Why aren’t hearing checks part of routine screening?

Colon and breast cancer screenings may not benefit older adults, the US Preventive Services Task Force says, but you’d think screenings for age-related hearing loss would. Hearing loss is the third most common health problem of older adults, according to the website Hearing Loss. 

Yet the USPSTF says that there is insufficient evidence to recommend hearing screenings. If you doctor listens to the USPSTF, I’ll bet you’ve never been asked during a medical exam whether you’ve had your hearing checked.

It just seems like common sense: Screening older adults for hearing loss is a cheap, effective, harmless way to determine if their hearing ability has worsened and might be helped with a hearing aid. And yet the US Preventive Services Task Force won’t recommend routine hearing exams for those 50 and older,” Candy Sagon blogged on the AARP website. “They won’t even commit to recommending that doctors ask about any hearing problems in older adults. Does this make sense?” 

Seniors are left to judge for ourselves whether we’re having trouble hearing. And since there’s still a stigma about wearing hearing aids, many older people say they’re hearing just fine.

I might have been among them had Northwestern University not offered hearing screenings during the annual employee health fair. The quick screening when I was age 58 showed a hearing decline in the upper frequencies — not enough to recommend hearing aids, but I was advised to pay attention for hearing difficulties. When I went on Medicare, my Medicare Advantage plan offered $2,000 toward hearing aids, so I decided to be tested by an audiologist. By then my hearing loss in the high frequencies was mild to moderate, and I was prescribed behind-the-ear hearing aids. I had no trouble adjusting in my 60s, while my late father, who started wearing hearing aids in his 90s, hated them. Another reason to be checked sooner rather than later.

Unsurprisingly, the advice of many audiologists differs from that of the USPSTF. The American Speech-Language-Hearing Association recommends a hearing check every three years for people over 50, when presbycusis (age-related hearing loss) begins to show up. By age 75, almost half of Americans suffer hearing loss and the accompanying risks of social isolation, depression, cognitive decline, and other problems.

The USPSTF advice may be different the next time around. If you go to the its page about hearing loss, you’ll see a yellow box reporting that the topic is being updated. 

As the USPSTF reviews its recommendations, it would be nice if Medicare rethought its noncoverage of hearing screenings. Medicare recipients have to pay for screenings, unless they are in a Medicare Advantage Plan. Traditional Medicare also doesn’t pay for hearing aids. The over-the-counter devices that the Food and Drug Administration is expected to approve may be an option to cut expenses, as long as people can adjust the devices on their own. 

But first things first: getting your hearing checked. You can access remote screening online and by phone in a number of places. The National Hearing Test ($8) is available at this link or by calling 800-299-9195. Many hearing aid manufacturers also offer online tests on their websites.


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  • Thanks for an interesting analysis. My doctor isn't calling me in for a while yet, so I have a do-it-myself hearing test: I leave my radio, recorded music, TV or PC on and go outside my apartment door. If I cannot hear it, it's low enough. (I wish my neighbors would try this.)

    As for hearing loss leading to increasing isolation, I'll wager I'm not the only 50-plus person living along who sees that and thinks "Ugh! Not more! I'll be careful!"

  • In reply to Margaret H. Laing:

    Interesting way to check whether your hearing ability has changed, Margaret.

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