Age-based disparities in hearing loss diagnosis and treatment in the United States population.

Objective: To investigate age-related disparities in the diagnosis and treatment of borderline/mild hearing loss (HL) in the United States.

Study Design: A cross-sectional epidemiologic study.

Setting: The National Health and Nutrition Examination Survey (NHANES).

Methods: Multivariable logistic regressions controlling for hearing level were performed to investigate the association between: (1) age and recent hearing test; (2) age and hearing aid use. Age was grouped into quartiles (<25, 25-49, 50-74, ≥75 years). The first quartile of life was used as a reference group in all odds ratios, controlling for hearing level.

Results: Of 2115 participants with borderline/mild HL, 3 % (n = 53) were in age quartile Q1; 7 % (n = 147) were in Q2, 56 % (n = 1190) were in Q3, and 34 % (n = 725) were in Q4. Compared to Q1, those in Q2, Q3, and Q4 had 4.06 times (95 % CI = 2.11-8.02, p < 0.001), 4.51 times (2.56-8.19, p < 0.001), and 4.56 times (2.55-8.39, p < 0.001) lower odds of a hearing test within the past 4 years. Similar, although slightly larger, odds ratios were obtained when the outcome was hearing test within 1 year. Compared to Q1, those in Q2, Q3, and Q4 respectively had 4.38 times (1.47-13.5, p < 0.05), 5.41 times (2.27-11.8, p < 0.001), and 3.95 times (1.65-8.72, p < 0.05) lower odds of using a hearing aid.

Conclusion: We have characterized a large, unaddressed, and modifiable disparity in the treatment of borderline/mild HL as individuals age out of the first quartile of life. Future studies are needed to explore factors, such as ageism, that may underlie these findings.