Insufficient Evidence to Weigh Benefits and Harms of Routine Screening for Age-related Hearing Loss

Age-related hearing loss is a common health problem that can affect independence, emotional well-being, and quality of life.

Several screening methods have proven accurate for identifying hearing impairment, including simple clinical tools and questionnaires.

In 1996, the United States Preventive Services Task Force recommended that primary care physicians periodically question older adults about their hearing, counsel them about hearing aids, and make referrals when appropriate. This recommendation was based on available evidence, and focused on patients with established or perceived hearing loss. To update its 1996 recommendations, the Task Force reviewed articles published between 1950 and January 2010 on screening for age-related hearing impairment in adults 50 and older who had not been previously diagnosed with hearing loss in the primary care setting.

The Task Force considered evidence on the association of screening with improved health outcomes; the accuracy of screening methods; the incremental benefits of early detection; the effectiveness of treatment; and the harms of screening and treatment.

While few studies showed that screening resulted in increased hearing aid use, no studies examined whether it improved emotional and social functioning, communication ability, and cognitive function. Since screening and confirmatory testing for hearing impairment are noninvasive and serious harms of treatment are rare, the Task Force can conclude that there are likely little to no adverse effects of screening for hearing loss.

However, no trials evaluate for adverse events. With many existing research gaps, the Task Force cannot recommend for or against screening for age-related hearing loss in the primary care setting.