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European Archives of Oto-Rhino-Laryngology

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13-07-2023 | Audiometry | Review Article

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

Authors: Peishan Li, Kaiyun Pang, Rong Zhang, Lan Zhang, Hui Xie

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2023

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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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

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-XCrossRef

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.0000000000001284CrossRefPubMed

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)CrossRef

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.19.230367CrossRefPubMedPubMedCentral

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

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)

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)

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.S362191CrossRefPubMedPubMedCentral

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.14905CrossRefPubMed

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.2020.14186CrossRefPubMedPubMedCentral

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/s13690-020-0398-1CrossRefPubMedPubMedCentral

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/10.1080/14992027.2017.1423404CrossRefPubMed

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.2011.631285CrossRef

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)

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)

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.2022.865821CrossRefPubMedPubMedCentral

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.5729CrossRef

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.1671-4199.2017.05.057CrossRef

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)CrossRef

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)

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)

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)

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)CrossRef

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)CrossRef

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)

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/s12877-020-01581-0CrossRefPubMedPubMedCentral

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)

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)

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)CrossRef

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)

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)

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/s41598-017-11556-8CrossRefPubMedPubMedCentral

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)CrossRef

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/135440CrossRefPubMedPubMedCentral

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/10.1080/00325481.2020.1855852CrossRefPubMed

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-21-00252CrossRefPubMed

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.2020.0900CrossRefPubMedPubMedCentral

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/10.3928/00989134-20200316-03CrossRefPubMed

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.2016.303299CrossRefPubMedPubMedCentral

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.2014.302475CrossRefPubMedPubMedCentral

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-2019-213437CrossRefPubMed

49.

Bowl MR, Dawson SJ (2019) Age-related hearing loss. Cold Spring Harb Perspect Med 9:a033217. https://doi.org/10.1101/cshperspect.a033217CrossRefPubMedPubMedCentral

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.2020.108093CrossRefPubMed

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-2020-039576CrossRefPubMedPubMedCentral

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-wCrossRefPubMed

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.2021.101423CrossRefPubMed

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-yCrossRefPubMed

Title: Prevalence and risk factors of hearing loss among the middle-aged and older population in China: a systematic review and meta-analysis
Authors: Peishan Li
Kaiyun Pang
Rong Zhang
Lan Zhang
Hui Xie
Publication date: 13-07-2023
Publisher: Springer Berlin Heidelberg
Keywords: Audiometry
Audiometry
Published in: European Archives of Oto-Rhino-Laryngology / Issue 11/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08109-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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