss in the entire sample and males only. Generation was not consistently associated with self-reported hearing difficulty or hearing aid use.

Conclusion: More recent generations had lower prevalence of audiometric hearing loss. There were no generational differences in self-reported hearing difficulty or hearing aid use. Secular hearing-related trends can inform accurate projections of the burden of hearing loss and health care utilization.

Keywords: Aging; Birth cohort; Cohort studies; Cross-sectional studies; Epidemiology; Hearing loss.

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Conflict of interest statement

Declarations. Ethics Approval: All protocols for this study were approved by the MUSC Institutional Review Board (approval ID: E-607R) and data were collected under informed written consent. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Relationships of age with pure-tone average (PTA) and Revised Hearing Handicap Inventory (RHHI) self-reported hearing difficulty by generation. dB HL, decibel hearing level
See this image and copyright information in PMC

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