According to the National Institute on Deafness and Other Communication Disorders (NIDCD), age-related hearing loss (ARHL) or presbycusis is a prevalent condition among aging adults. Approximately 15% of American adults aged 18 and over report experiencing some degree of hearing difficulty, with one in three individuals between the ages of 65 and 74 experiencing hearing loss. Furthermore, nearly half of individuals over the age of 75 struggle with hearing impairment.

In April 2024, the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO–HNSF) released their “Clinical Practice Guideline: Age-Related Hearing Loss”. While there are various causes of hearing loss, the AAO–HNSF’s guideline specifically addresses ARHL, which is characterized by progressive bilateral sensorineural hearing loss associated with the aging process in individuals aged 50 and older. Studies have shown a higher prevalence of high-frequency hearing loss in men compared to women as they age.

The primary objective of the clinical practice guideline (CPG) is to assist clinicians in identifying and managing ARHL as a recognized risk factor that impacts health outcomes and quality of life in the aging population. The CPG aims to utilize the most up-to-date scientific and clinical evidence to educate both clinicians and patients, ultimately enhancing access to hearing healthcare while minimizing sociodemographic and socioeconomic barriers. In instances where evidence is lacking, expert consensus is provided and outlined in the guideline.

In this discussion, we will explore the key takeaways and insights surrounding the guideline’s recommendations for age-related hearing loss. Please note that this list does not encompass all major points. For a complete list of recommendations, refer to the full text guideline located here or the pocket guide provided here.

2024 AAO–HNSF Age-Related Hearing Loss Guidelines – Key Takeaways:

  1. Recommendation for Screening: The guideline recommends that clinicians screen adults aged 50 years and older for age-related hearing loss.
    • It is important to note that there is a rising prevalence of underdiagnosed and undertreated hearing loss, which can result in an increased risk of frailty, depression, cognitive decline, and higher healthcare costs.
  2. Assessment and Examination: If screening indicates hearing loss, clinicians should conduct an examination of the ear canal and tympanic membrane using otoscopy. Alternatively, they may refer patients to a specialist for further evaluation of issues such as cerumen impaction, infection, or other abnormalities.
    • An ear examination can uncover treatable causes of hearing loss and facilitate prompt intervention.
  3. Counseling and Education: It is crucial for clinicians to educate and counsel patients with hearing loss, as well as their family members or care partners, about the impact of hearing loss on communication, safety, function, cognition, and overall quality of life.
  4. Amplification: Clinicians are advised to provide or refer patients to a specialist who can offer properly fitted amplification for individuals experiencing age-related hearing loss. Amplification, when combined with auditory rehabilitation, has been shown to effectively enhance quality of life.
  5. Cochlear Implants: Patients who continue to experience difficulty with speech understanding despite appropriate amplification should be referred for evaluation of cochlear implantation candidacy.
  6. Follow-Up: Regular follow-up visits are recommended to monitor the progression of hearing loss and make necessary adjustments to management strategies.
  7. Shared Decision Making: The guidelines stress the importance of shared decision making between clinicians and patients to determine the most suitable management plan based on individual preferences and values.

The following recommendations are intended to enhance the diagnosis, management, and quality of care for individuals suffering from age-related hearing loss. By doing so, we can improve their overall quality of life and communication abilities. Unfortunately, ageism and negative stigma surrounding hearing loss have led to the neglect of hearing as a health priority. This lack of awareness regarding the detrimental effects of hearing loss, as well as the importance of screening, diagnosis, and treatment, has contributed to the widespread underutilization of hearing healthcare services among the general public.

Thank you for joining us for our Guidelines Spotlight on “Age-Related Hearing Loss.” Please feel free to share your thoughts with us. We look forward to bringing you our next spotlight soon!.

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