Objective: To investigate the prevalence and incidence of hearing impairment (HI) in a longitudinal setting among adults. Design: An unscreened, population-based epidemiological 13-year follow-up study. Study sample: 850 randomly sampled 54 to 66-year-old baseline participants, of whom 559 participated in the follow-up study at the age of 68 to 79 years. A questionnaire-based interview, an otological examination and pure-tone audiometry were performed. Results: The overall prevalence of HI was 70.3%, defined by better ear hearing level (BEHL) ≥20 dB in the 0.5-4 kHz frequency range. The prevalence was higher among men (78.6%) than among women (63.7%). The overall incidence rate for HI was 45.8 per 1000 person years and the 13-year cumulative incidence was 60.9%. The incidence was higher among men and older participants. Conclusion: HI is highly prevalent and incident among older adults in Northern Finland.