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J Am Acad Audiol 2022; 33(02): 058-065
DOI: 10.1055/s-0041-1735520
Research Article

Hearing Screening Age Considerations for Adults: National Health and Nutrition Examination Survey

Jaxon Jordan
1   Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson, Mississippi
,
Rachael R. Baiduc 
2   Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, Boulder, Colorado
,
Christopher Spankovich
1   Department of Otolaryngology-Head and Neck Surgery, University of Mississippi Medical Center, Jackson, Mississippi
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Abstract

Background The United States Preventative Service Taskforce recently determined that there was insufficient evidence to recommend hearing screening in adults.

Purpose To determine the age to screen adults in the U.S. for hearing loss and identify factors related to increased odds of hearing loss.

Research Design Epidemiological Cross-Sectional Study.

Study Sample Data from 3,409 individuals aged 20–69 years(y) were analyzed from the 1999–2000 and 2000–2002 cycles of the National Health and Nutrition Examination Survey (NHANES).

Data Collection and Analysis Hearing sensitivity from 0.5–8 kHz was assessed and hearing loss was defined as pure tone average 0.5, 1, 2, 4 kHz (PTA4) > 15 dBHL for the worse ear. Thresholds were examined separately for men and women in 2-year intervals. A multivariate ordinal regression model adjusting for age, sex, race/ethnicity, and education was used to examine relationship to determinants.

Results Slight (>15 dBHL) hearing loss based on threshold at a single audiometric frequency was first evident in males aged 28–29y. For females, this occurred at age 34–35y. The age at which average PTA4 increased above 15 dBHL (slight hearing loss) was 46–47y for males and 56–57y for females. Multivariate ordinal regression revealed the following “high risk” factors: increased age, male sex, tinnitus, perceived hearing loss, and diabetes.

Conclusions For the function of primary prevention, these data suggest screening should initiate at ∼30y for males and 35y for females, the ages when average hearing thresholds at a single frequency can be classified as slight hearing loss. For secondary prevention, the recommended screening ages are higher – 45y for males and 55y for females. Hearing screening is recommended for asymptomatic adults, especially those with high risk factors. Our results also highlight the limitations of PTA4 in identifying early indices of hearing loss.

Keywords

hearing loss - epidemiology - screening

Jordan and Baiduc should be considered joint first authors


Disclaimer

Any mention of a product, service, or procedure in the Journal of the American Academy of Audiology does not constitute an endorsement of the product, service, or procedure by the American Academy of Audiology.




Publication History

Received: 12 February 2021

Accepted: 21 July 2021

Article published online:
01 September 2022

© 2021. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Bower CM, St John R. The otolaryngologist's role in newborn hearing screening and early intervention. Otolaryngol Clin North Am 2014; 47 (05) 631-649
    CrossrefPubMedSearch in Google Scholar
  • 2 Yoshinaga-Itano C, Coulter D, Thomson V. The Colorado Newborn Hearing Screening Project: effects on speech and language development for children with hearing loss. J Perinatol 2000; 20 (8 Pt 2): S132-S137
    CrossrefPubMedSearch in Google Scholar
  • 3 Young NM, Reilly BK, Burke L. Limitations of universal newborn hearing screening in early identification of pediatric cochlear implant candidates. Arch Otolaryngol Head Neck Surg 2011; 137 (03) 230-234
    CrossrefPubMedSearch in Google Scholar
  • 4 Mehra S, Eavey RD, Keamy Jr DG. The epidemiology of hearing impairment in the United States: newborns, children, and adolescents. Otolaryngol Head Neck Surg 2009; 140 (04) 461-472
    CrossrefPubMedSearch in Google Scholar
  • 5 Goman AM, Lin FR. Prevalence of Hearing Loss by Severity in the United States. Am J Public Health 2016; 106 (10) 1820-1822
    CrossrefPubMedSearch in Google Scholar
  • 6 Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years. JAMA Otolaryngol Head Neck Surg 2017; 143 (03) 274-285
    CrossrefPubMedSearch in Google Scholar
  • 7 Hodkinson HM. Mental impairment in the elderly. J R Coll Physicians Lond 1973; 7 (04) 305-317
    PubMedSearch in Google Scholar
  • 8 Lin FR, Ferrucci L. Hearing loss and falls among older adults in the United States. Arch Intern Med 2012; 172 (04) 369-371
    CrossrefPubMedSearch in Google Scholar
  • 9 Livingston G, Sommerlad A, Orgeta V. et al. Dementia prevention, intervention, and care. Lancet 2017; 390 (10113): 2673-2734
    CrossrefPubMedSearch in Google Scholar
  • 10 Mick P, Kawachi I, Lin FR. The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg 2014; 150 (03) 378-384
    CrossrefPubMedSearch in Google Scholar
  • 11 Golub JS, Brickman AM, Ciarleglio AJ, Schupf N, Luchsinger JA. Association of Subclinical Hearing Loss With Cognitive Performance. JAMA Otolaryngol Head Neck Surg 2020; 146 (01) 57-67
    CrossrefPubMedSearch in Google Scholar
  • 12 Moyer VA. U.S. Preventive Services Task Force. Screening for hearing loss in older adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012; 157 (09) 655-661
    CrossrefPubMedSearch in Google Scholar
  • 13 Healthy People. Hearing and Other Sensory or Communication Disorders. ( n.d. ). 2020
    PubMedSearch in Google Scholar
  • 14 Curtin LR, Mohadjer LK, Dohrmann SM. et al. The National Health and Nutrition Examination Survey: Sample Design, 1999-2006. Vital Health Stat 2 2012; 155 (155) 1-39
    Search in Google Scholar
  • 15 Clark JG. Uses and abuses of hearing loss classification. ASHA 1981; 23 (07) 493-500
    Search in Google Scholar
  • 16 Killion MC, Mueller GH. Twenty years later: A NEW Count-The-Dots method. Hear J 2010; 63 (01) 10-17
    CrossrefSearch in Google Scholar
  • 17 USDA. Center for Nutrition Policy and Promotion. Dietary Guidelines for Americans. (n.d.). Retrieved October 07, 2020, from www.cnpp.usda.gov/HealthyEatingIndex-Archive.htm
  • 18 WHO, Addressing the rising prevalence of hearing loss. World Health Organization. 2018
    Search in Google Scholar
  • 19 Olusanya BO, Davis AC, Hoffman HJ. Hearing loss grades and the International classification of functioning, disability and health . Bull World Health Organ 2019; 97 (10) 725-728
    CrossrefPubMedSearch in Google Scholar
  • 20 Fletcher H. 1929. Speech and hearing. Van Nostrand.
    Search in Google Scholar
  • 21 Glorig A. The problem of noise in industry. Am J Public Health Nations Health 1961; 51 (09) 1338-1346
    CrossrefPubMedSearch in Google Scholar
  • 22 American Academy Otolaryngology and American Council of Otolaryngology. Guide for the evaluation of hearing handicap. JAMA 1979; 241 (19) 2055-2059
    CrossrefPubMedSearch in Google Scholar
  • 23 Kryter KD, Williams C, Green DM. Auditory acuity and the perception of speech. J Acoust Soc Am 1962; 34 (9, Pt. I): 1217-1223
    CrossrefSearch in Google Scholar
  • 24 Lippmann RP. Accurate consonant perception without mid-frequency speech energy. IEEE Trans Speech Audio Process 1996; 4 (01) 66-69
    CrossrefSearch in Google Scholar
  • 25 Stelmachowicz PG, Pittman AL, Hoover BM, Lewis DE. Novel-word learning in children with normal hearing and hearing loss. Ear Hear 2004; 25 (01) 47-56
    CrossrefPubMedSearch in Google Scholar
  • 26 Suter AH. The Ability of Mildly Hearing-Impaired Individuals to Discriminate Speech in Noise. Environment Protect Agency 1978; 550 (09) 78-100
    Search in Google Scholar
  • 27 Hunter LL, Monson BB, Moore DR. et al. Extended high frequency hearing and speech perception implications in adults and children. Hear Res 2020; 397: 107922
    CrossrefPubMedSearch in Google Scholar
  • 28 Moore BCJ. Effects of bandwidth, compression speed, and gain at high frequencies on preferences for amplified music. Trends Amplif 2012; 16 (03) 159-172
    CrossrefPubMedSearch in Google Scholar
  • 29 Motlagh Zadeh L, Silbert NH, Sternasty K, Swanepoel W, Hunter LL, Moore DR. Extended high-frequency hearing enhances speech perception in noise. Proc Natl Acad Sci U S A 2019; 116 (47) 23753-23759
    CrossrefPubMedSearch in Google Scholar
  • 30 Curti A, Degruy JA, Spankovich C. et al. Relationship of Overall Cardiovascular Health and Hearing Loss in the Jackson Heart Study Population. Laryngoscope 2019; 00: 1-6
    Search in Google Scholar
  • 31 Bainbridge KE, Hoffman HJ, Cowie CC. Risk factors for hearing impairment among U.S. adults with diabetes: National Health and Nutrition Examination Survey 1999-2004. Diabetes Care 2011; 34 (07) 1540-1545
    CrossrefPubMedSearch in Google Scholar
  • 32 Lobarinas E, Spankovich C, Le Prell CG. Evidence of “hidden hearing loss” following noise exposures that produce robust TTS and ABR wave-I amplitude reductions. Hear Res 2017; 349: 155-163
    CrossrefPubMedSearch in Google Scholar