Epidemiology of Age-related Hearing Loss from 1990 to 2021: Global Burden of Disease and Forecasted Trends

Background: Age-related hearing loss (ARHL) is a prevalent progressive hearing loss that can lead to emotional impairment and cognitive decline in older adults. The aim of this study was to investigate the epidemiologic characteristics of ARHL from 1990 to 2021. Methods: We collected hearing data from the elderly using the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2018. Prevalence and disability-adjusted life years (DALYs) for ARHL were obtained from the Global Burden of Disease (GBD) 2021. Trends in ARHL burden were assessed using Joinpoint regression analysis. The Slope Inequality Index (SII) and Concentration Index (CI) were calculated to quantify absolute and relative cross-country inequalities in ARHL burden. Bayesian age-period cohort (BAPC) modeling was used to predict trends in ARHL prevalence and DALY over the next 30 years. Results: Mild to moderate hearing loss predominated among older adults in the U.S. between 2005 and 2018. In 2021, there will be more than 700 million cases of ARHL globally, increasing by 137.43% from 300 million cases in 1990. The age-standardized rate (ASR) has also increased, with an estimated annual percentage change of 16%. According to the Joinpoint regression analysis, the upward trend in the age-standardized prevalence rate (ASPR) for males intensified after 2010. In contrast, the upward trend in the ASPR for females slowed between 2000 and 2010. As the Socio-Demographic Index (SDI) rises, the ASR of DALYs and ASPR show a downward trend. Notably, as of the latest data, 204 countries and 21 regions globally still have significant health inequalities, although the slope index of inequality has declined over time. Projections of the global burden of ARHL over the next 30 years show a gradual increase in the ASR of DALYs and ASPR. For DALYs affecting ARHL the main factors include environmental risks, occupational risks, and occupational noise. Conclusions: The burden of ARHL varies by gender, age group, and geographic region. ASR has been on the rise over time and the burden of disease is high, particularly in low- and middle-income areas.