Hearing Loss Prevalence Among Older US Adults: HRS 2016 to 2018 Hearing Screener Data

OBJECTIVE: To estimate the prevalence of hearing loss among US adults based on a hearing screening device (HearCheck) in the Health and Retirement Study (HRS), and to compare these estimates with prevalence from the National Health and Nutrition Examination Survey (NHANES) based on pure-tone audiometry. STUDY DESIGN: Cross-sectional. SETTING: HRS 2016 to 2018 and NHANES 2015 to 2020. METHODS: Study cohort included HRS participants aged ≥55 years who completed HearCheck hearing screening (n = 12,756). Hearing loss was defined using a device score<6 in the better hearing ear. For NHANES audiometry data (n = 2552), hearing loss was defined using pre-defined cut-offs of the speech-frequency pure-tone average (PTA). Prevalence was estimated using survey weights, and the estimates were compared based on two-proportion z-tests. RESULTS: Among adults aged ≥55 years, the prevalence of hearing loss in HRS was 54.8% (95% CI, 53.7%-56.0%), which closely matched the estimated prevalence in NHANES at 54.5% (51.1%-57.8%) when hearing loss was defined as PTA ≥ 20dBHL (P = .82). Further comparing the estimates, the prevalence of mild hearing difficulties (HearCheck score 3-5) in HRS at 48.8% (47.6%-49.9%) matched with the prevalence of mild to moderate hearing loss (20-49dBHL) at 48.2% (45.4%-51.1%) in NHANES (P = .70). The prevalence of moderate to severe difficulties (HearCheck score 0-2) at 6.1% (5.6%-6.5%) in HRS matched with the prevalence of moderately severe or worse hearing loss (≥50dBHL) in NHANES at 6.2% (4.8%-8.0%) (P = .82). CONCLUSION: Hearing loss prevalence estimates derived from a hearing screening device in HRS closely matched those obtained from audiometry in NHANES. While standardized audiometry is preferred, hearing screening tools offer a useful alternative for objectively assessing hearing in large-scale population studies.