Abstract
BACKGROUND: The global rise in life expectancy and aging populations contributes to the increasing burden of age-related hearing loss. A Swedish study found significant improvements in hearing among 70-year-olds over the past four decades, particularly among men, with hearing loss prevalence decreasing from 53% to 28%, and from 37% to 23% in women. This study aimed to investigate the role of modifiable risk factors in improved hearing outcomes among 70-year-olds in Gothenburg. METHODS: This study is a part of the Gothenburg H70 Birth Cohort investigation. Two cohorts of 70-year-olds were included: one born in 1901-1907 (n = 674) and another born in 1944 (n = 1114). Audiometric, demographic, and health data were obtained from examinations conducted in the 1970s and 2014. Mediation analyses examined whether educational level, main occupation throughout life, smoking habits, and systolic blood pressure contributed to cohort differences in hearing. RESULTS: Three of the four variables-educational level, main occupation, and smoking habits-showed a mediating effect on hearing outcomes. In gender-stratified analyses, main occupation mediated the effect in men, while educational level did so in women. Systolic blood pressure showed no significant mediating effect. CONCLUSIONS: Today's 70-year-olds in Gothenburg generally have higher education levels and occupations with less noise exposure, supported by industrial hearing conservation programs. Reduced smoking rates in later-born cohorts have also benefited hearing health. Understanding the relationship between modifiable lifestyle and environmental factors and age-related hearing loss is crucial for developing effective preventive strategies to promote hearing health in older adults. KEY MESSAGES: • Socioeconomic factors such as main occupation and educational level impact age-related hearing loss. • Smoking habits across the life course influence age-related hearing loss.