Age of onset varies, depending on factors such as genetic susceptibility, the presence of diseases, and exposure to drugs that are toxic to hearing. Note 14, Note 15 Furthermore, hearing loss occurs gradually and represents the lifetime cumulative insults to the auditory system, Note 16, Note 17 initially affecting the high frequencies and later progressing to lower frequencies that can affect speech comprehension. Note 10-13 Survey respondents may not self-identify as having a hearing disability and/or may not even be aware of it, particularly if it is mild or moderate. Note 8, Note 9 However, self-reports may result in underestimates, especially among older adults and among people with mild hearing loss. For example, according to the Canada Community Health Survey and the Participation and Activity Limitations Survey, the self-reported prevalence of hearing impairment was 4% and 5% for the population aged 12 or older and 15 or older, respectively. In Canada, the prevalence of hearing loss has typically been estimated through self-reports. Note 4-6 Yet despite the importance of hearing for daily functioning, hearing loss is often unrecognized and undertreated. Note 3 The personal consequences may include social isolation, depression, safety issues, mobility limitations, and reduced income and employment opportunities. Note 1, Note 2 As well, hearing loss has been associated with worse quality of life and functional outcomes. At the beginning of the twenty-first century, the World Health Organization reported adult-onset hearing loss to be one of the leading causes of years lost due to disability (YLD) in 2001, hearing loss accounted for 4.7% of total YLD due to all causes, with the total global YLD for hearing loss estimated at 24.9 million years. Hearing loss is an important public health concern with far-reaching implications.
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