Evidence Insufficient to Recommend For, Against Screening for Hearing Loss in Asymptomatic Older Adults, Says USPSTF

In conjunction with the U.S. Preventive Services Task Force (USPSTF), the AFFP has concluded that evidence currently is insufficient to assess the balance of benefits and harms of screening asymptomatic adults 50 years and older for hearing loss.

An update to the task force's 1996 guidance, the I statement applies to adults aged 50 years and older who show no signs or symptoms of hearing loss, family physician and USPSTF member Joy Melnikow, M.D., M.P.H., of Sacramento, Calif., told AAFP News Now.

"This is not a statement about what to do when someone comes in, or is brought in by their caregiver, complaining about hearing loss," Melnikow said. "This is about someone who comes in and doesn't bring it up."

Melnikow said more evidence exists now than what was available in 1996, and there is convincing data showing that current screening tools reliably and accurately identify adults with objective hearing loss. However, the evidence still doesn't pass muster with regard to determining whether screening for hearing loss improves health outcomes in individuals who are unaware of hearing loss or have perceived hearing loss but have not sought care.

"In fact, there was one trial that came out and filled in some of the gaps, but what we really need in order to sort this out is a trial that looks at function after screening," said Melnikow. "And I don't know if that trial will ever be done or not. What we need to know is that when people don't complain that they have a hearing loss, can we help them if we ask and screen them anyway."

Age-related sensorineural hearing loss is a common health problem among adults aged 50 years or older and can affect social functioning and quality of life. According to the recommendation, clinical tests currently used to screen for hearing impairment include testing whether a person can hear a whispered voice, a finger rub, or a watch tick at a specific distance. Perceived hearing loss can be assessed by asking a single question or with a more detailed questionnaire.

Melnikow said this latest update will not influence her to change how she treats her patients.

"I evaluate hearing loss based on a concern from the patient or a caregiver," she said. "And whenever anyone expresses a concern, I evaluate it."