One Question Could Catch Hearing Loss

A simple, single-question hearing screening administered by medical assistants could effectively identify older adults with untreated hearing loss, according to a study presented at the Gerontological Society of America (GSA) 2024 Annual Scientific Meeting.
The study, conducted by researchers at the University of Massachusetts Amherst, involved 49 participants aged between 56 and 90 years who attended a health clinic with a Program for All-Inclusive Care for the Elderly (PACE). Most of the participants who are in PACE are dually eligible for both Medicare and Medicaid.
Medical assistants were trained to incorporate the following single-question hearing screener during health clinic appointments: “Do you have any difficulty with your hearing (without hearing aids)?” The screening offered a Likert-scale option of responses.
“A single-question hearing screener requires no equipment,” said study author Sara Mamo, AuD, PhD, and associate professor of Speech, Language, and Hearing Sciences at the University of Massachusetts Amherst. “It simply requires a systemic belief that addressing hearing loss matters.”
Following these screenings, the research team conducted on-site hearing threshold testing to evaluate the effectiveness of the method.
Mamo and her research team found that nearly three quarters of the participants had some degree of hearing loss, with 24 individuals showing mild hearing loss and 11 exhibiting moderate or worse hearing loss.
None of the participants were current users of hearing aids, which underscores the widespread issue of untreated hearing loss in older adults, according to Mamo.
“One benefit of screening by asking a question is that the patient who says ‘yes’ to having difficulty is more likely to accept support to address the difficulty,” said Mamo. “A medical provider asking about hearing loss is an important cue to action.”
The results showed a sensitivity of 71.4% and a specificity of 42.9%, suggesting that this simple screening can help identify individuals with untreated hearing loss during routine health visits.
Despite known links between age-related hearing loss and increased risks for dementia, depression, and loneliness, the US Preventive Services Task Force does not currently recommend routine hearing loss screening for adults.
“With minimal burden, we can identify individuals with untreated hearing loss during routine health appointments,” she said.
Carla Perissinotto, MD, MHS, professor in the Division of Geriatrics at the University of California, San Francisco, agreed.
“We do not screen enough for hearing loss,” said Perissinotto, who was not involved in the study.
The researchers also provide practical communication tips for healthcare providers working with patients with untreated hearing loss. These include speaking face-to-face, speaking slowly, and using personal sound amplifiers.
Perissinotto added that integrating an individual’s hearing status into their medical records could enhance overall care and any future communication strategies.
“Writing hearing status [into medical records] prominently could be very important, as I have had patients inappropriately labeled as having dementia when it was a hearing issue,” said Perissinotto.
Mamo and Perissinotto had no conflicts of interest.
Lara Salahi is a freelance journalist living in Boston.
 
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