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Original Investigation
June 6, 2019

Prevalence of and Characteristics Associated With Self-reported Good Hearing in a Population With Elevated Audiometric Thresholds

Author Affiliations
  • 1University of Mississippi Medical Center, Department of Otolaryngology and Communicative Sciences, Jackson
  • 2University of Mississippi Medical Center, Jackson
JAMA Otolaryngol Head Neck Surg. Published online June 6, 2019. doi:10.1001/jamaoto.2019.1020
Key Points

Question  What percentage of persons with elevated audiometric thresholds self-report good hearing, and what factors are associated?

Findings  This population-based survey study of 1373 participants showed that nearly two-thirds of people who have audiometric evidence of hearing loss report good hearing. Younger age, nonwhite race, and women, as well as those who reported overall good health, were more likely to report good hearing.

Meaning  A considerable number of people who have audiometric evidence of hearing loss self-perceive good hearing.

Abstract

Importance  Audiometric evidence of hearing loss does not always relate to self-reported hearing loss.

Objective  To determine the prevalence of self-reported good hearing in a population with audiometrically defined hearing loss and identify associated factors.

Design, Setting, and Participants  We analyzed audiometric data from adults aged 20 to 69 years from the 1999 to 2002 cycles of the US National Health and Nutrition Examination Survey, a cross-sectional, nationally representative interview and examination survey of the civilian, noninstitutionalized population. Logistic regression was used to examine unadjusted and multivariable-adjusted relationships between demographic, hearing health, and general health factors related to self-perceived hearing status. Analysis was conducted between September 4, 2018, and November 30, 2018.

Interventions  Audiometry and questionnaires.

Main Outcomes and Measure  The prevalence of persons reporting good hearing among those with audiometrically defined hearing loss and the variables associated with this population.

Results  The mean (SD) age was 47.0 (0.4) years for hearing loss defined by any frequency >25 dB HL and 52.5 (1.1) years for hearing loss defined by PTA >25 dB HL. For the sample with hearing loss defined by any frequency >25 dB HL, 744 (56.1%) were men and 629 (43.9%) were women. For the sample with hearing loss defined by PTA >25 dB HL 251 (68.5%) were men and 114 (31.5%) were women. Of the 1373 participants who were found to have hearing loss (at least 1 individual frequency >25 dB HL in either ear) 993 (68.5%) reported good hearing. Younger age, nonwhite race, and women were all more likely to report good hearing. When the definition of hearing loss was made more stringent (pure-tone average >25 dB HL), 365 participants had audiometric hearing loss, but 174 (43%) continued to report good hearing. We observed that better self-perceived general health status (OR, 1.90; 95% CI, 1.25-2.90) and higher dietary quality (OR, 1.01; 95% CI, 1.00-1.02) were significantly associated with increased self-report of good hearing, whereas tinnitus (OR, 0.25; 95% CI, 0.14-0.44), noise exposure (OR, 0.39; 95% CI, 0.26-0.58), and several comorbid conditions were associated with decreased self-report of good hearing.

Conclusions and Relevance  A significant proportion of the study population reported good hearing despite having audiometric evidence of hearing loss; the prevalence was related to how hearing loss was defined. The report of good hearing was significantly associated with demographics and general health status. The high prevalence of mild hearing loss and self-reported good hearing was associated with the low reported use of hearing aids.

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