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Only 9% of primary-care doctors in the United States offer hearing testing to patients aged 65 years or older despite the high prevalence and the severe burdens of hearing loss, including depression and functional decline.

On this basis, a comprehensive review published in April, 2003, in the Journal of the American Medical Association points out that tests that reliably detect hearing loss are simple to administer and endorsed by most professional organizations, including the US Preventive Services Task Force and the Canadian Task Force on Preventive Health Care.

One such test is the use of an audioscope, a hand-held combination otoscope and audiometer. Another is a self-administered questionnaire, the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S), which the patient fills out in the waiting room.

Routine screening may be helpful because it is difficult to diagnose hearing loss in the primary care setting. The onset of presbycusis is insidious, and patients, themselves, are frequently unaware of their hearing loss, while the doctors may overlook presbycusis in a quiet examination room, since the symptoms are more apparent in settings with background noise.

In their review of 1,592 articles and studies on hearing loss in elderly adults, the authors of the JAMA article indicate that the audiometer test and the HHIE-S used in combination provide easy and particularly reliable screening, creating the necessary basis for treatment and/or referrals to specialists.

Source: Journal of the American Medical Association, 2003; volume 289 No.15, April 16, 2003.

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