Adult hearing loss

Identification and evaluation of adult hearing loss is an important task for primary care physicians. Recent studies reporting the reliability and validity of simple testing instruments reinforce this conclusion. Although most cases will be secondary to noise exposure or age-related and benefit from amplification, a diligent search for more unusual causes, some of which have specific curative therapy, is always needed. The initial prescription and fitting of hearing aids is the realm of the audiologist. The primary care physician can enhance the treatment program by providing global evaluation, educating the patient as to likely therapy and realistic expectations of results, and providing long-term follow-up and functional assessment of hearing aid use. The burden of hearing loss is particularly heavy in the nursing home population. In this arena, the physician can ease the burden by being attentive to the possibility of hearing loss causing unexpected behavior, searching for, and when possible, treating reversible causes, and using assistive devices and behavioral techniques to enhance communication when the hearing impairment cannot be corrected.