title: Three decade change in the prevalence of hearing impairment and its association with diabetes in the United States.
abstract: OBJECTIVE
  To examine the secular change of the prevalence of hearing impairment over three decades in U.S. adults with and without diabetes.
  
  
  METHODS
  The cross-sectional National Health and Nutrition Examination Surveys (NHANES, the 1971-1973 [NHANES I] and the 1999-2004 [NHANES 1999-2004]) were used. Average pure-tone audiometry thresholds in decibels (dB) at 1, 2, 3, and 4 kHz frequencies of the worse ear were used to represent the participants' hearing status. Any hearing impairment was defined as average pure-tone audiometry threshold of the worse ear >25 dB.
  
  
  RESULTS
  From 1971 to 2004, among adults without diabetes aged 25 to 69 years, the unadjusted prevalence of hearing impairment decreased from 27.9% to 19.1% (P<0.001), but among adults with diabetes there was no significant change (46.4% to 48.5%). After adjustment for age, sex, race, and education, the prevalence of hearing impairment in the NHANES I and NHANES 1999-2004, respectively, was 24.4% (95% confidence interval [CI], 22.3-26.6%) and 22.3% (95% CI, 20.4-24.2) for adults without diabetes and 28.5% (95% CI, 20.4-36.6%) and 34.4 (95% CI, 29.1-39.7%) for adults with diabetes. The adjusted prevalence ratios of hearing impairment for persons with diabetes vs. those without diabetes was 1.17 (95% CI, 0.87-1.57) for the NHANES I and 1.53 (95% CI, 1.28-1.83) for NHANES 1999-2004.
  
  
  CONCLUSIONS
  Persons with diabetes have a higher prevalence of hearing impairment, and they have not achieved the same reductions in hearing impairment over time as have persons without diabetes.
authors: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ycheng@cdc.gov
authors: Yiling J
authors: YJ
authors: Cheng
authors: Edward W
authors: EW
authors: Gregg
authors: Jinan B
authors: JB
authors: Saaddine
authors: Giuseppina
authors: G
authors: Imperatore
authors: Xinzhi
authors: X
authors: Zhang
authors: Ann L
authors: AL
authors: Albright
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001301:Audiometry, Pure-Tone; D015897:Comorbidity; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D014481:United States