A quarter of deaf adults: more hearing tests?

By 2050, some 2.5 billion people worldwide will be affected by hearing loss, according to projections by the World Health Organization (WHO). Today, the WHO lists 1.5 billion. That is to say that hearing is a sense if not in danger, at least threatened.

An investigation on an unprecedented scale

In France, a quarter of adults are affected by some form of hearing loss, including 4% by disabling deafness. These unpublished figures result from a study carried out by the National Institute of Health and Medical Research (Inserm), in collaboration with the Public Assistant Hospitals of Paris (AP-HP) and the Foch Hospital, in Suresnes, in the Paris region. Unpublished, because never a study of this magnitude had previously been carried out in France – the last estimate of prevalence dates back to 2008, and it was based on self-reported responses. The conclusions of the work of Jean-Philippe Empana and Quentin Lisan were published on June 17 in the journal Jama Open Network.

The researchers relied on data from 186,460 volunteers, aged 18 to 75, all from the Constances cohort, representative of the general population, and in whom deafness was assessed from hearing tests carried out between 2012 and 2019. All these people completed questionnaires relating to their lifestyle (exposure to noise, smoking, etc.), their socio-economic characteristics (diplomas, income, etc.) or their medical history (diabetes, hypertension, cardiovascular diseases, etc.).

Factors associated with hearing loss

The authors of the study thus showed that 25% of the individuals in this sample were affected by a hearing loss. No less important was the meager percentage of hearing aid patients among those with severe hearing loss: only 37% wore hearing aids.

Data analysis also revealed, the authors write, that “age, male gender, body mass index (BMI), occupational noise exposure, diabetes, prevalent cardiovascular disease, depression, and smoking were associated with higher risks of hearing loss and disabling hearing loss”. Conversely, having “higher level of education, higher household income, current work status, living in urban areas and living alone were associated with a lower likelihood of hearing loss and disabling hearing loss”continue the two Inserm researchers.

Better target people at risk

A better understanding of the prevalence of hearing loss and, above all, the profile of the people concerned represents an important interest in terms of public health. “This makes it possible to draw up a reliable inventory and provide keys to public decision-makers while effective solutions exist to take charge of this major health problem.”, write Jean-Philippe Empana and Quentin Lisan.

Beyond the early diagnosis and management of ear diseases, it helps to act on the modifiable or preventable risk factors that are associated with hearing loss, “such as cardiometabolic risk factors (diabetes and prevalent cardiovascular disease) and lifestyle risk factors (BMI and smoking status)”, list the authors of the study. Without forgetting exposure to noise in the context of work, with the implementation of appropriate prevention strategies.

Generalize hearing tests

For Jean-Luc Puel, research director at Inserm, hearing specialist and professor of neurosciences at the University of Montpellier, “hearing tests should be integrated into general health, not just when people have hearing loss”. And to deplore that no auditory measurement is carried out either in school medicine or in occupational medicine. “We take care of the sight, but not the hearing, he continues. Similarly, when faced with patients who have diabetes, hypertension, a significant BMI or even sleep apnea, consideration should be given to carrying out a hearing test..”

Easy-to-use applications on smartphones or tablets are currently being studied. This would be, according to Professor Puel, “an ample way to screen more broadly, without going through the classic audiometer”.

Getting fitted to prevent the risk of dementia

Especially, as the authors of the study point out, since there are now much less stigmatizing, more effective and more affordable hearing aids, thanks in particular to the entry into force of the “100% health” reform – which was not yet deployed when this assessment of the prevalence of hearing loss was carried out. An essential device if we judge by the socio-economic inequalities among the hearing impaired, reported by the said evaluation.

Finally, many studies, including one from Inserm, have established, particularly in elderly subjects, that the device has a protective effect against the risk of isolation, depression and dementia. American studies have even suggested that hearing-impaired (and unaided) elderly people are more likely to develop Alzheimer’s disease than those with normal hearing. In short, don’t wait to get tested or, at the very least, to talk about it with your attending physician.