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The UK should take steps towards adopting a targeted, risk-stratified adult hearing screening programme that prioritises people with the highest risk of dementia and people in deprived communities, according to researchers from Nottingham Biomedical Research Centre's Hearing Theme. 

Hearing loss and dementia experts say a focused approach to hearing screening could help reduce health inequalities while supporting healthy ageing and the dementia prevention agenda. Their recommendations are outlined in a paper published in leading journal The Gerontologist.

Researchers from the Nottingham BRC who have supported this work have been examining the impact of hearing loss – which affects an estimated 18 million adults in the UK – and its overlap with dementia. The authors propose methodologies and suggest a shift in policy to support early identification and intervention for those most at risk.

The UK National Screening Committee does not currently recommend universal adult hearing screening. Although, research points to evidence of its cost effectiveness, there are practical implications, and therefore authors set out an approach that may be more feasible.

In arguing for a large-scale pilot programme to support a national policy shift towards risk-stratified screening, authors say that such a programme would be:

“Practical, equitable, and consistent with the Government’s prevention and personalised care agenda set out in the 10-year Health Plan for England.”

Jack Stancel-Lewis, first author of the paper, recent MBA graduate and Honorary Research Associate at the University of Nottingham, said:

“Hearing loss, when left unaddressed, can diminish health related quality of life, widen health inequalities and undermine healthy ageing.

“Research indicates that adults in the UK, with gradually progressive hearing loss, take on average around a decade to seek help. People from disadvantaged backgrounds typically access services when their condition is more progressed. Hearing loss is associated with range of adverse health conditions, including cognitive decline and dementia, sharing overlapping risk factors.

"Earlier intervention may mitigate negative effects, particularly in people with the highest risk, and reduce overall disease burden – we set out practical options felt worthy of large-scale piloting."

Dr Helen Henshaw, Principal Research Fellow at the Nottingham BRC Hearing Theme – one of just three such specialist hearing centres in the UK – is a co-author on the paper.

She said: “We believe a successful screening programme of this kind would serve to address unmet need, reduce inequalities and would further inform global debates on hearing screening strategies.

“This call to action builds upon previous work our BRC has done on co-existing dementia and hearing conditions, in particular the public agenda for future research.”

In July 2025, the James Lind Alliance and partners published the Top 10 research priorities for people with co-existing dementia and hearing conditions.

Two of the questions prioritised for research by patients, carers and clinicians ask whether routine health checks should assess both hearing and cognition, and whether screening hearing could improve outcomes for those at risk of dementia.

This Priority Setting Partnership (PSP) was the result of work carried out by researchers at the Nottingham BRC and the University of Nottingham, in partnership with Alzheimer’s Research UK and RNID (Royal National Institute for Deaf People).

More information on the PSP Top 10 is available here.