Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss

Abstract

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.

Association Between Hearing Loss and Multiple Negative Emotional States in the US Hispanic Population

“…This paper adds to the greater literature that HL may be linked to deleterious conditions rather than exist as an isolated communication or quality‐of‐life issue. Beyond socioemotional states, HL has also been linked to dementia, cognitive decline, serious mental illness, hospitalizations, and falls 13,25,29‐39 . The cognitive relationship is present even for a minimal level of HL 30,40‐42 .…”

“…Beyond socioemotional states, HL has also been linked to dementia, cognitive decline, serious mental illness, hospitalizations, and falls. 13,25,[29][30][31][32][33][34][35][36][37][38][39] The cognitive relationship is present even for a minimal level of HL. 30,[40][41][42] Disturbingly, even though older adults are at risk for many of these disorders, their HL may be less likely to be treated than younger individuals.…”

“…13,25,[29][30][31][32][33][34][35][36][37][38][39] The cognitive relationship is present even for a minimal level of HL. 30,[40][41][42] Disturbingly, even though older adults are at risk for many of these disorders, their HL may be less likely to be treated than younger individuals. 4 These data contribute to the growing field of the potential impact of HL beyond audition and the importance of equitable treatment in often overlooked groups.…”

“…This represents a significant proportion of the population at risk for the negative sequelae associated with HL 4 . Many studies have recently shown strong associations between HL and numerous deleterious medical comorbidities, including depression, cognitive decline, dementia, and most recently, serious mental illness 5‐13 . HL has also been linked with poorer interpersonal support, smaller social networks, and more familial conflict 14‐16 .…”