Summary

What it measures:

Various patient-reported and clinician-administered tools can screen individuals for auditory impairment.

Target Population:

• Individuals aged 50 and above
  • Prevalence of hearing loss among adults in the United States is 17-23%,^1,2 and it increases with age: 60-69 = 45%; 70-79 = 68%; 80+ = 90%.²
• May be indicated for patients with acute vertigo.

International Classification of Functioning, Disability and Health (ICF)

Domain: Body Function

Category: b230 Hearing

Taskforce Recommendations:

Although the 2021 U.S. Preventive Services Task Force found insufficient evidence to assess whether the benefits of screening for hearing loss in older adults outweigh the harms, ³ the 2024 American Academy of Otolaryngology, Head and Neck Surgery's Clinical Practice Guideline, Age-Related Hearing Loss Executive Summary, recommends screening individuals 50+ for hearing loss to improve early identification, promote effective communication with the patient, and improve awareness of the prevalence of hearing loss.⁴

Through appropriate screening and referrals, physical therapists can play a role in supporting the nation's Healthy People 2030 goal to "increase the proportion of adults who have had a hearing examination within the past 5 years."⁵

Clinical Insights

• Hearing loss can impact quality of life, including areas of communication, mental health, social isolation, cognition, falls, and hospitalizations.^6,7
• Hearing loss has been found to be correlated with cognitive testing in older adults and can be useful in identifying individuals at risk for cognitive impairment.⁸
• Age-related hearing loss is a risk factor for dementia and depression related to increased social isolation, changes in the brain, and depleting cognitive reserve. Aging individuals with hearing loss are also less likely to participate in physical activity, which contributes to increased risk of cardiovascular disease and hearing loss.⁴
• New onset hearing loss in patients with acute vestibular syndrome may be indicative of central cause of vertigo.^9,10 Screening for hearing loss using finger rub in addition to the Head Impulse, Nystagmus, Test of Skew (HINTS) exam increases exam sensitivity and is referred to as HINTS Plus.¹¹
• A positive hearing screen warrants a referral to an appropriate health care professional. Clinicians also may consider following up a positive hearing screen with Weber and Rinne hearing tests to differentiate sensorineural, conductive, or mixed and unilateral or symmetrical hearing loss.⁶