Introduction: Hearing loss adversely impacts communication, cognitive function, and quality of life, yet early detection among adults remains inadequate. Despite the availability of portable, cost effective tablet-based audiometric screening tools, national-level prevalence data on adult hearing loss in Mongolia are scarce, and no large-scale screening studies in primary health care settings have been conducted to date. Goal: This study aimed to determine the prevalence of screen-detected hearing loss among adults in Ulaanbaatar, evaluate its association with age and test frequency, and identify associated factors. Material and Methods: A cross-sectional study was conducted at primary health care clinics across nine districts of Ulaanbaatar (2024–2025), enrolling 2,335 adults (≥18 years). Hearing screening was performed using the MAICO easyTone device with DD65 v2A headphones at 500–6000 Hz (30 dB HL at 500 Hz; 20 dB HL at remaining frequencies), with ambient noise monitored per ANSI S3.1-2008. Each ear was classified as Pass or Refer at each frequency. Outcomes included screen-detected hearing loss (SD-HL), speech-frequency hearing loss (SD SFHL, 500–2000 Hz), and high-frequency hearing loss (SD-HFHL, 4000–6000 Hz), each categorized as bilateral or unilateral. Associated factors were assessed by univariable and multivariable logistic regression. Results: SD-HL was identified in 37.2% of participants (bilateral: 31.5%; unilateral: 5.7%), SD-SFHL in 30.6%, and SD-HFHL in 36.3%. Prevalence increased markedly with age, from 29.9% (40–49 years) to 96.6% (≥70 years) (p<0.001). On multivariable logistic regression, male sex was inversely associated with a positive screening result (OR=0.65, 95% CI: 0.42–0.99, p=0.049). Conclusion The findings of this study confirm that the MAICO easyTone tablet-based hearing screening device is a feasible and appropriate tool for the early detection of hearing loss among adults in routine primary health care settings in Ulaanbaatar. The high prevalence of screening-detected hearing loss underscores the urgent need to establish adult hearing screening programs in Mongolia. Future studies should include standard audiometric confirmation in participants with positive screening results to determine the diagnostic validity of this hearing screening approach.

Background: Speech audiometry is a widely used standard diagnostic method in the evaluation of hearing and auditory function. It requires word materials that are developed in the native language of the target population and that reflect its phonetic characteristics. Because the phonetic structure, pronunciation, and familiarity of words directly influence speech recognition, it is essential to use language-specific word lists that are phonetically balanced, uniformly distributed, and psychometrically validated to ensure the accuracy and reliability of testing. Therefore, there is a strong need to develop Mongolian bisyllabic word lists that are balanced in both phonetic and psychometric properties, which forms the basis of this study. Aim: To develop psychometrically balanced Mongolian bisyllabic word lists for use in speech audiometry and to evaluate their suitability for determining the Speech Recognition Threshold (SRT). Materials and Methods: Fifty-five commonly used and phonetically balanced Mongolian bisyllabic words were selected and recorded by a professional female speaker. The recordings were presented to 50 normal-hearing participants aged 18–29 years at ten intensity levels ranging from –4 to 14 dB HL in 2-dB steps. Based on participants’ responses, the 50% SRT and the 20–80% slope of the psychometric function for each word were calculated using logistic regression. Chi-square and one-way ANOVA analyses were performed to examine the equivalence between lists. On the basis of these results, two psychometrically balanced half-lists, each containing 25 words, were constructed, and digital level adjustments were applied to ensure uniform intensity. Result: The slopes of the psychometric functions for the two half-lists ranged from 11.2 to 11.6 %/dB. Chi-square and one-way ANOVA analyses showed no statistically significant differences between the two lists in terms of the 50% SRT and psychometric slope derived from logistic regression [χ²(24, N=50) = 2.21, p = 0.99; F(1,48) = 0.00895, p = 0.925]. The mean pure-tone average (PTA) threshold of the 50 normal-hearing participants was 2.23 dB HL with a standard deviation of 4.4 dB. The difference between PTA and SRT was less than 10 dB HL for all participants, which is within the clinically acceptable range. Conclusion The developed Mongolian bisyllabic word lists, consisting of two 25-word sets, are suitable for determining the Speech Recognition Threshold and can be reliably applied in clinical speech audiometry practice.