A woman having a hearing test with an otoscope.

Difficulty hearing can have profound effects. It has been associated with depression, concentration, and memory problems, may take a significant toll on relationships with friends, family, and co-workers, and is possibly even linked to dementia.

But in a Consumer Reports survey of more than 120,000 members on hearing and hearing loss, almost 30 percent said they've gone for more than a decade without getting their hearing tested or have never had it tested at all.

And people may not always recognize when they have a hearing issue. Some older adults may be underestimating their level of hearing loss, according to a new study published in the journal JAMA Otolaryngology-Head & Neck Surgery. This may lead to some people not getting the hearing help they'd benefit from, the researchers say. 

The study, which included 2,613 people age 60 or older, analyzed the way participants rated their own hearing and compared that to the results from hearing tests. The researchers found that 42 percent of people who reported no hearing trouble actually turned out to have mild hearing loss when tested. (The study also found that in people ages 60 to 69, 35 percent of those who thought they had hearing loss didn't.)

More on Hearing

While there are no official evidence-based guidelines on how often to get your hearing checked in adulthood, most medical providers—including audiologists—recommend a screening every three years beginning at age 50, says Sarah Sydlowski, Au.D., Ph.D., audiology director of the Hearing Implant Program at the Cleveland Clinic.

And you might consider being screened every 10 years before that, she adds. (See Centers for Disease Control and Prevention recommendations on hearing screenings for children.) 

Why Getting Tested Is Important

It’s wise to consider this screening schedule even if you have no concerns about your hearing, according to the experts we interviewed. 

Not only is hearing loss associated with some mood and cognitive issues, but it also becomes more common with age. That's due to factors like long-term noise exposure, which damages the tiny hair cells in your ear that allow you to hear, says Paul K. Farrell, Au.D., CCC-A, associate director of audiology practices at the American Speech-Language-Hearing Association.

As we age, we're also more likely to have conditions such as high blood pressure or diabetes, which have been associated with hearing loss.

In addition, it can be easy for people to miss subtle signs of hearing loss. “One of the barriers to care is that individuals with gradual, age-related hearing loss don’t realize they have it,” says Catherine Palmer, Ph.D., director of audiology and hearing aids at the University of Pittsburgh.

Most insurance—including Medicare—will cover the cost of a comprehensive hearing exam as long as you have a referral from your healthcare provider.  

When and how should you get your hearing checked? Here's what you need to know.

Spotting Possible Signs of Hearing Trouble

In addition to considering the screening schedule above, talk with your doctor about having a hearing test if you notice one or more of the following:

  • Conversations sound muffled, almost as if you’re underwater.
  • It's difficult deciphering consonant sounds. “Vowel sounds are made at lower frequencies, which are easier to hear,” says James C. Denneny III, M.D., executive vice president/CEO of the American Academy of Otolaryngology-Head and Neck Surgery.
  • You find hearing in settings with background noise, such as restaurants, is difficult.
  • You're constantly asking people to speak more slowly or repeat themselves.
  • You turn the TV up so loudly that others complain.
  • You have trouble hearing people on the phone.
  • People tell you that you're not hearing what they say. 

Not Sure Whether There's a Problem?

If you’re unsure whether your hearing is faltering, you can take a quick online assessment before seeing a professional, suggests Denneny.

One option is the 8-minute telephone-based National Hearing Test, which was developed by researchers at Indiana University, the VU University Medical Center in Amsterdam, and Communications Disorders Technology.

The American Academy of Audiology has partnered with the digital health company hearX Group to create a self-screening app, hearScreen USA. (If you fail the exam, the app automatically directs you to a local audiologist.)

You can also consider trying one of the free hearing screenings that are sometimes offered in drugstores or at health fairs. “If you fail any of these screenings, it doesn’t mean that you have hearing loss, but it’s a sign that you need to see an audiologist for formal evaluation,” says Denneny.

Get Tested Right

When it's time to get tested, start with your primary care physician. He or she will check your ears for physical causes of hearing loss, such as an ear infection or too much earwax

But if there doesn’t seem to be anything blocking your ear canal, you’ll probably need to get your hearing checked by a licensed audiologist. These healthcare professionals have a doctoral degree in audiology (Au.D) and must be licensed in their state.

The audiologist will ask about your medical history and any hearing problems you might have before looking into your ears with a lighted device called an otoscope to make sure there's nothing there that might make it hard to test you properly. 

The most common test is the pure-tone test, says Denneny. Here, you listen for sounds while wearing earphones and raise your hand whenever you hear a beep.

The speech test is also common. For this, the audiologist says words to you through headphones, and you repeat them.

These tests work together to rule out hearing loss, because you may be able to hear a tone or noise but not actually make out the actual sound of words, Sydlowski says. 

Note that some primary care physicians may try to gauge whether or not patients have hearing loss by performing either the whisper test (where they stand behind you and whisper) or a finger rub test (where they rub their fingers together near your ear).

These tests were fairly accurate at picking up possible hearing problems in a 2017 study published in the Journal of the American Geriatric Society.

But they don’t completely exclude the possibility of hearing problems. While you may be able to hear fingers rubbing together, you may still have subtle hearing loss, where you have trouble understanding words, says the study's author, William Strawbridge, Ph.D., M.P.H., an adjunct professor at the Institute of Health & Aging at the University of California in San Francisco. That’s why it makes sense to have your doctor refer you to a licensed audiologist to get your hearing checked.

If the audiologist wants to run more complex tests, such as one for auditory brainstem response—where electrodes are placed on your head to record brainwave activity in response to sounds—and one for otoacoustic emissions, which uses a probe in your ear to measure sounds, ask why and whether the results will alter your treatment.

These generally aren’t required to diagnose most cases of hearing loss, says Denneny. You usually need these only if the audiologist is concerned about the possibility of hearing loss due to brain damage or a blockage in your middle ear.

If testing reveals that you have a hearing problem, and you're considering hearing aids, see our hearing aid buying guide.