title: Predictors of hearing acuity: cross-sectional and longitudinal analysis.
abstract: BACKGROUND
  This study aimed to identify predictors of hearing thresholds (best-ear pure-tone average at 1, 2, and 4 kHz) and hearing deterioration in order to define potential target groups for hearing screening.
  
  
  METHODS
  We analyzed data from the Maastricht Aging Study, a Dutch cohort (aged 24-81 years; N = 1,721) that was observed for 12 years. Mixed model analysis was used to calculate each participant's average hearing threshold deterioration rate during the follow-up period. We built ordinary least square linear regression models to predict the baseline threshold and deterioration rate. Potential predictors included in these models were age, gender, type of occupation, educational level, cardiovascular disease, diabetes, systemic inflammatory disease, hypertension, obesity, waist circumference, smoking, and physical activity level. We also examined the relationship between baseline threshold and the deterioration rate.
  
  
  RESULTS
  Poorer baseline thresholds were strongly associated with faster hearing deterioration. Higher age, male gender, manual occupation, and large waist circumference were statistically significantly associated with poorer baseline thresholds and faster deterioration, although the effects of occupation type and waist circumference were small.
  
  
  CONCLUSIONS
  This study indicates that age and gender must be taken into account when determining the target population for adult hearing screening and that the time interval between repeated screenings should be based either on age or on the hearing thresholds at the first screening.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, School for Mental Health and Neuroscience of the Faculty of Health, Medicine and Life Sciences, Maastricht University, anouk.linssen@mumc.nl.
authors.forename: Anouk M
authors.initials: AM
authors.lastname: Linssen
authors.affiliation: School for Mental Health and Neuroscience of the Faculty of Health, Medicine and Life Sciences, Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht University.
authors.forename: Martin P J
authors.initials: MP
authors.lastname: van Boxtel
authors.affiliation: Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, and School for Public Health and Primary Care of the Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Manuela A
authors.initials: MA
authors.lastname: Joore
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, School for Mental Health and Neuroscience of the Faculty of Health, Medicine and Life Sciences, Maastricht University.
authors.forename: Lucien J C
authors.initials: LJ
authors.lastname: Anteunis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Epidemiology; Hearing loss; Risk factors.