The early prevention of hearing loss in older adults: the public audiology service in Italy

Objective. With the rise in life expectancy and increased age-related hearing loss (ARHL), audiological assessment is essential to enable prevention of cognitive decay associated with social isolation. This study evaluates audiological services in Italy to support future research, prevention strategies, and public health policies. Methods. We analysed national audiological service data in Italy from 2021 to 2023, focusing on the use of pure-tone and speech audiometry. Service provision was examined in relation to population size, estimated ARHL prevalence, and availability of specialised personnel. Results. The number of pure tone audiometry tests rose from 634,996 in 2021 to 790,245 in 2023; speech audiometry tests increased from 179,279 to 230,008 respectively. The national prevalence of pure-tone and speech audiometry tests performed in 2023 was 1340.1 x 100,000 and 390 x 100,000 respectively. Delivery of audiometry tests varied by area, with the North-East exhibiting the highest prevalence of speech audiometry tests in 2023, whereas pure tone tests were more more prevalent in the North-West of the country. The availability of audiology professionals was limited, with a just 2.16 consultant medical audiologists and 1.82 technicians per 100,000 residents. Conclusions. The supply of audiology tests perfomed in Italy during 2021-2023 was insufficient to meet the growing demand for hearing assessments among the aging population. However, the effectiveness of any screening audiological programme depends not only on the availability of welltrained specialists, but also on effective education programmes for the general population.