Hearing loss is a prevalent health issue among middle-aged and older adults, adversely affecting quality of life and social interaction, and is associated with an increased risk of cognitive decline. With China's deepening population aging and growing proportion of middle-aged and older adults, trends in the disease burden of hearing loss within this demographic from 1990 to 2021 remain unclear.

To analyze trends in the disease burden of hearing loss among middle-aged and older adults (≥55 years) in China from 1990 to 2021, providing evidence for formulating effective public health strategies and healthcare resource allocation.

Data on the disease burden of hearing loss for individuals aged ≥55 years in China were extracted from the Global Burden of Disease Study 2021 (GBD 2021). This included prevalence counts, disability-adjusted life years (DALY), prevalence rates, DALY rates, and their age-standardized rates. Joinpoint regression analysis was employed to identify temporal trends and inflection points in the disease burden. The age-period-cohort model was utilized to estimate the age, period, and cohort effects on hearing loss prevalence rates.

From 1990 to 2021, the number of prevalent cases, prevalence rate, number of DALY, and DALY rate for hearing loss among individuals ≥55 years in China all increased. Prevalent cases rose from 100.99 million to 286.85 million, while the prevalence rate increased from 70 372.2 per 100 000 to 75 697.3 per 100 000. DALY increased from 2.81 million person-years to 8.71 million person-years, and the DALY rate increased from 1 961.0 per 100 000 to 2 298.9 per 100 000. Joinpoint regression indicated a consistent upward trend during 1990-2021 for crude prevalence rate, crude DALY rate, age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR). The average annual percentage changes (AAPC) were 0.24%, 0.53%, 0.19%, and 0.28%, respectively (all P<0.05). The disease burden was slightly higher in males than in females. The male ASPR increased most rapidly during 2000-2009 (APC=0.31%, P<0.05), while the male ASDR increased most rapidly during 2001-2004 (APC=1.68%, P<0.05). The female ASPR and ASDR both increased most rapidly during 2015-2019 (APC=0.47%, 0.91%; P<0.05) but showed declining trends during 2019-2021 (APC=-0.07%, -0.23%; P<0.05). The age-period-cohort model revealed that the age effect manifested as an initial increase followed by stabilization in prevalence rates with advancing age among those ≥55 years (RR ranged 0.74 to 1.08 across age groups). The period effect showed a monotonic increase in prevalence rates over time (RR ranged 0.96 to 1.05 across periods). The cohort effect indicated a gradual decrease in prevalence with more recent birth cohorts (RR ranged 0.96 to 1.06 across cohorts). Gender differences in these effects were not pronounced.

The burden of hearing loss among middle-aged and older adults in China steadily increased from 1990 to 2021.

听力损失是中老年人常见的健康问题，影响生活质量与社交，还关联认知下降风险。近年来我国老龄化程度加深，中老年人口比例增加，而1990—2021年该人群的听力损失疾病负担相关变化趋势尚不明确。

分析1990—2021年我国中老年人听力损失疾病负担变化趋势，为制定有效的公共卫生策略和医疗资源配置提供参考。

基于2021年全球疾病负担研究（GBD 2021）数据库提取我国≥55岁人群听力损失的疾病负担数据，包括患病数、伤残调整寿命年（DALY）数和患病率、DALY率及其标化率，运用Joinpoint回归分析探究我国≥55岁人群听力损失疾病负担变化趋势和转折点，并借助年龄-时期-队列模型估算我国听力损失患病率的年龄、时期和队列效应。

1990—2021年，我国≥55岁人群听力损失患病数、患病率、DALY数及DALY率均升高，患病数从10 099.7万上升至28 685.9万，患病率从70 372.2/10万增至75 697.3/10万；DALY数从281.4万人年增至871.2万人年，DALY率从1 961.0/10万增至2 298.9/10万。Joinpoint回归分析显示，1990—2021年，我国≥55岁人群听力损失患病率、DALY率、年龄标化患病率（ASPR）和年龄标化DALY率（ASDR）均呈增长态势，平均年度变化百分比（AAPC）分别为0.24%、0.53%、0.19%和0.28%（均P<0.05）。男性疾病负担略高于女性，男性听力损失ASPR在2000—2009年上升最快，APC为0.31%（P<0.05）；ASDR在2001—2004年上升最快，APC为1.68%（P<0.05）。女性听力损失ASPR、ASDR均在2015—2019年上升最快（APC分别为0.47%、0.91%，P<0.05）；但在2019—2021年呈下降趋势（APC分别为-0.07%、-0.23%，P<0.05）。年龄效应表现为≥55岁人群听力损失患病率随年龄增长先升高后不变，各年龄组相对危险度（RR）范围为0.74~1.08；时期效应为患病率随时期推移单调上升，各时期RR范围为0.96~1.05；队列效应显示为患病率随出生队列发展而逐步降低，各出生队列RR范围为0.96~1.06。性别间效应差异不明显。

1990—2021年我国中老年人的听力损失负担逐渐加重。