Screening Adults Aged 50 Years or Older for Hearing Loss: A Review of the Evidence for the US Preventive Services Task Force

Background: Hearing loss is common in older adults. Screening could identify untreated hearing loss and lead to interventions to improve hearing-related function and quality of life. Purpose: To update the 1996 U.S. Preventive Services Task Force evidence review on screening for hearing loss in primary care settings in adults aged 50 years or older. Data Sources: MEDLINE (1950 and July 2010) and the Cochrane Library (through the second quarter of 2010). Study Selection: Randomized trials, controlled observational studies, and studies on diagnostic accuracy were selected. Data Extraction: Investigators abstracted details about the patient population, study design, data analysis, follow-up, and results and assessed quality by using predefined criteria. Data Synthesis: Evidence on benefits and harms of screening for and treatments of hearing loss was synthesized qualitatively. One large (2305 participants) randomized trial found that screening for hearing loss was associated with increased hearing aid use at 1 year, but screening was not associated with improvements in hearing-related function. Good-quality evidence suggests that common screening tests can help identify patients at higher risk for hearing loss. One good-quality randomized trial found that immediate hearing aids were effective compared with wait-list control in improving hearing-related quality of life in patients with mild or moderate hearing loss and severe hearing-related handicap. We did not find direct evidence on harms of screening or treatments with hearing aids. Limitation: Non-English-language studies were excluded, and studies of diagnostic accuracy in high-prevalence specialty settings were included. Conclusion: Additional research is needed to understand the effects of screening for hearing loss compared with no screening on health outcomes and to confirm benefits of treatment under conditions likely to be encountered in most primary care settings.