The use of hearing aids, regardless actual implementation, may be interpreted as a cry for help in hearing difficulty. We assessed factors contributing to hearing aid possession and predicted needs of hearing assistance from the distribution of hearing level in self-estimated (subjective) hearing loss and hearing loss pointed out by others (objective) in a population-based aging cohort. Of 1192 men and 1163 women aged 40 to 84 years, the prevalence of hearing loss using the criteria of a mean hearing threshold>25dB at frequencies of 0.5, 1, 2, and 4 kHz in the better ear was 23.6%. Hearing aids were possessed by 11.0% in the hearing loss group. Statistical analysis by gender was done to identify factors associated with hearing aid possession using stepwise multiple regression in which independent variables were age, hearing in the better and worse ear, and items from response to a questionnaire on self-estimated hearing loss, hearing loss pointed out by others, job, household income, financial satisfaction, education, housemate, how often others were talked to and how often those surveyed went out. Age, better-ear hearing, worse-ear hearing, and education statistically influenced hearing aid possession in men, and age, better-ear hearing, and hearing loss pointed out by others statistically influenced women. Age had a negative effect on hearing aid possession in both men and women, indicating that possession decreased with aging. Scattergrams were plotted with worse-ear hearing on the y axis and better-ear hearing on the x axis for 4 groups of respondents divided into groups with self-estimated hearing loss or hearing loss pointed out by others: (1) no subjective and objective hearing loss, (2) subjective but no objective hearing loss, (3) objective but no subjective hearing loss, and (4) both subjective and objective hearing loss. Many respondents had either subjective or objective or both subjective and objective hearing loss, even within 20 dB of hearing level of both ears in their 40s. These facts implied that early-stage candidates for hearing aids may not require threshold reduction, although aided thresholds were commonly used indicators in fitting.