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The aim of this study was to assess the prevalence of hearing loss among people aged 65 years and over and to offer hearing aids where necessary. The study was carried out in a large health centre practice in Birmingham with a computerized record system. All patients aged 65 years, and a 20% random sample of patients aged 66 years and over were invited for interview. They were questioned about hearing loss and examined audiometrically. All patients with a hearing loss in the better ear of 35 decibels or more over the speech frequencies (0.5-4 kHz) were offered a hearing aid. A total of 322 patients attended (72% of those invited) and of these 34 patients already had a hearing aid. A further 142 patients were identified for whom an aid was recommended and 69 of these accepted. The acceptance rate was higher among men than women (57% compared with 43%). Sixty one patients (19% of those screened) had an asymmetrical hearing loss and of these 24 required consultant assessment; none had serious underlying pathology. There is a large unmet need for hearing aid provision. Simple audiometric assessment in health centres provides an opportunity to meet this need.