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J Am Geriatr Soc. 2017 Aug;65(8):1642-1649. doi: 10.1111/jgs.14860. Epub 2017 Apr 24.

Studies of Physician-Patient Communication with Older Patients: How Often is Hearing Loss Considered? A Systematic Literature Review.

Author information

State University of New York Upstate Medical University, Syracuse, New York.
Wagner Graduate School of Public Service, New York University, New York, New York.
Department of Population Health, New York University School of Medicine, New York, New York.
Doctor of Audiology Program, The Graduate Center, City University of New York, New York, New York.
Oregon Health & Science University School of Medicine, Portland, Oregon.
Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, New York.
Department of Emergency Medicine, New York University School of Medicine, New York, New York.
VA New York Harbor Heathcare System, New York, New York.


Hearing loss is remarkably prevalent in the geriatric population: one-quarter of adults aged 60-69 and 80% of adults aged 80 years and older have bilateral disabling loss. Only about one in five adults with hearing loss wears a hearing aid, leaving many vulnerable to poor communication with healthcare providers. We quantified the extent to which hearing loss is mentioned in studies of physician-patient communication with older patients, and the degree to which hearing loss is incorporated into analyses and findings. We conducted a structured literature search within PubMed for original studies of physician-patient communication with older patients that were published since 2000, using the natural language phrase "older patient physician communication." We identified 409 papers in the initial search, and included 67 in this systematic review. Of the 67 papers, only 16 studies (23.9%) included any mention of hearing loss. In six of the 16 studies, hearing loss was mentioned only; in four studies, hearing loss was used as an exclusion criterion; and in two studies, the extent of hearing loss was measured and reported for the sample, with no further analysis. Three studies examined or reported on an association between hearing loss and the quality of physician-patient communication. One study included an intervention to temporarily mitigate hearing loss to improve communication. Less than one-quarter of studies of physician-elderly patient communication even mention that hearing loss may affect communication. Methodologically, this means that many studies may have omitted an important potential confounder. Perhaps more importantly, research in this field has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication.


communication; hearing loss; physician-patient

[Indexed for MEDLINE]

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