Aging Options

Hearing Aids Improve How We Hear – and How We Think

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Are you or a spouse experiencing hearing loss? If you’re over 65, according to the National Council on Aging, the odds are about one in three that the answer is yes. If you’re 75 or older, there’s a 40 percent chance that hearing loss is part of your life or that of a loved one. 

If hearing loss is a problem, what are you doing to help solve it? After reading this recent article from NextAvenue, we’ve learned the sad answer: most people do nothing. Instead, they wait an average of seven to nine years before seeking help, and that, says the article by author and editor Anneke Campbell, is a serious mistake. That’s because hearing loss affects much more than how we hear: it can also affect how we think. A wide range of serious conditions in older adults can be traced to untreated hearing loss. 

Let’s take a closer look at Campbell’s article. As you read, ask yourself if this article describes you or someone you love. Perhaps it’s well past time to take remedial action. 

Don’t Ignore Hearing Loss, Even if it’s Age-Related  

Campbell has personal experience with impaired hearing. “I was starting to notice that at busy restaurants, I could not distinguish voices clearly from the background noise,” she writes. “At the same time my mate Jeremy had more trouble hearing me in our own quiet home, and I found myself getting irritated repeating myself over and over.” 

A friend with knowledge of hearing loss urged the couple to see an audiologist immediately and get hearing aids. Campbell protested that her hearing had been tested recently and, while she had some hearing loss, her doctor called it “slight” and normal for her age. “I could wait a while before being fitted for hearing aids,” her physician had told her. 

But her friend pushed back. “Yes,” she told Campbell, “some degree of hearing loss is normal as we age, but it’s usually so gradual you don’t notice it and you lose a lot before it becomes hard to distinguish the pattern. Imagine people telling you not to bother with glasses, that your vision is normal for your age? Does ‘normal for your age’ mean not driving? No, you get glasses.” 

Most People Ignore Hearing Problems for 7-9 Years 

Campbell was persuaded by her zealous friend, and she sought out a new audiologist. But her fast action puts her in the minority. 

“It turns out most people wait seven to nine years before seeking intervention,” she writes, “even though it is now well established that hearing loss impairs how we think, and mounting evidence that it is accompanied by cognitive decline and even dementia. Yet people often resist being tested, buying hearing aids or wearing them after purchase.” 

She says she started noticing this reluctance in others who had hearing aids but did not like using them. For some, their hearing problems were a minor annoyance; for others, such as one woman resentful of her husband’s unwillingness to socialize because he couldn’t join in the conversation, the effects of hearing loss were far more frustrating. 

“It seems obvious that given our ageist culture, many don’t want to appear old or dependent,” Campbell notes. “But we don’t seem to stigmatize dependence on glasses in the same way. I wondered why.” 

Hearing Aids Remain a Target of Stereotype and Prejudice 

In researching her NextAvenue article, Campell interviewed her “new” audiologist, Melissa Alexander. As she told Campbell, “Hearing aids have come a long way in terms of design, functionality and style.” Still, there remains what Campbell describes as a “public prejudice [that] makes many people feel old or handicapped if they use them.” 

Campbell takes aim at the misperception still believed by many that wearing hearing aids creates a kind of laziness in the brain. In fact, the opposite is true: improved hearing stimulates the brain. Alexander cited scientific research showing that the failure to wear hearing aids when they are necessary “can degrade cognition because the brain requires a certain amount of aural stimulation to maintain neural connections, and hearing aids provide that stimulation.” 

The Brain, Not the Ear, Interprets What We Hear 

“Our sense of hearing is always on,” Campbell writes. “The structures and physiology of hearing are incredibly complex. The outer, middle and inner ear, the hair cells, fluid and bones conduct sound but it’s the auditory cortex in the brain that makes sense of and interprets the sound, or ‘hears’ it.” 

And therein lies the problem, says the article. “Over time it’s not just that hearing worsens: the ability to recognize words and understand speech also deteriorates. Losing our ability to translate sounds into words and combine them clearly, means hearing loss impairs how we think, as well as our memory and mood.” The deterioration becomes a downward spiral in which “the brain can forget how to hear something, forget how to listen.” 

Hearing Aids Take Time to Work Properly 

Many of us have family and friends who have tried hearing aids for a short period, only to give up in frustration, but that’s the exact wrong response. The physiology of hearing explains why hearing aids are so complex and expensive – far more than glasses, says Campbell. Moreover, unlike glasses, hearing aids typically will not work instantaneously.  

“They work by teaching the brain to hear again,” she explains, “which takes about a month or two of uninterrupted wear, and maybe some adjustment and coaching. Folks who expect immediate improvement in their hearing may conclude that their hearing aids are not working.” They’re the ones who give up too soon. 

Paying for Hearing Aids is a Mixed Bag 

As Campbell notes, besides the stigma of hearing aids, cost is the chief barrier to adoption.  

“Most health insurance plans, including Medicare, do not cover the cost of hearing aids,” she writes, although Medicare Advantage plans generally do offer modest benefits for hearing exams and hearing aids. There are also a wide range of newer over-the-counter aids designed for use by people with mild to moderate hearing loss. These cost between $100 and $1,000 and can be purchased without a prescription. 

“Hearing aids tailored to an individual’s auditory issues need a prescription,” Campbell writes, “and cost from $1,000 to $7,500 or more; the median cost is roughly $2,500—a price unaffordable to 77 percent of Americans with functional hearing loss, according to one recent study.” 

The Cost of Inaction is Far Greater 

On the other hand, Campbell’s article makes an important point: hearing aids might be expensive, but the social cost of leaving hearing loss untreated is far greater. That’s because of what Campbell calls “the correlation between hearing loss and diminished cognition or even dementia — and the fact that dementia is very expensive to treat.” 

We lack the space here to include all of Campbell’s arguments, but they are persuasive. For example, she cites one New York study that compared total health care expenses over the final five years of life for 1,700 research subjects – some with dementia, some with cancer, a third group with heart disease, and a final group who died from other causes. The 5-year care cost for patients with dementia exceeded the others by as much as 66 percent.  

Another study, by scientists at Johns Hopkins University in Baltimore, found that hearing aids reduced the rate of cognitive decline in older adults at high risk of dementia by almost 50 percent over a three-year period. Similarly, Campbell writes, “an article published in the medical journal Frontiers in Neuroscience in 2022 said that giving older people hearing aids for just six months improved their cortical and cognitive function and offset physical changes in the brain. Even when the aids were removed, patients’ brains showed signs of reorganizing.” 

Hearing Aids Can Slow Cognitive Decline, Improve Relationships 

Campbell makes the case that wider availability of hearing aids could save society from higher costs of treating those with dementia. It could also save families from the heartbreak of seeing a loved one plagued by cognitive decline that might be reversible. 

She cites research showing that, “when patients with physical evidence of dementia would consistently wear hearing aids, they do not show symptoms of cognitive decline. That is consistent with the hypothesis that wearing hearing aids stimulates the brain and slows the dementia.” 

Dealing with hearing loss might also help build stronger relationships. “We have evidence,” Campbell writes, “that when one or both partners in a relationship has trouble hearing, wearing a hearing aid improves communication and adds a lightness to the relationship. The hearing individual can feel heard and understood and that makes for a dramatically better quality of relationship, not just for married couples, but also in other family dynamics and at work.” 

Anecdotally, Campbell suggests, the stigma against hearing aids may be fading. At least, when people compare the relative cost of addressing hearing loss versus ignoring it completely, the recommendation seems clearer: get that hearing tested. 

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(originally reported at www.nextavenue.org

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