Abstract
OBJECTIVE: To describe the trend of changes in the disease burden of age-related hearing loss in China and globally from 1990 to 2021, to forecast the prevalence and years lived with disability (YLD) rates of age-related hearing loss from 2022 to 2036, and to provide a reference for the prevention and control of the disease burden associated with age-related hearing loss. METHODS: Using the Global Burden of Disease 2021 (GBD2021) data, this study selected age-standardized prevalence rate (ASPR) and YLD as indicators. The disease burden and long-term trends of age-related hearing loss in China and globally from 1990 to 2021 were described by different socio-demographic index (SDI) and gender. Joinpoint regression was used to calculate the average annual percent change (AAPC) to assess the trend changes in the disease burden. Decomposition analysis was applied to explore the relative impacts of aging, population growth, and epidemiological changes on the variation in disease burden. An autoregressive integrated moving average (ARIMA) model was used to forecast the age-standardized pre-valence rate and YLD rates from 2022 to 2036. RESULTS: The prevalence of age-related hearing loss in China in 2021 was 82 162.49 (73 288.08-89 187.21) per 100 000, higher than the global SDI level of 66 238.16 (59 982.54-72 669.82) per 100 000, the high SDI region ' s level of 57 650.42 (52 059.12-63 889.02) per 100 000, the upper-middle SDI region ' s level of 69 115.59 (62 494.18- 75 340.64) per 100 000, the middle SDI region ' s level of 72 365.56 (65 181.43-78 912.01) per 100 000, the lower-middle SDI region ' s level of 64 439.66 (58 368.22-71 468.27) per 100 000, and the low SDI region ' s level of 61 725.25 (55 749.18-68 477.67) per 100 000. The age- related hearing loss YLD rate in China was 2 762.98 [95% uncertainty interval (UI): 1 855.28-3 880.68] per 100 000, higher than the global SDI level of 2 236.75 (95%UI: 1 511.56-3 155.88) per 100 000, the high SDI region ' s level of 1 805.79 (95%UI: 1 212.69-2 577.17) per 100 000, the upper-middle SDI region ' s level of 2 316.58 (95%UI: 1 557.53-3 274.87) per 100 000, the middle SDI region ' s level of 2 480.99 (95%UI: 1 678.17-3 489.24) per 100 000, the lower-middle SDI region ' s level of 2 313.28 (95%UI: 1 578.35-3 271.50) per 100 000, and the low SDI region ' s level of 2 383.55 (95%UI: 1 623.66-3 365.68) per 100 000. From 1990 to 2021, both the prevalence and YLD rate of age-related hearing loss in China showed an increasing trend, rising by an average of 0.18% (95%CI: 0.16%-0.19%) and 0.29% (95%CI: 0.27%-0.30%) per year, respectively. The rates of increase in prevalence were the same for both men and women, with men showing a 0.18% increase (95%CI: 0.17%-0.19%, P < 0.001) and women showing a 0.18% increase (95%CI: 0.16%-0.19%, P < 0.001). However, the YLD rate increase was faster in men than in women, with men experiencing a 0.32% increase (95%CI: 0.27%-0.37%, P < 0.001) and women experiencing a 0.27% increase (95%CI: 0.26%-0.28%, P < 0.001). Decomposition analysis showed that population growth was the main factor driving the increase in prevalence and YLD rate globally and across different SDI regions. However, aging was the primary factor contributing to the increase in prevalence and YLD rate in China. ARIMA model predictions suggested that the prevalence and YLD rate of age-related hearing loss would continue to rise from 2022 to 2036, with the predicted prevalence and YLD rate in 2036 reaching 89 723.99 per 100 000 and 2 872.47 per 100 000, respectively. CONCLUSION: The prevalence and disease burden of age-related hearing loss in individuals aged 60 and above in China rank first globally. From 1990 to 2021, both the prevalence and YLD rate of age-related hearing loss have shown a continuous upward trend, consistently surpassing the levels observed in various SDI regions worldwide. The prevalence and disease burden of age-related hearing loss are particularly significant among elderly men. Moreover, projections indicate that the disease burden of age-related hearing loss will continue to rise over the next 15 years. Therefore, it is urgent to pay close attention to age-related hearing loss in this specific population, and early intervention measures are crucial to reduce the disease burden associated with age-related hearing loss.