Audiometric Findings in Senior Adults of 80 Years and Older

Trends and driving factors of age-related hearing loss and severity over 30 years: a cross-sectional study

BACKGROUND

Age-related hearing loss (AHL) is a modifiable risk factor for chronic disability and cognitive decline in adults over 60 years globally. Despite its preventable nature, long-term trends (1992-2021) in AHL burden and its demographic, socioeconomic, occupational noise exposures, and geographic drivers remain underexplored, limiting targeted intervention strategies.

METHODS

This observational study analyzed age-standardized prevalence and years lived with disability (YLDs) for AHL among adults aged ≥60 years using the Global Burden of Disease Study 2021 (1992-2021). Data were stratified by sex, age, region, and nation, with demographic decomposition to isolate population aging effects and Bayesian spatiotemporal regression to quantify modifiable drivers (e.g., occupational noise). Temporal trends were evaluated by calculating annual average percentage change (AAPC) with 95% confidence intervals (CI).

RESULTS

From 1992 to 2021, AHL-related prevalence and YLDs showed an upward trend globally (AAPC prevalence = 0.14 [95% CI: 0.13, 0.14]; AAPC YLDs = 0.17 [95% CI: 0.15, 0.20]). There was a downward trend in the YLDs of AHL from 1992 to 1995 (AAPC YLDs = -0.08 [95% CI: -0.19, 0.04]). Regionally, while most regions showed an increasing trend in AHL prevalence, 1990-2019, some regions still showed a decreasing trend (AAPC Western sub-Saharan Africa = -0,22 [95% CI: -0.37, -0.08]). In 2021, in the countries with middle socio-demographic index (SDI) levels, the older the population, the higher the prevalence and YLDs of AHL. Furthermore, the burden of AHL varies by age and sex and has unique temporal and spatial features. Notably, higher SDI levels correlated with reduced occupational noise-attributable burdens, while adults aged 70-74 years exhibited the highest occupational noise-driven YLDs.

CONCLUSION

The global burden of AHL continues to rise, which is a growing problem for countries with medium SDI levels. Occupational noise exposure emerges as a critical modifiable risk factor, particularly in rapidly industrializing economies, highlighting the urgent need to prioritize workplace hearing protection programs and targeted noise control policies tailored to regional contexts. These interventions are especially vital for older men in low-resource settings and medically underserved countries to mitigate preventable disability and address health inequities.

Interindividual variability in the benefits of personal sound amplification products on speech perception in noise: A randomized cross-over clinical trial

OBJECTIVE

The aging population is prone to hearing loss, which has several adverse effects on quality of life, including difficulty following conversations in noisy environments. Personal Sound Amplification Products (PSAPs) are a less expensive, over-the-counter alternative to traditional, more expensive hearing aids. Although some studies have shown that PSAPs can mitigate hearing loss, the literature generally only addresses group differences without considering interindividual variability. This study aimed to 1) determine how PSAPs affect listening effort and speech perception in noise and 2) measure interindividual variability and identify contributing demographic and health factors.

DESIGN

We used a cross-over design in which all participants were assigned to each condition.

PARTICIPANTS

Twenty-eight adults aged 60 to 87 years with normal hearing and mild hearing loss fulfilled the study requirements.

INTERVENTION

In one session, speech-in-noise perception tasks were performed without PSAPs, and in the other, the tasks were performed with bilateral PSAPs. The two sessions were separated by one week, and the order of the sessions was balanced across participants.

MAIN OUTCOME MEASURES

In both sessions, participants performed the Quick speech-in-noise test and a word discrimination task in noise, in which their self-reported listening effort was measured.

RESULTS

PSAPs use improved speech perception in noise in both tasks and reduced listening effort. There was considerable variability between individuals, with approximately 60-70% of participants showing benefit. Age, hearing and cognitive status were significant predictors of the benefits.

CONCLUSION

Not all individuals may benefit from the effect of PSAPs to the same extent at their first use, and this depends on specific health and demographic factors, particularly age, hearing, and cognitive status. These results underscore the importance of demographic and health factors in assessing the benefits of hearing amplification in older adults.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05076045.