31 Jul “I Can’t Hear You”……Study Finds Most Older Adults Have Hearing Loss
MedicalResearch.com Interview with:
Dr. Reed
Nicholas S. Reed, AuD PhD
Assistant Professor | Department of Epidemiology
Johns Hopkins University Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study?
Response: To date, national estimates of hearing loss have often been based on self-report, which is a fine metric in its own right but underestimates the prevalence of hearing loss against criterion standard measures, and most studies with criterion-level hearing measures are limited to relatively younger samples of older adults. For example, some previous nationally representative samples don’t allow reporting age data over 80 years because there aren’t enough participants in that age group. It is not surprising given that it is difficult to design nationally representative studies that truly allow older adults (80+ years) to participate and measuring hearing can be onerous. However, understanding the prevalence of hearing loss in this age group is vital for public health and policy planning efforts to address hearing loss at the national level.
MedicalResearch.com: What makes this study different from previous national estimates?
Response: The National Health Aging Trends Study (NHATS) is a landmark nationally representative cohort study of Medicare Beneficiaries over 65 years of age and performs in-home assessments across the continental United States. In-home assessments are a key feature of the study as it significantly reduces the burden of participation for older adults (e.g., no travel). Moreover, the NHATS oversamples oldest-old adults which allows for more discrete and robust inferences from adults over 80 years of age. Amazingly, the NHATS added pure-tone audiometry (criterion-standard for estimating peripheral hearing loss) using a portable tablet-based audiometer (Shoebox) at a recent visit.
MedicalResearch.com: What are the main findings?
Response: Overall, we estimate approximately 7 in 10 Americans over 70 years of age have hearing loss but less than 30% of those with hearing loss own and use hearing aids. We knew the prevalence of hearing loss increased with age. However, this study provides incredible insights that ~85% of Americans over 80 years of age have hearing loss while ~95% of Americans over 90 years of age have hearing loss. At such ubiquitous levels, it’s important to look at the severity of hearing loss. Whereas we once assumed the vast majority of hearing loss among older adults was mild in nature, this new data suggests that hearing loss is moderate or greater among ~57% of Americans over 80 years and ~77% of Americans of 90 years of age.
MedicalResearch.com: Did the study examine risk factors for hearing loss?
Response: This is not a risk factor analysis. Rather, our aim was to provide nationally-representative estimates of hearing loss among older adults. However, our work does corroborate previous evidence in younger cohorts that the prevalence of hearing loss is higher among males versus females, White versus Hispanic and Black Americans, Americans with lower education levels, and Americans with lower income levels. However, the differences in the prevalence of hearing loss seem to narrow as age increases. For example, among Americans 71-74 years 47% of Females versus 60% of Males have hearing loss while this gap narrows to 92% versus 94% among Americans 85 and older. While this work is not a risk factor analysis, it does shed some light on the process of aging and hearing loss by some sociodemographic groups which future research could examine more deeply.
MedicalResearch.com: What should readers take away from your report?
Response: Hearing loss is highly prevalent among older adults yet hearing aid use remains relatively low. As major efforts to address access and affordability of hearing aids continue, including over-the-counter hearing aid sales and Congressional consideration of Medicare expansion to include a hearing aid benefit, these estimates will help with considerations and planning by providing more accurate estimates. For example, we may have previously underestimated just how many older adults might benefit from a hearing aid given that we assumed most had more mild hearing losses that don’t always require hearing aids. However, these new estimates suggest the prevalence of moderate or greater hearing loss is high among those over 80 years of age.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: This data is just a stepping stone to using the NHATS dataset to better understand how hearing loss affects older adults and for future risk factor analyses.
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.
Funding/Support: This study was supported by the National Health and Aging Trends Study (grant U01AG032947) and the National Institute on Aging, National Institutes of Health (grant K23AG065443 to Dr Reed and grant K01AG054693 to Dr Deal).
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Citation:
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