Hearing assessment as part of the Comprehensive Geriatric Assessment - A pilot study

Abstract Background Dementia currently affects approximately 57 million people worldwide, with projections indicating a near threefold increase to 153 million by 2050. In Ireland, 64,142 individuals were living with dementia in 2020, with figures expected to more than double by 2045. The 2024 Lancet Commission highlights 14 modifiable risk factors, attributing 7% of preventable dementia cases to hearing loss alone. Hearing loss affects 65% of adults over 60 and ranks as the third leading cause of chronic disability in this age group. It is closely linked to increased dementia risk and all-cause mortality. Despite this evidence, audiological assessment is not routinely integrated into Comprehensive Geriatric Assessment (CGA) in Ireland. This pilot study explored the feasibility and benefits of embedding audiological screening within CGA. Methods Over 12 months, an audiologist participated weekly in CGA delivery at St. Vincent’s University Hospital (SVUH). Patients received hearing screenings, informational leaflets, and on-site services such as earwax removal and minor hearing aid repairs. Data collected included screening outcomes, age, otoscopic findings, hearing aid use, and medical card status. Referrals were made for full audiological assessment and hearing aid fitting when required. Results Of 122 patients reviewed (mean age 84, range 70–97), 80% completed screening; 91% of these were referred for full audiological assessment. Among screened patients, 73% failed, 17% were advised follow-up within a year, and 10% passed. One-third were already using hearing aids. Earwax impaction was found in 55%, with 49% receiving removal. Of 89 referred patients, 61 had scheduled appointments, with 61% attending and 76% of these proceeding to hearing aid fitting. Conclusion Audiology referrals from the Care of the Older Persons Service increased five-fold, from 9 in 2023 to 45 in 2024. Integration proved feasible, well-received, and potentially impactful, with plans underway to train nursing staff to support ongoing delivery and scalability.