Modifiable determinants of hearing impairment in adults

Weihai Zhan, Karen J. Cruickshanks, Barbara E.K. Klein, Ronald Klein, Guan Hua Huang, James S. Pankow, Ronald E. Gangnon, Theodore S. Tweed

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Objective: To identify factors contributing to the declining prevalence of hearing impairment in more recent generations. Methods: We used data on hearing thresholds and potential risk factors of hearing impairment collected from studies in Beaver Dam, Wisconsin, the Epidemiology of Hearing Loss Study (1993-1995, n = 3753; 1998-2000, n = 2800 and 2003-2005, n = 2395), the concurrent Beaver Dam Eye Study on the same cohort, and a subgroup (n = 2173) of the Beaver Dam Offspring Study (2005-2008). Results: Educational attainment significantly reduced the odds ratio (OR) of the birth cohort effect on hearing impairment from 0.90 to 0.93, while a history of ear infection had a reverse effect on the decreasing trend (significantly changing the OR from 0.93 to 0.94). Occupational noise exposure, smoking, and a history of cardiovascular disease, while associated with hearing impairment, did not attenuate the cohort effect. The cohort effect remained significant after known risk factors were adjusted (OR = 0.93; 95% confidence interval, 0.89-0.97). Conclusion: These data provide strong evidence that environmental, lifestyle, or other modifiable factors contribute to the etiology of hearing impairment and add support to the idea that hearing impairment in adults may be prevented or delayed.

Original languageEnglish (US)
Pages (from-to)338-342
Number of pages5
JournalPreventive medicine
Issue number4-5
StatePublished - Oct 2011

Bibliographical note

Funding Information:
The project described was supported by R01AG021917 (KJC) from the National Institute on Aging , National Eye Institute , and National Institute on Deafness and Other Communication Disorders . Additional support was from grants R37AG11099 (KJC) from the National Institute on Aging and U10EY06594 (RK) from the National Eye Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health.


  • Birth cohort effect
  • Education
  • Hearing impairment
  • Hearing loss


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