Highlights
– In a nationally representative, Hispanic-oversampled cohort of Medicare beneficiaries aged 65+, 54.6% had hearing loss in the better ear (>25 dB HL).
– Severity breakdown: mild 38.4%, moderate 12.8%, severe 3.4%.
– Hearing aid uptake was very low: 8.3% among those with hearing loss.
– The results highlight urgent needs for culturally competent access, affordability strategies, and targeted public health outreach for older Hispanic adults.
Background: Why this study matters
Hearing loss is a highly prevalent, age-related chronic condition that affects communication, social participation, quality of life, and is associated with adverse outcomes including cognitive decline and social isolation. Prior US prevalence estimates for adults 65 years and older have often been derived from samples in which Hispanic individuals were underrepresented. Because the Hispanic older adult population is growing and heterogeneous, accurate, representative estimates are essential to guide public health planning, hearing health services, and policy decisions relevant to Medicare beneficiaries.
Study design and methods
This cross-sectional analysis used data from the 2022 National Study of Aging and Health Trends, which purposefully oversampled Hispanic adults aged 65 years and older to produce nationally representative estimates for this subgroup. The analytic sample included 591 participants, representing a weighted population estimate of approximately 5.17 million Hispanic US adults aged 65 and older. Standard audiometric testing across a wide frequency range (0.25 to 8 kHz) was used to quantify hearing thresholds. The primary outcome was hearing loss defined as greater than 25 dB hearing level (HL) in the better ear; self-reported hearing aid use was collected as a secondary outcome. Survey weights were applied so estimates reflect the US Hispanic 65+ Medicare beneficiary population. Data were collected in 2022 and analyzed between March and April 2025.
Key findings
Prevalence and severity
– Overall, an estimated 54.6% (95% CI, 49.2%–59.9%) of the weighted Hispanic Medicare beneficiary population aged 65 and older had hearing loss in the better ear (defined as >25 dB HL).
– Severity strata among those assessed in the full sample were: mild hearing loss 38.4% (95% CI, 32.6%–44.6%), moderate hearing loss 12.8% (95% CI, 10.0%–16.2%), and severe hearing loss 3.4% (95% CI, 2.1%–5.6%). These categories reflect the distribution across the sample and indicate that a substantial fraction had hearing loss likely to affect daily communication.
Age and frequency effects
– As expected, hearing thresholds increased with both advancing age and with higher test frequencies. The study reports incremental increases in mean thresholds across age strata at low (0.25 kHz) and high (8.0 kHz) frequencies in each ear. The reporting in the abstract includes specific threshold values by age and frequency for the right and left ears; these values demonstrate the classic audiometric pattern of increasing threshold (worse hearing) at higher frequencies and in the oldest age groups.
Sex differences
– The study abstract presents sex-specific prevalence but contains language that appears internally inconsistent: it reports an overall prevalence figure that is numerically higher in one sex but states the opposite direction in text. The numeric data should be interpreted directly from the tabulated results in the full manuscript. Overall, sex differences were observed, which aligns with prior literature showing higher prevalence of certain patterns of hearing loss among men, though patterns may vary by frequency and exposure history.
Hearing aid use
– Hearing aid use among participants with hearing loss was 8.3%. This low uptake is clinically and policy-relevant: it suggests that the majority of Hispanic older adults who would benefit from hearing rehabilitation are not using hearing aids, mirroring gaps reported in other underserved populations.
Sample characteristics
– The unweighted analytic sample size was 591, producing a weighted estimate of 5.17 million Hispanic adults aged 65 and older. Approximately half the weighted population were female (50.2%; 95% CI, 44.1%–56.2%). The study reported age-stratified estimates; readers should consult the full article tables for exact distribution and any typographical corrections to confidence intervals that appear in the abstract.
Interpretation and clinical implications
This study provides new, nationally representative estimates specifically for Hispanic Medicare beneficiaries, addressing an important knowledge gap. Key implications include:
- High population burden: More than half of Hispanic adults 65 years and older have measurable hearing loss, indicating a substantial need for hearing services among this group.
- Low uptake of hearing aids: With only 8.3% of those with hearing loss using hearing aids, there are critical unmet needs in access, affordability, awareness, and culturally competent service delivery.
- Heterogeneity within the Hispanic population: Hispanic older adults are diverse by country of origin, language preference, acculturation, and socioeconomic status; these factors likely influence access to care, health literacy, and attitudes toward hearing technologies and rehabilitation.
- Policy relevance: Because Medicare currently does not routinely cover hearing aids, financial barriers remain a major obstacle for many older adults. The availability of over-the-counter (OTC) hearing aids for adults with perceived mild-to-moderate hearing loss through recent regulatory changes may improve access, but uptake will depend on outreach, availability of bilingual support, and integration with clinical diagnosis and follow-up for those with more severe loss.
Expert commentary and limitations
Strengths of the study include its focus on a historically underrepresented group, use of objective audiometric data across frequencies, and application of survey weights to produce population estimates. These elements increase the study’s value for informing public health planning and targeted interventions.
Limitations include the cross-sectional design, which precludes causal inference about factors driving hearing loss. The unweighted sample size is modest (591 participants), and although oversampling and weighting improve representativeness, subgroup analyses (for example by Hispanic origin, primary language, or socioeconomic status) may have limited precision. The abstract contains a few apparent typographical inconsistencies in reported confidence intervals and in a sentence describing sex differences; readers should consult the full publication for corrected tables and exact subgroup estimates.
Other considerations: Hispanic communities face structural barriers to hearing care, including lower rates of insurance coverage for hearing devices, language and cultural mismatches with providers, limited availability of Spanish-language audiology services, and lower health literacy around hearing loss and its consequences. Interventions that address these multilevel barriers are likely necessary to increase uptake of hearing rehabilitation.
Policy and practice recommendations
– Improve access: Consider policy mechanisms to improve affordability of hearing devices for Medicare beneficiaries, such as targeted subsidies, enhanced Medicare benefit coverage, or voucher programs for low-income older adults.
– Leverage OTC hearing aid availability: Promote culturally tailored education about safe OTC device use for eligible adults, while ensuring pathways to professional care for those with more severe or complex hearing loss.
– Expand bilingual and culturally competent services: Invest in workforce training and teleaudiology models to reach Spanish-preferring older adults and rural communities.
– Implement community-based screening and navigation: Partner with community organizations, senior centers, and primary care practices to screen, educate, and link patients to affordable hearing care options.
Research gaps and future directions
– Longitudinal studies to quantify incidence, trajectories, and clinical outcomes of hearing loss among Hispanic older adults.
– Implementation research testing culturally tailored interventions to increase hearing aid uptake and adherence in Hispanic communities.
– Economic analyses to model the cost-effectiveness of expanding Medicare coverage versus community-based subsidized programs.
– Evaluation of the real-world impact of OTC hearing aids on access and outcomes for diverse older adults, including measures of hearing-specific quality of life.
Conclusion
This nationally representative analysis of Hispanic Medicare beneficiaries aged 65 years and older found that more than half experience hearing loss, while only a small fraction use hearing aids. The findings highlight substantial unmet need and support targeted public health, clinical, and policy actions to expand access to hearing care for Hispanic older adults. Addressing affordability, cultural and linguistic barriers, and integrating new access pathways such as OTC devices will be important steps toward closing the gap.
Funding and clinicaltrials.gov
Funding and trial registration information was not provided in the abstract excerpt. Readers should consult the full article for detailed disclosures, funding sources, and any registry information.
References
1. Yévenes-Briones H, García-Morales EE, Coco L, Stickel AM, Schrack JA, Reed NS, Martinez-Amezcua P. Prevalence of Hearing Loss and Hearing Aid Use Among Hispanic Medicare Beneficiaries 65 Years and Older. JAMA Otolaryngol Head Neck Surg. 2025 Nov 6:e253834. doi: 10.1001/jamaoto.2025.3834. PMID: 41196606; PMCID: PMC12593663.
2. World Health Organization. World Report on Hearing. 2021. Available at: https://www.who.int/publications/i/item/world-report-on-hearing
3. U.S. Food and Drug Administration. FDA finalizes rule establishing over-the-counter hearing aids for adults with perceived mild to moderate hearing loss. 2022. Available at: https://www.fda.gov/news-events/press-announcements/fda-finalizes-rule-establishing-over-counter-hearing-aids-adults-perceived-mild-moderate-hearing-loss
4. Medicare.gov. What Medicare covers: hearing exams and hearing aids. Available at: https://www.medicare.gov/what-medicare-covers/what-part-b-covers
