In the United Kingdom, two and a half million people over 70 are thought to
have hearing impairment that would benefit from an aid. Only one-third of
these will possess one, and as many as 10 per cent probably never use their
aid. Although it is important to examine the relative merits of different
aids, there is also a need to look at how audiological services may reduce
the unmet need that results from underuse of aids. This review examines the
important question of 'what is the most effective way of providing hearing
aids for the elderly affected by presbyacusis?' Extensive searching of fou
r electronic databases and hand searching of relevant journals revealed the
paucity of evidence to guide audiology practice. In particular there is li
ttle consensus on the best outcome measures for evaluating audiological reh
abilitation or hearing aid fitting. Audiological services for the elderly a
re another example of an area where there is a need to fund research and de
velopment rather than continue to commission services that are variable and
poorly evaluated.