Monitoring hearing and vision functions in older adults: rationale and process

Hearing and vision impairment are highly prevalent in ageing individuals and are significant public health concerns given their meaningful impacts on individuals and society. Yet, many cases of both visual and hearing impairment remain unidentified and thus, unaddressed. This article describes the rationale and process of monitoring for visual and hearing impairment in older adults, by summarising guidance and resources available from the World Health Organisation (WHO) that were developed based upon the best current available evidence. It is recommended that vision screening be offered at least annually to adults aged over 50 years and hearing screening be offered every 5 years to adults aged 50-64 years, and every 1-3 years to adults aged 65 years or older. Both hearing and vision screening can be conducted in community, home or clinical settings by trained health workers with simple equipment. More specifically, vision screening can be conducted with a simple eye chart. Hearing screening can be conducted without specialised equipment by using pure tones set to a fixed level, an automated mobile- or web-based digits-in-noise test, or the whispered voice test. Hearing screening can also be conducted in audiology clinics using pure-tone air conduction threshold testing. There exists WHO guidance to support the monitoring of hearing and vision impairment, which, when warranted, can facilitate referral for comprehensive assessment and prompt appropriate, person-centred interventions to mitigate the negative consequences of hearing and vision impairment.