Race and sex differences in age-related hearing loss: the Health, Aging and Body Composition Study.
OBJECTIVE
To determine the prevalence of and risk factors for hearing loss in a sample of 2,052 older adults (aged 73-84; 46.9% male, 37.3% black) enrolled in the Health, Aging and Body Composition (Health ABC) Study.


METHODS
Cross-sectional analysis of a longitudinal cohort study.


METHODS
Pittsburgh, Pennsylvania, and Memphis, Tennessee, areas.


METHODS
Random sample of Medicare beneficiary subjects enrolled in the Health ABC program from 1997 to 1998. They included 2,052 individuals: 660 white men (32.2%), 631 white women (30.8%), 310 black men (15.1%), and 451 black women (22.0%). Participants ranged in age from 73 to 84, with a mean age of 77.5.


METHODS
Hearing sensitivity was measured using pure-tone threshold testing. Hearing loss was defined based on two averages of hearing thresholds: 500, 1,000, and 2,000 Hz greater than 25-decibel (dB) hearing level (HL) (hearing loss); and 2,000, 4,000, and 8,000 Hz greater than 40-dB HL (high-frequency hearing loss). Potential hearing loss correlates, including demographics, medical history, ototoxic medication use, occupational noise exposure, and lifestyle factors, were collected via questionnaire.


RESULTS
The prevalence of hearing loss was 59.9%; the prevalence of high-frequency hearing loss was 76.9%. Hearing loss was most common in white men, followed by white women, black men, and black women. Older age, white race, diabetes mellitus, cerebrovascular disease, smoking, poorer cognitive status, occupational noise exposure, and ear surgery were associated with hearing loss after multivariable adjustment. Race- and sex-specific risk factors included higher blood pressure and occupational noise exposure (white men), poorer cognitive status and smoking (black women), and low total hip bone mineral density (black men). Possible protective factors included salicylate use (overall sample, black men) and moderate alcohol intake (black women).


CONCLUSIONS
Hearing loss was extremely common in this population. Because many of the identified hearing loss risk factors are modifiable, some of the burden associated with hearing loss in older people should be preventable.
Helzner
Elizabeth P
EP
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. ehelzner@pitt.edu
Cauley
Jane A
JA
Pratt
Sheila R
SR
Wisniewski
Steven R
SR
Zmuda
Joseph M
JM
Talbott
Evelyn O
EO
de Rekeneire
Nathalie
N
Harris
Tamara B
TB
Rubin
Susan M
SM
Simonsick
Eleanor M
EM
Tylavsky
Frances A
FA
Newman
Anne B
AB
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology* / Q000208:ethnology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology