Hearing loss in persons 65 years and older based on WHO global estimates on prevalence of hearing loss

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Hearing loss in persons 65 years and older based on WHO global estimates on prevalence of hearing loss Mortality and Burden of Diseases and Prevention of Blindness and Deafness WHO, 2012

In 2012, WHO released new estimates on the magnitude of disabling hearing loss. The estimates are based on 42 population-based studies. Global estimates for population above 65 years are as follows: There are 164.4 million persons of above 65 years with disabling hearing loss, i.e. 33% of the world s population above 65 years. Approximately one-third of persons above 65 years are affected by disabling hearing loss. The prevalence of disabling hearing loss in persons above 65 years is highest in Sub-Saharan Africa, Asia Pacific, and South Asia. In general lower the income, and the literacy of the region s population, higher is the prevalence of disabling hearing loss.

Definition of disabling hearing loss Disabling hearing loss refers to hearing loss greater than 40 db in the better hearing ear in adults (15 years or older) and greater than 30 db in the better hearing ear in children (0 to 14 years).

Hearing loss: WHO global estimates Children 9%:32M Adults 65 years: 50% Adults 15 or more years: 91%: 328M *MBD, WHO, 2011 DHL estimates; DHL adults (15+ years) threshold is 41 db and children threshold is 31 db. Adults of more than 65 years 50%

Disabling hearing loss in population above 65 years, is unequally distributed across the world East Asia 23% High-income 17% Latin America & Carib. 9% Asia Pacific 9% South Asia 21% Middle East and North Africa 3% *MBD, WHO, 2011 DHL estimates; DHL adult threshold is 41 db, adults of 15 years or older. Cent/East Europe and Central Asia 11% Sub-Saharan Africa 7%

The prevalence of disabling hearing loss in adults aged 65 years or more is highest in Sub-Saharan Africa, South Asia, Asia Pacific. Prevalence in low and middle income countries is almost the twice the prevalence in the high income region. Adults (65 years or more) Adults (15-65 years) Selected Regions Both sexes Males Females prevalence prevalence prevalence millions (%) millions (%) millions (%) High-income 28 18.4 19 4.9 18 4.4 Central/Eastern Europe and Central Asia 18.4 36.1 14 9.0 16 8.8 Sub-Saharan Africa 11.3 44.1 17 7.4 13 5.5 Middle East and North Africa 5.2 26.3 6 4.1 4 2.9 South Asia 34.4 48.1 52 9.5 36 7.0 Asia Pacific 14.8 43.5 19 8.7 15 6.8 Latin America and Caribbean 14.7 38.6 15 7.6 13 6.0 East Asia 37.6 34.4 41 7.4 30 5.6 World 164.4 32.8 183 7.5 145 5.9 MBD, WHO, 2011 DHL estimates

Prevalence of Disabling Hearing Loss Prevalence of disabling hearing loss for children, adults 15-65 years and adults above 65 years, by region. The prevalence in adults above 65 years could be upto 5 times higher, as compared to children and adults upto 65 years of age. 50.00% 45.00% 40.00% 35.00% 36.14% 44.15% 48.08% 43.51% 38.62% 34.44% 32.79% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 18.40% 26.32% Prevalence of DHL for children until 14 years old (per 1000 children) Prevalence of DHL for adults 15 years or older (per 100 populuation) *MBD, WHO, 2011 DHL estimates, where DHL adult threshold is 41 db and children threshold is 31 db (children 0 until 14 years old).

Prevalence of Disabling Hearing Loss for adults (65 years or older) Prevalence of hearing loss for adults above 65 years by degree of hearing loss, for selected regions. Approximately 15% of the world's adult population has some degree of hearing loss, and 25% of them are aged above 65 years. 50.0% 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Slight HL ( 26-40 db HL) Moderate HL (41-60 db HL) Severe HL (61-80 db HL) Profound HL (61-80 db HL) Disabling HL( 41 db) * MBD, WHO, 2011 DHL estimates, where DHL adult threshold is 41 db.

Prevalence of Disabling Hearing Loss Prevalence of disabling hearing loss for children, adults 15 years or older, and 65 years or older by selected regions. 50.00% 45.00% The prevalence increases with age, i.e. prevalence in children is 1.7%, in adults aged 15 years or more, it is around 7%, rapidly increasing to around one in three in adults older than 65 years. 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Prevalence of DHL for children until 14 years old (per 100 children) Prevalence of DHL for adults 15 years or older (per 100 populuation) Prevalence of DHL for adults 65 years or older (per 100 population) *MBD, WHO, 2011 DHL estimates, where DHL adult threshold is 41 db and children threshold is 31 db (children 0 until 14 years old).

- 5 10 15 20 25 30 35 40 45 50 Prevalence of Disabling Hearing Loss (adults 65+) Prevalence of disabling hearing loss for adults (65 years or older) versus average GNI per capita for selected regions. 60.00% In adults of 65 years and older, prevalence decreases exponentially as income increases. 50.00% 40.00% 30.00% 20.00% 10.00% South Asia: 48% S-Sahara Africa: 44% Asia Pacific: 43.5% Latin America and Caribbean: 39% Cent/East Europe and Cent Asia 36% Middle East and North Africa: 26% East Asia: 34% High Income: 18% y = 0.5212x -0.208 0.00% Average GNI per capita (thousands US Dollars) Prevalence of Disabling Hearing Loss for adults over 65 years old Power (Prevalence of Disabling Hearing Loss for adults over 65 years old) *MBD, WHO, 2011 DHL estimates.

50 55 60 65 70 75 80 85 90 95 100 Prevalence of Disabling Hearing Loss adults of 65 + years Prevalence of Disabling Hearing Loss for people of above 65 years versus average adult literacy rate for low and middle income in selected regions. 60% Hearing loss in adults of above 65 years decreases linearly as the adult literacy rate increases for selected low and middle income regions. 50% 40% 30% South Asia: 48% S-Sahara Africa: 44% Asia Pacific: 44% y = -0.0028x + 0.6406 Latin America & Car.: 39% Cent/East Europe & Cent Asia 36% East Asia 34% 20% 10% 0% Average Literacy rate (% of population of 15 or more years old) Prevalence of Disabling Hearing Loss for adults of 65 or more years old Linear (Prevalence of Disabling Hearing Loss for adults of 65 or more years old) *MBD, WHO, 2011 DHL estimates, where DHL children threshold is 31 db.

Population in thousands ('000) World Population growth for all ages and people aged of 65 or more years old (2010-2020 in thousands '000) *Population will grow from 6,853 millions people to 7,770 million in the period 2010-2020 (growth 11%), and the people of 65 years or more will grow from 626 millions in 2010 to 855 millions in 2019 representing a growth of 37%. 9,000,000 8,000,000 7,000,000 6,853 m Tot Pop : 11% 7,770 m 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 Tot Pop 65+ : 37% 1,000,000 626 m 855 m - 2010 2012 2014 2016 2018 2020 World Population: all people (in thousands ) World Population: people aged of 65 or more years old (in thousands)

Proportion of HL cases growth for 65+ years old population Percentage increase in number of persons (65 years or older) with hearing loss from 2010-2020.* 60.0% Population of persons above 65 years old will increase from 2010-2020 in all regions with ranges going from 18.4% to 49.7%. Consequently, the number of persons with hearing loss will grow proportionately, due to population growth and ageing in all the selected regions. 50.0% 40.0% 30.0% 20.0% 10.0% 25.8% 18.4% 38.0% 49.0% 42.9% 46.4% 44.1% 49.7% 50.0% 40.0% 30.0% 20.0% 10.0% Proportion of people of 65 years or older growth 0.0% * MBD, WHO, 2011 DHL estimates, where DHL adult threshold is 41 db. *: projections for a ten year period (200-2020) assuming no change in current prevalence rates.

Appendix: References and Indicators Indicator Source Hearing Loss Estimates MBD: All degrees of hearing loss for adults and children Population 2008 Estimates WHO, 2011 Hearing Loss estimates *UNDP 2010 World Population Prospects GNI per capita, Atlas method (current US $ Dollars) **Worldbank Database 2008 Literacy rate, adult total (% of people ages 15 and above) **Worldbank Database 2009 *UNDP WPP available at: http://www.un.org/esa/population/ **Worldbank database available at: http://data.worldbank.org/

Subregion East Asia Southeast Asia Oceania South Asia Central Asia Central Europe Eastern Europe North Africa and Middle East Central Africa East Africa Southern Africa West Africa Andean Latin America Central Latin America Southern Latin America Tropical Latin America Caribbean Asia-Pacific Australasia North America Western Europe A2: Selected Regions Countries East Asia region China, Hong Kong SAR (China), Macau SAR (China), Democratic People's Republic of Korea, Taiwan. Asia Pacific region Cambodia, Indonesia, Lao People's Democratic Republic, Malaysia, Maldives, Myanmar, Philippines, Sri Lanka, Thailand, Timor-Leste, Viet Nam. Cook Islands, Fiji, French Polynesia, Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Vanuatu, Tuvalu and Niue. South Asia region Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan Central / Eastern Europe and Central Asia region Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Mongolia, Tajikistan, Turkmenistan, Uzbekistan. Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Hungary, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, Macedonia (Former Yugoslav Republic of). Belarus, Estonia, Latvia, Lithuania, Moldova, Russian Federation, Ukraine. Middle East and North Africa region Algeria, Bahrain, Egypt, Iran (Islamic Republic of), Iraq, Jordan, Kuwait, Lebanon, Libyan Arab Jamahiriya, Morocco, Occupied Palestinian Territory, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Tunisia, Turkey, United Arab Emirates, Yemen. Sub-Saharan Africa region Angola, Central African Republic, Congo, Democratic Republic of the Congo, Equatorial Guinea, Gabon. Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Rwanda, Seychelles, Somalia, Sudan, Uganda, United Republic of Tanzania, Zambia. Botswana, Lesotho, Namibia, South Africa, Swaziland, Zimbabwe. Benin, Burkina Faso, Cameroon, Cape Verde, Chad, Côte d'ivoire, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, São Tomé and Príncipe, Togo. Latin America and Caribbean region Bolivia, Ecuador, Peru. Colombia, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Venezuela (Bolivarian Rep. of). Argentina, Chile, Uruguay. Brazil, Paraguay. Antigua and Barbuda, Bahamas, Barbados, Belize, Bermuda, British Virgin Islands, Cuba, Dominica, Dominican Republic, Grenada, Guyana, Haiti, Jamaica, Netherlands Antilles, Puerto Rico, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago. High-income region Brunei Darussalam, Japan, Republic of Korea, Singapore. Australia, New Zealand. Canada, United States of America. Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Greenland, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, Monaco and San Marino.