Building epidemiological evidence to fill research gaps for hearing screening of older adults - PROJECT SUMMARY/ABSTRACT Age-related hearing loss (ARHL) is a highly prevalent chronic condition and is associated with poorer psychosocial well-being, communication, and cognitive function. However, there are long delays between the time of hearing loss onset and its diagnosis, as well as its diagnosis and treatment, placing individuals at risk of experiencing the negative consequences of ARHL and for longer periods of time. On a population level, systematic screening could promote the earlier awareness, detection and management of ARHL, which ultimately could mitigate some negative consequences of ARHL. However, there are various research gaps, several of which were underscored in a 2021 report from the US Preventive Services Task Force, that must be addressed to implement universal screening for ARHL. Research gaps relate to (i) whether interventions to treat hearing loss, including hearing aids, improve health outcomes among screened adults, (ii) the optimal age to recommend screening and treatment intervention, and whether these recommendations should differ by key risk factors for hearing loss, and (iii) the optimal approaches to screen for ARHL, which could include the use of self-reported measures of hearing. These research gaps could be addressed using epidemiological (observational) studies, however, there are few longitudinal studies of the general population with comprehensive hearing-related measures and sufficiently long follow-up times. In this proposed project, two complementary but distinct aims will leverage data from 5 longitudinal epidemiological studies of the general population with rich hearing data and outcome data related to general and hearing-related health to address the research gaps related to screening for ARHL. Aim 1 will (i) characterize the natural history of ARHL to inform recommendations on the optimal age to begin screening for ARHL and screening intervals, and whether they should vary by key risk factors for hearing loss, such as sex or noise exposure history, and (ii) determine the optimal hearing-related question(s) that could be used to screen for ARHL. Aim 2 will (i) determine benefits of hearing aid use across wide-ranging outcomes of general and hearing-related health, and predictors of hearing aid benefit, and (ii) determine whether age of hearing aid uptake is a predictor of long-term benefit, to evaluate whether there is an optimal age to recommend treatment. Results from this project could inform policy recommendations related to screening for ARHL, in terms of at what age it should begin, how often it should occur, and with which methods. Moreover, the results could inform the design of clinical trials to evaluate the effectiveness of screening on outcomes of general health. This project and line of research directly address the National Academies of Sciences, Engineering, and Medicine (2016) recommendation to improve prospective population-based evidence on impacts of ARHL and its treatment and aligns with NIDCD’s 2023-2027 Strategic Plan on secondary and tertiary prevention and health promotion for individuals with ARHL.
