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February 9, 2026Open Access

Self-Perceived Hearing Handicap and Audiometric Severity in Age-Related Hearing Loss: Associations with Age and Sex

Key Points

The aim is to clarify the relationship between self-perceived hearing handicap and audiometric severity, while considering demographic factors like age and sex.
Analyzed 145 adults aged 60–89 years using better-ear pure-tone average thresholds for hearing status.
Assessed self-perceived hearing handicap using the Croatian Hearing Handicap Inventory for the Elderly–Screening version.
Used correlation and linear regression analyses adjusted for age and sex to explore associations.
Tested group differences with the Kruskal-Wallis test and analyzed monotonic trends via ordinal logistic regression.
Increased self-perceived hearing handicap scores were associated with worse audiometric measures.
Strong correlations between self-perceived handicap scores and audiometric measures were found.
Age and sex were not significantly associated with self-perceived hearing handicap in linear regression analysis.
Significant differences in self-perceived handicap scores were observed across hearing loss categories.

Abstract

Background/Objective: Self-perceived hearing handicap (SPHH) reflects functional consequences of hearing loss beyond audiometric measures. Clarifying its relationship with audiometric severity and demographic factors is important for understanding age-related hearing loss (ARHL). This study examined associations between SPHH, audiometric measures, age, and sex in individuals with ARHL. Methods: A total of 145 adults (50 men, 95 women) aged 60–89 years (mean 71.65 ± 7.19 years) participated. Hearing status was defined using better-ear pure-tone average thresholds at 0.5, 1, 2, and 4 kHz (BE PTA-4), with ≥20 dB HL as the cutoff and World Health Organization (WHO)-defined severity categories. SPHH was assessed using the Croatian Hearing Handicap Inventory for the Elderly–Screening version (HHIE-S-CRO). HHIE-S-CRO total and subscale scores were examined across BE PTA-4 values and hearing loss categories. Associations were analyzed using correlation and linear regression adjusted for age and sex; group differences were tested using the Kruskal–Wallis test, and ordinal logistic regression assessed monotonic trends across ordered severity categories. Results: HHIE-S-CRO total and subscale scores increased with worsening BE PTA-4 and across hearing loss categories, with substantial overlap. Strong correlations were observed between HHIE-S-CRO scores and audiometric measures. In linear regression, BE PTA-4 was independently associated with HHIE-S-CRO total, emotional, and social/situational scores, whereas age and sex were not. Kruskal–Wallis tests showed significant differences across hearing loss categories. Ordinal logistic regression anchored to WHO severity categories demonstrated graded associations for HHIE-S-CRO total and emotional scores, while the social/situational subscale showed greater dispersion and overlap despite a statistically significant association. Conclusions: SPHH in ARHL shows a strong association with audiometric severity, with particularly robust correspondence for overall and emotional domains, underscoring the complementary role of patient-reported outcome measures alongside audiometric assessment.

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