Incidence of Hearing Impairment and Changes in Pure-Tone Average Across Generations

Abstract

IMPORTANCE Age-adjusted prevalence of hearing impairment (HI) decreased across generations in the 20th century, suggesting that HI is partially preventable. It is not known whether HI incidence differs by generation. OBJECTIVES To examine whether HI incidence and change in pure-tone average (PTA) differ by generation and identify factors underlying these differences. DESIGN, SETTING, AND PARTICIPANTSThis cohort study used data from the Epidemiology of Hearing Loss Study (EHLS) and Beaver Dam Offspring Study (BOSS), a pair of studies of adults in Beaver Dam, Wisconsin. Baseline examinations occurred from 1993 to 1995 in the EHLS and 2005 to 2008 in BOSS, with two 5-year follow-up examinations in each cohort. This longitudinal cohort study assessed 3651 participants without HI at baseline who had follow-up data. MAIN OUTCOMES AND MEASURESThe primary outcome was incident HI measured by pure-tone audiometry, defined as PTA greater than 25-dB hearing level (dB HL) in either ear. Associations of 5-year incidence were estimated by relative risks (RRs) and 10-year cumulative incidence with generation, as categorized by commonly used sociodemographic descriptors of year of birth, by hazard ratios (HRs). The 10-year change in PTA was investigated using a generation × time interaction term in generalized estimating equation models.RESULTS Among the 3651 participants (mean [SD] age at baseline 53.1 [10.6] years; 2255 [61.8%] female; and 3567 [97.7%] non-Hispanic White), the 5-year HI incidence was 14.1% (95% CI, 13.0%-15.3%) and the 10-year cumulative incidence was 26.0% (95% CI, 24.6%-27.6%). The incidence increased with age. The risk of 5-year incident HI decreased by generation (RR, 0.80; 95% CI, 0.66-0.97) when adjusting for multiple covariates. The decreased risk was similar in the 10-year period (HR, 0.86; 95% CI, 0.73-1.01). The PTA change rate (per 5 years of follow-up) decreased by generation, with the Greatest Generation (born 1901-1924) experiencing the highest rate (7.03 dB HL). The rates were all significantly lower for the other generations (Silent Generation [born 1925-1945 Baby Boom Generation [born 1946-1964 and Generation X [born 1965-1984], 2.33 dB HL).CONCLUSIONS AND RELEVANCE This study suggests that the risk of HI and rate of PTA change is lower for the Silent Generation and Baby Boom Generation compared with the Greatest Generation. Part of this lower risk is likely associated with changes in modifiable factors. A potential continued benefit may exist for Generation X. Combined with the reduced risk of HI for the Silent Generation and Baby Boom Generation, this finding implies that the future HI burden may be lower than current estimates suggest.

Progression and trajectory network of age-related functional impairments and their associations with mortality: a two-decade prospective study

“…The incidence rates reported in this study were comparable with previous studies. 37 38 39 40 41 42 43 44 45 For instance, the incidence rate of cognitive impairment was 52.6 cases/1000 person-years in a 5-year follow-up study of Aboriginal Australians aged over 60 years, 46 which is similar to our result (64.6 cases/1000 person-years). The observed sex- and age-disparities in incidence rates also corresponded to prior knowledge.…”

“…41 Also, our results echoed the established knowledge that the risk of impairments in sensory, physical, and cognitive function was higher in older ages. 40 42 43 46 47 48 Other than confirming previous findings, our study added valuable evidence of age- and sex-specific incidence rates of AFRIs in a wide range of age groups (51-90 years) within a cohort, which provided important evidence for the prevention of ARFIs in the aging era.…”

Progression and trajectory network of age-related functional impairments and their combined associations with mortality

“… 22 , 24 , 27 , 28 , 29 For example, a review reported that women had a greater incidence of depression than men, and the incidence rate decreased after the age of 50 years Also, our results echoed the established knowledge that the risk of impairments in sensory, physical, and cognitive function was higher in older ages. 23 , 25 , 30 , 31 , 32 Compared to other ARFIs, the exponential increase periods for restless sleep and depression traits may have occurred earlier and may have higher incidence in the middle-aged population. 24 Therefore, our observation that their incidence rate increased less rapidly in older adults should be interpreted with caution.…”

Associations of Hearing Loss and Hearing Aid Use With Cognition, Health-Related Quality of Life, and Depressive Symptoms

“…Across both cohorts, 59 participants (EHLS, n = 51; BOSS, n = 8) did not have audiometric data so were not included in this study. Previous studies have pooled samples from EHLS and BOSS cohorts (Fischer et al, 2017; Paulsen et al, 2021).…”