Abstract
Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. Purpose: The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. Action Statements: The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
Original language | English |
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Pages (from-to) | S1-S54 |
Journal | Otolaryngology - Head and Neck Surgery (United States) |
Volume | 170 |
Issue number | S2 |
DOIs | |
State | Published - May 2024 |
Bibliographical note
Publisher Copyright:© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
Funding
Betty S. Tsai Do, none; Matthew L. Bush, research funding (Advanced Bionics), consultant\u2014travel fees only (Stryker), advisory board (Med El); Heather M. Weinreich, none; Seth R. Schwartz, none; Samantha Anne, royalty (Plural Publishing royalties); Oliver F. Adunka, royalty (Advanced Bionics, Inc.), consulting fee (Advanced Bionics, MED\u2010EL Corporation), intellectual property rights (Advanced Cochlear Diagnostics); Kaye Bender, none; Kristen M. Bold, none; Michael J. Brenner, research funding (Unrestricted Educational Grant\u2014Medtronic, AAO\u2010HNSF CORE Grants, University of Michigan Research Innovation Grant); Note: None of these grants are related to Hearing Loss; Ardeshir Z. Hashmi, Consulting Fee (Cognivue Inc. Advisory Board, AI Based Cognitive Assessment Device); Ana H. Kim, research funding (Advanced Bionic research funding for Single sided deafness research), Medical Consultant for Advanced Bionic; Teresa A. Keenan, none; Den\u00E9e J. Moore, none; Carrie L. Nieman, no disclosures related to for\u2010profit entities; Catherine V. Palmer, salary (University of Pittsburgh, UPMC), consulting fee (Thieme Publisher, NBME); Erin J. Ross, none; Kristen K. Steenerson, consulting fee (Medical\u2010legal independent consulting), Honoraria (Otolith), Stock or Stock Options (Neuro\u2010Sync, Otolith); Kevin Y. Zhan, MD, none; Joe Reyes, salaried employee of the AAO\u2010HNSF; Nui Dhepyasuwan, salaried employee of the AAO\u2010HNSF.
Funders | Funder number |
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Advanced Bionics Corporation | |
Medtronic | |
AAO-HNSF | |
Michigan Retirement Research Center, University of Michigan |
Keywords
- age-related hearing loss
- amplification
- cochlear implantation
- presbycusis
- sensorineural hearing loss
ASJC Scopus subject areas
- Surgery
- Otorhinolaryngology