To investigate disparities in hearing aid use across the life span for borderline/mild hearing loss, a cross-sectional epidemiologic study in the National Health and Nutrition Examination Survey was conducted. Multivariable logistic regressions controlling for hearing level analyzed the association between hearing aid use and age in borderline/mild hearing loss. Age was grouped into quartiles. Of 2470 subjects, 2.0% (n = 50) were <25 years old; 12.0% (n = 297), 25 to 49 years; 65.5% (n = 1618), 50 to 74 years; and 20.5% (n = 505), ≥75 years. When compared with the youngest quartile and while controlling for hearing level, those in the second quartile were 4.6 times less likely to use hearing aids ( P < .01); those in the third were 4.2 times less likely ( P < .01); and those in the fourth were 4.7 times less likely ( P < .001). The dramatically lower hearing aid usage of all older age groups as compared with children/younger adults represents a large unaddressed age-related disparity in the treatment of borderline/mild hearing loss.

ObjectiveSubclinical hearing loss (SCHL) (previously defined by our group as a four-frequency pure tone average [PTA4] >0 to ≤25 dB) has recently been associated with depressive symptoms and cognitive decline. This suggests that the common 25 dB adult cutpoint in the United States for normal hearing may not be sensitive enough. We aim to characterize real-world hearing difficulties, as measured by hearing aid use and self-reported hearing difficulty, among individuals with SCHL.Study DesignAnalysis of biennial cross-sectional epidemiologic survey (National Health and Nutrition Examination Survey, 1999–2012, 2015–2016).SettingCommunity, multicentered, national.SubjectsNoninstitutionalized US citizens ≥12 years old, n = 19,246.MeasuresPTA4 (500, 1,000, 2,000, 4,000 Hz), high-frequency pure tone average (PTAhf) (6,000, 8,000 Hz), reported hearing aid use, subjective difficulty hearing.ResultsThere were 806,705 Americans with SCHL who wore hearing aids (or 0.35% of the 227,324,096 Americans with SCHL; 95% confidence interval = 0.23%–0.54%). Among those with SCHL, 14.6% (33.1 million Americans) perceived a little trouble hearing and 2.29% (5.21 million Americans) perceived moderate/a lot of trouble hearing. When restricted to the borderline subcategory (>20 to ≤25 dB), 42.43% (6.64 million Americans) had at least a little trouble hearing. Among those with SCHL who wore hearing aids, 81% had a PTAhf >25 dB.ConclusionDespite hearing loss traditionally being defined by PTA4 ≤ 25 dB in the United States, nearly 1 million adults and adolescents with SCHL wore hearing aids, and nearly half with borderline HL had subjective difficulty hearing. To better reflect real-world difficulties, stricter definitions of hearing loss should be explored, including a lower cutpoint for the PTA4 or by using the more sensitive PTAhf.

ObjectiveCurrent definitions of hearing loss (HL) may be insufficiently strict, as subclinical hearing loss (SCHL; >0 and ≤25 dB hearing level) has been associated with deleterious age‐related conditions. SCHL prevalence and mean age of HL onset in the United States has not been characterized.Study DesignA cross‐sectional epidemiologic prevalence study.SettingUS Community.MethodsWe analyzed cross‐sectional audiometric data in the US National Health and Nutrition Examination Survey (2005‐2012, 2015‐2018, n = 15,649). Results were scaled to the current population using weighting.Results79.6% of participants (227.32 million Americans) had SCHL. The mean age of HL onset at thresholds of 25, 20, and 15 dB was 74, 66, and 55 years, respectively, for the 4‐frequency pure‐tone average, and 48, 44, and 35 years for the high‐frequency pure‐tone average.ConclusionWe present SCHL prevalence and define HL onset by various sensitive definitions. These results inform ongoing public health efforts to increase hearing aid utilization, particularly given the arrival of over‐the‐counter hearing aids.