Abstract
Objective: Age related hearing loss (ARHL) or presbyacusis is a complex condition caused by an interaction between
environmental and genetic factors and is the most prevalent sensory impairment in the elderly. To date, only few
environmental/lifestyle risk factors have been found. Research into risk factors underlying ARHL is increasingly urgent
as populations grow older. Here, we investigate the relationship between ARHL and educational/occupational factors in
a large cohort of people from isolated villages in Italy, Crimea region, Caucasus and Central Asia. Methods: Two thousand
and sixty-eight people (aged 40 – 95 years) were recruited and analysed. Education was classified at fi ve levels: no education,
elementary, secondary, high school and university. Cases and controls were defined after a detailed evaluation of the
hearing phenotype. Data were analysed using a mixed-effects logistic regression. Results: A statistically significant association
between ARHL and education was detected. People with no education showed a higher association with the condition
than people with a higher education ( p < 0.001). Explanations could be many, including individual jobs. A strong correlation
( φ >0.45) between occupation and level of education was also found. Conclusion: Present findings provide a better
knowledge of environment/lifestyle factors related to ARHL and might help in defining new preventive strategies for aging
people.