Screening for Hearing Loss in Older Adults
August 14, 2012

Insufficient Evidence On Benefits Of Hearing Loss Screenings

Connie K. Ho for — Your Universe Online

The U.S. Preventive Services Task Force (USPSTF) recently looked at the benefits and harms of hearing loss screenings. The authors believe that the study is important as age-related hearing loss is prevalent among the elderly who are 50 years or older. It is also an issue of concern as it can affect the quality of life and social functioning of seniors.

To begin, the USPSTF looked at evidence that was published from 1950 to January 2010. The studies were related to screenings for age-related sensorineural hearing impairments in adults who were 50 years of age or older who were not diagnosed with hearing loss. Based on the results of the review, the authors recommended that, for asymptomatic adults who were 50 years of age or older, there was not enough current evidence to understand or measure the benefits and harms of having screenings for hearing loss.

"If you have a hearing problem, you should absolutely bring it up with your doctor," USPSTF co-vice chair Dr. Albert Siu, a professor at the Mount Sinai School of Medicine, told Reuters Health.

In one part of the statement, the authors described how screening tools can help identify hearing loss in adults. Clinical tests can test a person´s ability to hear things like a finger rub, a whispered voice, or an insect. A handheld screening instrument, made up of an otoscope with an audiometer built-in, is also utilized in exams. Further testing includes single test questions or more detailed questionnaires like the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S).

As well, the authors explained in the statement how hearing loss may be due to a number of different things. The risk factors include past exposure to loud noises, recurring inner ear infections, some systemic diseases like diabetes, or genetic factors. For individuals who believe they need a hearing aid, they can confirm hearing loss with a pure-tone audiogram. Studies have shown that hearing aids can improve communication, social functioning, and self-reported hearing for adults who have age-related hearing loss.

"Ask them how they're doing. If they say they're fine, just leave it there," remarked Ellen O'Neil, associate director of audiology at the Massachusetts Eye and Ear Infirmary, in the Reuters Health article.

Older adults may not realize that they have hearing loss. On one hand, they may change their daily activities to deal with the hearing loss. On the other hand, they might feel a social stigma to seeking out treatment or obtaining a hearing-aid. So, even though the USPSTF statement doesn´t make any recommendations, some experts believe it is still important for physicians to ask their patients about possible hearing loss.

"If you don't ask, you won't find out," Ronald A. Hoffman, medical director of the New York Eye and Ear Infirmary's Ear Institute, told Reuters Health.

The recommendation replaces a recommendation made in 1996 by the USPSTF that advised older adults to consider periodic examination and counseling regarding the availability of hearing aids. There have been few other studies that have examined the effectiveness of the “treatment” for hearing loss. The statement calls for more studies to be done to understand if screenings can be helpful of harmful for the health of the elderly.

"I think the recommendation is nothing more than a call to action for researchers," commented Jaynee A. Handelsman, vice president of audiology practice for the American Speech-Language-Hearing Association (ASHA), in the Reuters Health article. "The gist of the recommendation is that there is not sufficient evidence to say whether we are or we're not supposed to be screening adults 50 years old and older.”