Age-related hearing loss (presbycusis) affects a substantial proportion of older adults and is frequently encountered in family medicine and primary care settings, yet it remains significantly under-detected and under-managed despite its impact on communication, cognitive function, and quality of life. This systematic review synthesised evidence on the early detection and management of hearing loss in adults aged 55 years and older within family medicine and primary care contexts, with a focus on ear, nose, and throat (ENT)-related outcomes. A systematic search of PubMed, Google Scholar, and the Cochrane Library was conducted from 2000 to 2026 using terms related to hearing loss, presbycusis, screening, primary care, and family medicine. Eligible studies included original research, randomised controlled trials (RCTs), cohort studies, cross-sectional studies, and pragmatic trials, reporting ENT-related outcomes in primary care or community health settings. Studies were quality-appraised using design-appropriate tools: Cochrane Risk of Bias 2 (RoB 2) for RCTs, Newcastle-Ottawa Scale for cohort studies, Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) for diagnostic accuracy studies, Appraisal Tool for Cross-Sectional Studies (AXIS) for cross-sectional surveys, and Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) for non-randomised interventional studies. Of 888 records identified, 11 studies were included after deduplication and screening and were synthesised narratively, comprising a total of 25,964 participants across six countries. Screening tools, including the Hearing Handicap Inventory for the Elderly-Screening version (HHIE-S), whispered voice test, single-question screening, and smartphone-based audiometry, demonstrated moderate-to-high diagnostic accuracy when validated against pure-tone audiometry. Primary care-based electronic screening alerts increased audiology referral rates by approximately fivefold. Both conventional hearing aids and personal sound amplification devices improved self-perceived hearing function, and hearing aid use was associated with reduced emergency department visits and hospitalisations. General practitioners (GPs) demonstrated suboptimal knowledge and practices regarding age-related hearing loss screening. Overall, the evidence supports integrating structured hearing screening protocols into family medicine using validated brief tools and electronic health record alerts, while management through hearing aids and community-based amplification models is effective; however, addressing GP knowledge gaps and systemic barriers is essential to translate evidence into routine primary care practice.
Almutairi et al. (Mon,) studied this question.