Hearing tests are cheap and effective. There are no known health harms. And they can identify older adults with compromised hearing who might benefit from using a hearing aid.
So why didn’t the United States Preventive Services Task Force’s new statement, published Monday in Annals of Internal Medicine, advise that adults age 50 and older be screened for hearing problems?
“We just don’t have enough evidence to show there would be a benefit,” said Dr. Albert Siu, a vice chairman of the task force and chairman of geriatrics at Mount Sinai School of Medicine. “Hearing loss hasn’t been adequately addressed in the research literature.”
That’s an understatement. Although mild to severe hearing loss affects 27 million adults ages 50 and older, only one randomized controlled trial — the gold standard of medical research — has looked at the effect of screening for hearing problems in this population.
The results of that study, known as SAI-WHAT (Screening for Auditory Impairment-Which Hearing Assessment Test), found that adults who tested positive for hearing loss were more likely to use a hearing aid one year later. But the effects were modest, and the study had significant limitations. Notably, a sizable majority of participants reported some hearing problems before it began, so results can’t be generalized to older adults without symptoms — the population addressed by the new task force recommendations.
This paucity of research is remarkable, given that hearing loss is the third most common health condition affecting older adults, behind hypertension and arthritis. But it’s not altogether surprising, given that this condition has traditionally been considered a natural consequence of aging and that it remains underdiagnosed and untreated in older adults.