Abstract: Background　Primary healthcare institutions play a crucial role in the management of hearing loss in the elderly. However，the available evidence is extensive and fragmented，and there is currently no scientific or standardized clinical practice guideline. Objective　To comprehensively review and analyze the best evidence on the management of hearing loss in community-dwelling older adults within primary health care settings，providing a reference for clinical practice and guideline development. Methods　Systematic searches were conducted in BMJ Best Practice，UpToDate，International Guideline Collaboration，Medlive.cn，National Institute for Health and Care Excellence，World Health Organization，National Guideline Clearinghouse，Canadian Medical Practice Guidelines Network，Scottish Intercollegiate Guidelines Network，Ontario Nurses Association，Joanna Briggs Institute（JBI）Collaboration Centre Library，Cochrane Library，PubMed，Web of Science， CINAHL，CNKI，Wanfang Data，and China Biomedical Literature Database. The search covered all evidence related to the management of hearing loss in older adults，including clinical decisions，guidelines，systematic reviews，and expert consensus，published between January 2014 and September 2024. The best available evidence was summarized according to the JBI Evidence-Based Healthcare Center's grading system（2016 version）. Results　A total of 14 documents were included，consisting of 2 clinical decisions，5 guidelines，5 systematic reviews，and 2 expert consensus reports. 35 pieces of best evidence were identified，covering 8 key areas：clinical characteristics of hearing loss，screening，assessment，referral，support for hearing assistive devices，hearing rehabilitation training，social support and health education. Conclusion　The best evidence for managing hearing loss in elderly individuals developed in this study provides evidence-based support for primary healthcare professionals，helping them manage elderly patients' hearing loss in a standardized and scientific manner，thereby improving their hearing health and overall well-being.

Key words: Primary health care, Hearing loss, Aged, Evidence-based medicine, Management, Evidence synthesis

摘要： 背景　初级卫生保健机构在老年听力损失管理方面的作用至关重要，但目前其证据内容广泛且分散，临床尚无科学、规范的实践指导方案。目的　全面检索和分析初级卫生保健机构关于老年人听力损失管理的最佳证据，为临床实践与标准制订提供参考。方法　系统检索BMJ Best Practice、UpToDate、国际指南协作网、医脉通、英国卫生与保健研究所、世界卫生组织、美国国立指南库、加拿大临床医学实践网、苏格兰学院间指南网、加拿大安大略注册护士协会、JBI循证卫生保健国际合作中心图书馆、Cochrane Library、PubMed、Web of Science、CINAHL、中国知网、万方数据知识服务平台和中国生物医学文献数据库中关于老年人听力损失管理的所有证据，包括临床决策、指南、系统评价和专家共识等。检索时限为2014年1月—2024年9月。依据JBI循证卫生保健中心证据预分级系统（2016版）进行证据分级，对最佳证据进行汇总。结果　共纳入文献14篇文献，包括临床决策2篇、指南5篇、系统评价5篇和专家共识2篇。总结出35条最佳证据，共涉及社区老年人听力损失的临床特征、筛查、综合评估、转诊、听力辅助设备支持、听力康复训练、社会支持和健康教育8个方面。结论　本研究制订的老年人听力损失管理的最佳证据可为基层卫生保健人员提供循证支持，帮助其以规范、科学的方法有效管理老年人的听力损失，从而改善老年人的听力健康和整体福祉。

关键词: 初级卫生保健, 听力损失, 老年人, 循证医学, 管理, 证据总结