Sex differences in age-related hearing loss

@article{PhysioNet-sex-differences-hearing-loss-1.0.0,
  author = {KIM, SUNGHEE},
  title = {{Sex differences in age-related hearing loss}},
  journal = {{PhysioNet}},
  year = {2026},
  month = sep,
  note = {Version 1.0.0},
  doi = {10.13026/76jk-9b36},
  url = {https://doi.org/10.13026/76jk-9b36}
}

@article{pollard_physionet_2026, title = {{PhysioNet} as a global platform for biomedical research}, volume = {1}, issn = {3005-0693}, url = {https://doi.org/10.1038/s44360-026-00096-z}, doi = {10.1038/s44360-026-00096-z}, abstract = {Twenty-five years after its first public repository was established, the PhysioNet resource for biomedical and clinical data has enabled tens of thousands of research papers. Further efforts are ongoing to advance secure data sharing, community engagement and scalable research infrastructure.}, number = {8}, journal = {Nature Health}, author = {Pollard, Tom and Moody, Benjamin E. and Lehman, Li-wei H. and Gow, Brian J. and Fernandes, Chrystinne and Xie, Chen and Johnson, Alistair and Mark, Roger G. and Heldt, Thomas}, month = aug, year = {2026}, pages = {792--795},}

Abstract

The purpose of this study was to obtain sex- and age-specific reference levels for hearing threshold of normal aging in Koreans and to determine if the rate of change in pure-tone hearing thresholds differed by sex. Subjects were clients who visited the Health Promotion Center, Daegu Fatima Hospital, Daegu, Korea, from January 2004 to April 2010. Pure-tone audiometric measures were obtained from 16,884 subjects who also completed a hearing questionnaire. Data were excluded for the present analyses if the subjects were foreigners, repeated testers, or did not complete the questionnaire. Also excluded were subjects with a positive history of otorrhea for any ear, usage of intravenous antibiotics, diuretics, and chemotherapeutic agents, head injury, job in a noisy environment, and military service. Any subjects with asymmetric hearing results were also excluded. More than a 15 dB difference at 0.5, 1, or 2 kHz was defined as asymmetric hearing. Subjects younger than 18 years were excluded to ensure completion of puberty among female subjects. Because no men were older than 80 years, women older than 80 years were excluded to match the age range between sexes. Finally, 4,084 subjects, 910 men and 3,174 women, were included. As part of the health check, subjects completed continuous pure tone audiometric testing followed by pulsed pure-tone testing. Hearing threshold levels were obtained at six frequencies (0.25, 0.5, 1, 2, 4, and 8 kHz). This dataset provides reference values for age-related hearing loss in a carefully screened normal aging population.

Background

A few studies of age-related hearing loss have been conducted in Korea. However, reports of sex differences in hearing sensitivity of Koreans have been inconsistent. An early Korean study concluded that women have poorer hearing than men above 2 kHz [1]. To date no sex difference in the incidence of presbycusis has been reported [2, 3]. Other studies have reported better hearing sensitivity in women than in men [4-6]. The aim of our study was to establish sex- and age-specific reference ranges of hearing thresholds in normally aging Koreans and to identify age-related sex differences in pure-tone hearing thresholds.

Methods

Subjects were clients who visited the Health Promotion Center, Daegu Fatima Hospital, Daegu, Korea, between January 2004 and April 2010. 16,884 subjects completed hearing questionnaires, including 10,286 men and 6,598 women. Subjects were excluded from the present study if they were foreigners, repeated testers, or did not complete the questionnaire. Also excluded were subjects with a positive history of otorrhea for any ear, usage of intravenous antibiotics, diuretics, and chemotherapeutic agents, head injury, job in a noisy environment, and military service. Any subjects with asymmetric hearing results were also excluded. More than a 15 dB difference at 0.5, 1, or 2 kHz was defined as asymmetric hearing.

Subjects younger than 18 years were excluded to ensure completion of puberty among women subjects. Because no men were older than 80 years, women older than 80 years were excluded to match the age range between sexes. Finally, 4,084 subjects, 910 men and 3,174 women, were included.

As part of the health check, subjects underwent pulsed pure-tone audiometric testing. Hearing threshold levels were obtained at six frequencies (0.25, 0.5, 1, 2, 4, and 8 kHz) using a Beltone Model 112 Audiometer (Beltone Electronics Corporation, Chicago, IL, USA). Subjects were instructed to press a hand-held response key upon hearing a tone. Each ear was tested individually with pulsed tones presented through TDH 50P headphones. The better ear was tested first, or the right ear if the subject indicated that hearing sensitivity was the same in both ears. During the audiometric tests, subjects were seated in a sound-treated chamber (Model IAC 400 A, Industrial Acoustics Company Inc., Bronx, NY, USA). Testing began at 1 kHz, and continued successively to the higher test frequencies (2, 4, and 8 kHz) and then back to 1 kHz for a reliability check. The lower frequencies, 0.5 and 0.25 kHz, were presented last. Threshold levels were determined in 5-dB steps by three ascending and descending crossings. The audiometer was calibrated to audiometric zero in accordance with standards set by the American National Standards Institute (ANSI 1989).

Data Description

The dataset is provided in a single comma-separated values (CSV) file: hearing_thresholds.csv.

File Structure

Each row represents one subject. The file contains 14 columns in the following order:

Measurement Details

All hearing thresholds were obtained using a Beltone Model 112 Audiometer calibrated to American National Standards Institute (ANSI 1989) standards. Threshold levels are expressed in decibels hearing level (dB HL) and were determined using 5-dB steps. Right ear values are listed in columns 3–8, followed by left ear values in columns 9–14.

Usage Notes

Prior Use

Some of the data from men and women has been used for "Sex differences in a cross sectional study of age-related hearing loss in Korea" (Kim et al., CEO 2010) and all the men data has been used for "Long-term effect of noise exposure during military service in South Korea" (Kim et al., IJA 2017) as a control group.

Potential Applications

This dataset can serve as a reference for age-related hearing loss in a normal aging population. The data can be reused for reference values of age-related hearing loss or to compare slope differences with other noise-exposed groups.

Limitations

This dataset was compiled with stringent exclusion criteria for known external causes of hearing loss, making it highly focused and not representative of age-related hearing loss in the general population. Users should note that these data cannot be generalized to populations with occupational noise exposure, ototoxic medication use, or other external hearing loss risk factors.

Release Notes

Version 1.0.0

Initial Release

Ethics

All methods were approved by Human Subjects Institutional Review Boards in Daegu Fatima Hospital (DFH09OT032) and were conducted according to the principles of the Declaration of Helsinki. All participants provided informed consent.

Conflicts of Interest

The author declares that she has no competing interests.

References

1. Chung TI. An audiological survey of presbycusis. Korean J Otolaryngol. 1969;12(3):31-40.
2. Kim HN, Kim SG, Lee HK, Ohrr H, Moon SK, Chi J, et al. Incidence of presbycusis of Korean populations in Seoul, Kyunggi and Kangwon provinces. J Korean Med Sci. 2000 Oct;15(5):580-4.
3. Choi IS, Han YH, Jun BH. An audiologic study of presbycusis. Korean J Audiol. 1997;1(2):149-54.
4. Rha KS, Park CI. Audiologic study of presbycusis. Korean J Otolaryngol. 1982;25(4):632-40.
5. Lee JH, Kim JS, Oh SY, Kim KS, Cho SJ. Effects of age on hearing thresholds for normal adults. Korean J Audiol. 2003 Jun;7(1):15-23.
6. Kim SH, Jarng SS, Shin JH, Yoe CK, Han YK, Lee JK. Age- and gender-specific reference levels for hearing thresholds of normal aging in Korean. J Acoust Soc Korea. 2005 Aug;24(6):353-7.