Adrenaline auto-injector prescribing may be putting patients at risk

1 is apposite in view of the publication in July of the Lancet Commissions' report Dementia prevention, intervention, and care, which expands on several of the themes raised. 2 In particular, the editorial's focus on the role of general practice in prevention and research is to be welcomed.However they do not mention hearing loss, to which the Lancet report devotes considerable space and ascribes a significant potential preventive role.Hearing loss is independently associated with developing dementia in about one-third of cases.Recent research has suggested that use of hearing aids may reduce or prevent the increased prevalence of dementia seen in adults with hearing loss. 3,4This needs confirmation, as current evidence is weak due to the large number of confounding factors.General practice is ideally suited to carry out this research thanks to our largescale and long-duration databases.In the meanwhile, GPs are likely to see increasing numbers of patients asking for referral for hearing aids, as some in the commercial sector are stating this benefit of hearing aids as fact.Such referral should be expedited; GPs are sometimes accused of minimising hearing loss and delaying referral, but early users of hearing aids are more likely to use aids successfully over a longer timescale as they can be difficult to use.Hearing loss is associated with depression and social isolation; 5 denial of the disability is common, as is irritability and interference with relationships.By the age of 70 years, 70% of GP patients have hearing loss.If in doubt, or if the patient is reluctant, a simple validated screening test is available over the phone or online.