Prevalence and risk factors of hearing impairment in older Singaporeans: a population-based study

We investigated the prevalence and risk factors of hearing impairment (HI) and significant hearing impairment (SHI) in a multi-ethnic older Asian population.

We included 2,494 adults aged ≥60 years from a population-based study. Hearing was evaluated using a SHOEBOX portable audiometer, with any HI defined as a pure-tone average hearing threshold >25 dB and SHI defined as >40 dB, based on the better-hearing ear. Sociodemographic, lifestyle and clinical characteristics were collected via a standardised clinical examination and validated questionnaires. Weighted prevalence rates were calculated using age-, gender- and ethnicity-specific sampling weights from the 2020 Singapore Census. Multivariable regression analysis was performed to identify risk factors for HI and SHI.

Of the 2494 participants (mean age ± SD, 73.4 ± 8.4 years; 55.2% female), the weighted prevalence of any HI was 67.9%, while that of SHI was 22.7%. The weighted prevalence of any HI increased with age, from 58.1% in individuals aged 60-69-years to 94.9% in those aged ≥80 years, while that for SHI increased from 9.8% in individuals aged 60-69 years to 64.5% in those aged ≥80 years. Risk factors for HI included older age (odds ratio [OR] 10.33, P < 0.001), male sex (OR 2.05, P < 0.001), Malay ethnicity (OR 1.43, P = 0.021 vs. Chinese ethnicity), lower socioeconomic status (OR 2.58, P < 0.029), living alone (OR 1.62, P = 0.032) and prior stroke (OR 2.72, P = 0.016). Similar risk factors were associated with SHI.

Two in three community-living older Singaporeans live with HI, with one in five having SHI. Targeted community hearing screening programmes for older and vulnerable groups are essential to identify individuals requiring referral and treatment.