Hearing screening for healthy aging: the U.K. should take a targeted approach.

Hearing loss affects an estimated 18 million U.K. adults and is the third leading cause of years lived with disability worldwide. Hearing loss diminishes quality of life, activities of daily living, mental health, and negatively impacts the economy. When left unaddressed, hearing loss exacerbates health inequalities and is associated with an increased risk of developing dementia. Hearing loss and dementia frequently co-occur and have overlapping risk factors. People from disadvantaged backgrounds typically access hearing and memory services at a more progressed stage of their conditions. Early intervention is essential to mitigate negative effects and reduce disease burden. Universal adult hearing screening is not currently recommended by the U.K. National Screening Committee, despite evidence of cost-effectiveness and international recommendations. We argue that the U.K. should adopt targeted, risk-stratified screening that prioritizes those at greatest risk of dementia and people in deprived communities, where unmet need is highest. Such an approach is practical, equitable, and consistent with the Governments' prevention and personalized care agenda set out in the 10-year Health Plan for England. We outline the evidence, discuss implementation pathways and targeting strategies, and call on policymakers to commission a targeted, risk-stratified adult hearing screening pilot. A successful program would address unmet need, reduce inequalities, and further inform global debates on hearing screening strategies.