Li Fen-Fen, Fu Zi-Yue, Han Ke, Liang Bing-Yu, Han Yan-Xun, Liu Ye-Hai, Tong Bu-Sheng, Liu Yu-Chen
Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230031, China.
Department of Allergy, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
BMC Geriatr. 2025 May 29;25(1):387. doi: 10.1186/s12877-025-06066-6.
Age-related hearing loss (AHL) is a modifiable risk factor for chronic disability and cognitive decline in adults over 60 years globally. Despite its preventable nature, long-term trends (1992-2021) in AHL burden and its demographic, socioeconomic, occupational noise exposures, and geographic drivers remain underexplored, limiting targeted intervention strategies.
This observational study analyzed age-standardized prevalence and years lived with disability (YLDs) for AHL among adults aged ≥60 years using the Global Burden of Disease Study 2021 (1992-2021). Data were stratified by sex, age, region, and nation, with demographic decomposition to isolate population aging effects and Bayesian spatiotemporal regression to quantify modifiable drivers (e.g., occupational noise). Temporal trends were evaluated by calculating annual average percentage change (AAPC) with 95% confidence intervals (CI).
From 1992 to 2021, AHL-related prevalence and YLDs showed an upward trend globally (AAPC = 0.14 [95% CI: 0.13, 0.14]; AAPC = 0.17 [95% CI: 0.15, 0.20]). There was a downward trend in the YLDs of AHL from 1992 to 1995 (AAPC = -0.08 [95% CI: -0.19, 0.04]). Regionally, while most regions showed an increasing trend in AHL prevalence, 1990-2019, some regions still showed a decreasing trend (AAPC = -0,22 [95% CI: -0.37, -0.08]). In 2021, in the countries with middle socio-demographic index (SDI) levels, the older the population, the higher the prevalence and YLDs of AHL. Furthermore, the burden of AHL varies by age and sex and has unique temporal and spatial features. Notably, higher SDI levels correlated with reduced occupational noise-attributable burdens, while adults aged 70-74 years exhibited the highest occupational noise-driven YLDs.
The global burden of AHL continues to rise, which is a growing problem for countries with medium SDI levels. Occupational noise exposure emerges as a critical modifiable risk factor, particularly in rapidly industrializing economies, highlighting the urgent need to prioritize workplace hearing protection programs and targeted noise control policies tailored to regional contexts. These interventions are especially vital for older men in low-resource settings and medically underserved countries to mitigate preventable disability and address health inequities.
年龄相关性听力损失（AHL）是全球60岁以上成年人慢性残疾和认知衰退的一个可改变的风险因素。尽管其具有可预防性，但AHL负担的长期趋势（1992 - 2021年）及其人口统计学、社会经济、职业噪声暴露和地理驱动因素仍未得到充分探索，限制了有针对性的干预策略。
这项观察性研究使用《2021年全球疾病负担研究》（1992 - 2021年）分析了60岁及以上成年人中AHL的年龄标准化患病率和残疾生活年数（YLDs）。数据按性别、年龄、地区和国家分层，进行人口统计学分解以分离人口老龄化影响，并采用贝叶斯时空回归来量化可改变的驱动因素（如职业噪声）。通过计算年度平均百分比变化（AAPC）及其95%置信区间（CI）来评估时间趋势。
1992年至2021年，全球与AHL相关的患病率和YLDs呈上升趋势（AAPC = 0.14 [95% CI：0.13, 0.14]；AAPC = 0.17 [95% CI：0.15, 0.20]）。1992年至1995年，AHL的YLDs呈下降趋势（AAPC = -0.08 [95% CI：-0.19, 0.04]）。在区域层面，虽然1990 - 2019年大多数地区AHL患病率呈上升趋势，但一些地区仍呈下降趋势（AAPC = -0.22 [95% CI：-0.37, -0.08]）。2021年，在社会人口统计学指数（SDI）中等水平的国家，人口年龄越大，AHL的患病率和YLDs越高。此外，AHL的负担因年龄和性别而异，具有独特的时间和空间特征。值得注意的是，SDI水平越高，与职业噪声所致负担的降低相关，而70 - 74岁的成年人表现出最高的职业噪声驱动的YLDs。
AHL的全球负担持续上升，这对SDI中等水平的国家来说是一个日益严重的问题。职业噪声暴露成为一个关键的可改变风险因素，特别是在快速工业化的经济体中，凸显了迫切需要优先开展针对工作场所的听力保护计划以及根据区域情况制定有针对性的噪声控制政策。这些干预措施对于资源匮乏地区和医疗服务不足国家的老年男性尤为重要，以减轻可预防的残疾并解决健康不平等问题。
