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Prevalence and risk factors of hearing loss among the middle-aged and older population in China: a systematic review and meta-analysis

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Abstract

Purpose

This paper was aimed at estimating the prevalence and risk factors of hearing loss (HL) among the middle-aged and elderly in China.

Methods

Databases including the CQVIP (VIP) Database, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), Wanfang, PubMed, Web of Science, Excerpta Medica Database (Embase) and the Cochrane Library were comprehensively searched. In this review, random-effect models were used for pooling the prevalence of HL and the odds ratios (ORs) of potential risk factors.

Results

34 studies were included in the meta-analysis. HL among the middle-aged and elderly in China had a pooled prevalence of 45% (95% confidence interval (CI) 40–51%). There were significant differences in the prevalence of HL between males and females (47% vs. 42%), between different screening methods by self-report and pure-tone audiometry (44% vs. 46%), between the middle-aged and the elderly (18% vs. 52%), and between the uneducated and the educated (49% vs. 36%). In urban areas, the prevalence was slightly higher than that in rural areas (50% vs. 48%). The findings suggested that the middle-aged and elderly in the South Central China region (61%, 95% CI 45–78%) and Northwest China (57%, 95% CI 55–58%) were more likely to develop HL. In addition, it was confirmed that advanced age, being male, noise exposure history, hypertension and hyperglycemia were related to a higher prevalence of HL among middle-aged and older adults.

Conclusion

The prevalence of HL among the middle-aged and older population in China is 45%, nearly half of the total population. It is urgent to take great efforts to raise people’s awareness of HL prevention and early hearing screening.

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Availability of data and materials

All data generated or analyzed during this study are included in the article.

Code availability

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References

  1. National Bureau of Statistics (2021) Interpretation of the Bulletin of the seventh National Census of China. http://www.stats.gov.cn/tjsj/sjjd/202105/t20210512_1817336.html. Accessed 17 Jan 2023

  2. GBD 2019 Hearing Loss Collaborators (2021) Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet 397:996–1009. https://doi.org/10.1016/S0140-6736(21)00516-X

    Article  Google Scholar 

  3. Ye X, He P (2022) Direct costs attributable to hearing loss in China: based on an econometric model. Ear Hear 44:330–337. https://doi.org/10.1097/AUD.0000000000001284

    Article  PubMed  Google Scholar 

  4. Xian Y-Y, Gao J, Chen H, Zhang H, Bai D (2022) Incidence of hearing loss among Chinese old people: a meta-analysis. Mod Prev Med 49:2451–2458. https://doi.org/10.20043/j.cnki.MPM.202104275. (Published in Chinese)

    Article  Google Scholar 

  5. Olusanya BO, Davis AC, Hoffman HJ (2019) Hearing loss grades and the international classification of functioning, disability and health. Bull World Health Organ 97:725–728. https://doi.org/10.2471/BLT.19.230367

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rostom A, Dubé C, Cranney A et al (2004) Appendix D. Quality assessment forms. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK35156/. Accessed 20 Jan 2023

  7. Tian L, LaBa SZ, OuZhu LB (2016) Research on the actuality and influences factors of hearing loss among the elderly in Xigaze. Tibetan Med 37:57–59 (Published in Chinese)

    CAS  Google Scholar 

  8. He X, Pan X-F, Zhang Y-J, Hu D-X, Li T-T, Liu Y, He M-L, Wang F (2020) Prevalence and risk factors of hearing impairment of Shui nationalities resident in the rural areas of Sandu County in Guizhou. Mod Prev Med 47:4042–4046 (Published in Chinese)

    Google Scholar 

  9. Zhao Y-L, Ding Q-F, Lin T-P, Shu X-Y, Xie D-M, Gao L-L, Yue J-R (2022) Combined vision and hearing impairment is associated with frailty in older adults: results from the west China health and aging trend study. Clin Interv Aging 17:675–683. https://doi.org/10.2147/cia.S362191

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wang L, Song M, Zhao X, Zhu Q, Yu L, Wang R, Gao Y, An C, Wang X (2021) Functional deficit of sense organs as a risk factor for cognitive functional disorder in Chinese community elderly people. Int J Clin Pract 75:e14905. https://doi.org/10.1111/ijcp.14905

    Article  PubMed  Google Scholar 

  11. Rong H, Lai X, Jing R, Wang X, Fang H, Mahmoudi E (2020) Association of sensory impairments with cognitive decline and depression among older adults in China. JAMA Netw Open 3:e2014186. https://doi.org/10.1001/jamanetworkopen.2020.14186

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bright T, Shan X, Xu J, Liang J, Xiao B, Ensink R, Mactaggart I, Polack S, Yip JLY (2020) Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao’an, Jiangxi province, China. Arch Public Health 78:16. https://doi.org/10.1186/s13690-020-0398-1

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gong R, Hu X, Gong C, Long M, Han R, Zhou L, Wang F, Zheng X (2018) Hearing loss prevalence and risk factors among older adults in China. Int J Audiol 57:354–359. https://doi.org/10.1080/14992027.2017.1423404

    Article  PubMed  Google Scholar 

  14. Bu X, Liu C, Xing G, Zhou L, Liang C, Zheng Y, Meng J, Wang Y, Yang C, Liu Y, Du B, Zhang Y, Du B (2011) WHO ear and hearing disorders survey in four provinces in China. Audiol Med 9:141–146. https://doi.org/10.3109/1651386X.2011.631285

    Article  Google Scholar 

  15. Wang Y, Yang C, Xu S, Xue X, Li F, Liu Y, Ye Q (2007) Report on the study of who ear and hearing disorders survey protocol in Guizhou province. J Clin Otorhinolaryngol Head Neck Surg 21:731–734 (Published in Chinese)

    Google Scholar 

  16. Du B, Zhang Y, Wang Y-S, Ren D-W, Fu T, Yin W-Z, Sun L, Chen F-F, Zhang Y-D, Du B-D, Lei A-J (2007) Epidemiologic study on hearing impairment and ear diseases in Jilin province of China. Chin J Otol 4:359–362 (Published in Chinese)

    Google Scholar 

  17. Liu C (2006) The epidemiologic study on hearing impairment and ear diseases in Jiangsu Province China. Nanjing Medical University, Jiangsu Province (Published in Chinese)

  18. Wang J, Liu D, Tian E, Guo Z-Q, Chen J-Y, Kong W-J, Zhang S-L (2022) Hearing impairment with cognitive decline increases all-cause mortality risk in Chinese adults aged 65 years or older: a population-based longitudinal study. Front Aging Neurosci 14:865821. https://doi.org/10.3389/fnagi.2022.865821

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zhang T-J (2018) Successful aging and its associated factors among the community-dwelling elderly in Liaoning province. Chinese Medical University, Liaoning Province (Published in Chinese)

  20. Jiang F, Kuper H, Zhou C, Qin W, Xu L (2022) Relationship between hearing loss and depression symptoms among older adults in China: the mediating role of social isolation and loneliness. Int J Geriatr Psychiatry 37:1–8. https://doi.org/10.1002/gps.5729

    Article  Google Scholar 

  21. Feng G-Z (2017) Investigation and preventive measures of presbycusis among community residents in Jiaozuo City. Chin J Public Health Eng 16:687–690. https://doi.org/10.19937/j.issn.1671-4199.2017.05.057

    Article  CAS  Google Scholar 

  22. Liu T-R, Li X, Pang Z-C, Wang S-J (2013) Prevalence and influence factors of hearing impairment among rural senior people in Qingdao Municipality. Chin J Public Health 19:264–265. https://doi.org/10.16406/j.pmt.issn.1672-9153.2013.04.031. (Published in Chinese)

    Article  Google Scholar 

  23. Liu H, Liu W (2019) An epidemiological study on hearing impairment of the elderly in Xiangtan City. Chin Community Dr 35:193–195 (Published in Chinese)

    Google Scholar 

  24. Ding J-M, Chen X-P, Guo S-S, Liu H (2016) Elderly health status and community nursing strategy. Chin J Mod Nurs 22:774–779 (Published in Chinese)

    Google Scholar 

  25. Li M-Q, Huang H-H, Mou X, Jiang G-X, Chen Q-H (2016) Investigation on the disability and care needs of the elderly in Jianghan Oilfield. Chin J Gerontol 36:184–186 (Published in Chinese)

    CAS  Google Scholar 

  26. Zhao L, Ying B-H, Chen J-H, Chen Y-L, Dong H-N, Tao R, Wang M-Y (2016) Ability of daily living among elderly people and its influence factors in Lishui City. J Nurs (China) 23:46–49. https://doi.org/10.16460/j.issn1008-9969.2016.05.046. (Published in Chinese)

    Article  Google Scholar 

  27. Ma W, Guan B (2015) Survey on hearing conditions of elderly, middle-aged and young people in Yangzhou Area. Chin J Mult Organ Dis Elderly 14:498–501. https://doi.org/10.11915/j.issn.1671-5403.2015.07.115. (Published in Chinese)

    Article  Google Scholar 

  28. Hou Q-J, Liang Z, Li X-Y, Sun H-Y (2012) The epidemiologic study on hearing impairment and ear diseases in Tangshan. Pract Prev Med 19:1502–1503 (Published in Chinese)

    Google Scholar 

  29. Li H (2022) Investigation on presbycusis and preventive measures of community residents in Zunyi. Zunyi Medical University, Guizhou province (Published in Chinese)

  30. Gao J, Hu H, Yao L (2020) The role of social engagement in the association of self-reported hearing loss and health-related quality of life. BMC Geriatr 20:182. https://doi.org/10.1186/s12877-020-01581-0

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ren L-H, Miao Z-Y, Yu J-J, Lv J-Y, Zhang D-J, Xie F (2018) An analysis on the causes for hearing disability in presenium and senile population. J Clin Exp Med 17:406–409. http://qikan.cqvip.com/Qikan/Article/Detail?id=674444448(Published in Chinese)

  32. Cai M, Zhang Y-G, Xie X-Q, Wu S-Y (2021) Disability status of the elderly aged 60 and above at home in China and its influence factors. Chin J Hosp Stat 28:389–400 (Published in Chinese)

    Google Scholar 

  33. Liu B, Guo S-X (2013) Hearing impairment among old people in Shihezi: a correlation factor analysis. J Nongken Med 35:343–346 (Published in Chinese)

    Google Scholar 

  34. Ma F, Qu C-Y, Wang T, Yin J, Zhang X-D, Meng J, Zhang C-P (2009) Study on hearing impairment among elderly population in the community of Taiyuan City, Shanxi Province. Chin J Epidemiol 30:247–251. https://doi.org/10.3760/cma.j.issn.0254-6450.2009.03.011. (Published in Chinese)

    Article  Google Scholar 

  35. Liu L-M, Zhang Y, Peng Y (2022) Prevalence and influencing factors of hearing loss in physical examination people aged ≥ 45 years Old in Chongqing. S China J Prev Med 48:164–168 (Published in Chinese)

    CAS  Google Scholar 

  36. Liu Y-Q, Wang Y-Q, Yang C-L, Xu S-W, Xue X-H, Li F, Ye Q (2007) Epidemiologic study on hearing impairment and ear diseases in the presenium and senium in Guizhou province. Chin J Otol 5:363–367 (Published in Chinese)

    CAS  Google Scholar 

  37. Wang D, Wang Z, Zhou M, Li W, He M, Zhang X, Guo H, Yuan J, Zhan Y, Zhang K, Zhou T, Kong W, Chen W (2017) The combined effect of cigarette smoking and occupational noise exposure on hearing loss: evidence from the Dongfeng-Tongji Cohort Study. Sci Rep 7:11142. https://doi.org/10.1038/s41598-017-11556-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Zhang H-L, Gong X-C, Hao X-J, Deng J, Liu H-Y, Wu D, Huo X-X, Guo R (2019) Investigation of hearing loss and speech recognition ability of the elderly and analysis of its high risk factors. Chin J Otorhinolaryngol Head Neck Surg 54:116–120. https://doi.org/10.3760/cma.j.issn.1673-0860.2019.02.004. (Published in Chinese)

    Article  CAS  Google Scholar 

  39. Wang D-H, Zhu Y-J, Li C-H, Wang Y, Wang S-C, Wu S, Zhang S-Y, Xu L-W (2021) Relationship between cigarette smoking and hearing loss in China: a cross-sectional study in Zhejiang province. Tob Induc Dis 19:40. https://doi.org/10.18332/tid/135440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Yang D, Liu J, Yang Q-X, Lin Q-X, Zhang X, Wang M-X, Li X, Tu J, Wang J-H, Ning X-J (2021) Hearing impairment prevalence and risk factors among adults in rural China: a population-based cross-sectional study. Postgrad Med 133:369–376. https://doi.org/10.1080/00325481.2020.1855852

    Article  PubMed  Google Scholar 

  41. World Health Organization (2021) World report on hearing—executive summary. https://www.who.int/publications/i/item/9789240021570. Accessed 3 Jan 2023

  42. Aural Rehabilitation Clinical Practice Guideline Development Panel, Basura G, Cienkowski K, Hamlin L, Ray C, Rutherford C, Stamper G, Schooling T, Ambrose J (2022) American speech-language-hearing association clinical practice guideline on aural rehabilitation for adults with hearing loss. Am J Audiol 32:1–51. https://doi.org/10.1044/2022_AJA-21-00252

    Article  PubMed  Google Scholar 

  43. Meng J, Tao Y, Wang K, Xu K, Meng Z-L, Liang C-Y, Zheng Y (2007) Epidemiological investigation of ear diseases and hearing loss in the elderly in Sichuan Province, The 10th National Academy of Otolaryngology - Head and Neck Surgery of the Chinese Medical Association, Nanjing in Jiangsu province of China, p 1076 (Published in Chinese)

  44. Sharma RK, Lalwani AK, Golub JS (2020) Prevalence and severity of hearing loss in the older old population. JAMA Otolaryngol Head Neck Surg 146:762–763. https://doi.org/10.1001/jamaoto.2020.0900

    Article  PubMed  PubMed Central  Google Scholar 

  45. Mormer E, Bubb KJ, Alrawashdeh M, Cipkala-Gaffin JA (2020) Hearing loss and communication among hospitalized older adults: prevalence and recognition. J Gerontol Nurs 46:34–42. https://doi.org/10.3928/00989134-20200316-03

    Article  PubMed  Google Scholar 

  46. Goman AM, Lin FR (2016) Prevalence of hearing loss by severity in the United States. Am J Public Health 106:1820–1822. https://doi.org/10.2105/AJPH.2016.303299

    Article  PubMed  PubMed Central  Google Scholar 

  47. Chou CF, Beckles GL, Zhang X, Saaddine JB (2015) Association of socioeconomic position with sensory impairment among US working-aged adults. Am J Public Health 105:1262–1268. https://doi.org/10.2105/AJPH.2014.302475

    Article  PubMed  PubMed Central  Google Scholar 

  48. Luo Y, Gao J, Zheng X (2020) Individual-level and area-level socioeconomic inequalities in hearing impairment among Chinese adults: a population-based study. J Epidemiol Community Health 74:541–547. https://doi.org/10.1136/jech-2019-213437

    Article  PubMed  Google Scholar 

  49. Bowl MR, Dawson SJ (2019) Age-related hearing loss. Cold Spring Harb Perspect Med 9:a033217. https://doi.org/10.1101/cshperspect.a033217

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Frisina RD, Bazard P, Bauer M, Pineros J, Zhu X, Ding B (2021) Translational implications of the interactions between hormones and age-related hearing loss. Hear Res 402:108093. https://doi.org/10.1016/j.heares.2020.108093

    Article  CAS  PubMed  Google Scholar 

  51. Zhou J, Shi Z, Zhou L, Hu Y, Zhang M (2020) Occupational noise-induced hearing loss in China: a systematic review and meta-analysis. BMJ Open 10:e039576. https://doi.org/10.1136/bmjopen-2020-039576

    Article  PubMed  PubMed Central  Google Scholar 

  52. Toyama K, Mogi M (2022) Hypertension and the development of hearing loss. Hypertens Res 45:172–174. https://doi.org/10.1038/s41440-021-00789-w

    Article  PubMed  Google Scholar 

  53. Samocha-Bonet D, Wu B, Ryugo DK (2021) Diabetes mellitus and hearing loss: a review. Ageing Res Rev 71:101423. https://doi.org/10.1016/j.arr.2021.101423

    Article  CAS  PubMed  Google Scholar 

  54. Hara K, Okada M, Takagi D, Tanaka K, Senba H, Teraoka M, Yamada H, Matsuura B, Hato N, Miyake Y (2020) Association between hypertension, dyslipidemia, and diabetes and prevalence of hearing impairment in Japan. Hypertens Res 43:963–968. https://doi.org/10.1038/s41440-020-0444-y

    Article  CAS  PubMed  Google Scholar 

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Funding

This research was funded by “Science & Technology Department of Sichuan Province”, Grant Number: 2022JDKP0018.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, China

    Peishan Li, Kaiyun Pang, Rong Zhang, Lan Zhang & Hui Xie

  2. College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China

    Peishan Li, Kaiyun Pang, Rong Zhang, Lan Zhang & Hui Xie

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  1. Peishan Li
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Contributions

Conceptualization and methodology, PSL and KYP; data entry and analyses: RZ and LZ; writing—original draft preparation, PSL and RZ; writing—review and editing, PSL and KYP; supervision, HX. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Hui Xie.

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Li, P., Pang, K., Zhang, R. et al. Prevalence and risk factors of hearing loss among the middle-aged and older population in China: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 280, 4723–4737 (2023). https://doi.org/10.1007/s00405-023-08109-3

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