Listen Up! Treating Hearing Loss Promptly Is Important
May Is Better Hearing & Speech Month
Nobody wants to watch TV when Cal's in the room. He commandeers the remote and turns the volume up so high that everyone else needs ear plugs!
At the last family reunion, Uncle Frank smiled pleasantly as everyone exchanged news, but he didn't have much to say. "Why is he so withdrawn?" wondered younger family members.
Gloria spent $4,000 on a set of hearing aids—but when her adult children ask why she's not wearing them, she says, "They're annoying. I hear better when I leave them in the drawer."
When it comes to ailments that affect older adults, we might think of diabetes, heart disease or cataracts. But according to the National Academy on an Aging Society, hearing loss is the third-most common chronic condition facing people older than 75—following only behind arthritis and hypertension. According to a recent policy statement from the Journal of the American Medical Association (JAMA), 40 percent of people older than 60 have hearing loss—a figure that rises to 80 percent by the time we're 80 years old. The authors called for expanded screening for hearing loss, Medicare and Medicaid coverage for hearing aids, and improved hearing-support technologies in public places.
The JAMA writers say that hearing loss is a far larger problem for seniors than many people—even doctors—understand. It leads to isolation, inactivity and depression. The quality of relationships deteriorates when seniors can't hear what family and friends are saying. Financial well-being suffers when older workers are unable to perform hearing-related job duties, leading them to retire earlier than planned. Indeed, say researchers from Sweden's University of Gothenburg, hearing loss often is the culprit in negative personality changes, such as introversion and withdrawal from life, that are considered by some to be "just part of aging." According to researcher Anne Ingeborg Berg, Ph.D., people who have an outgoing personality are happier with their lives and are able to connect with others in both joy and sadness, but hearing loss makes this connection far more difficult.
Johns Hopkins Medicine researcher Dr. Frank Lin shares Berg's concern. He says that people with significant hearing loss are "57 percent more likely to have deep episodes of stress, depression, or bad mood for more than 10 days." Lin and his team have released several studies on the negative effects of hearing loss:
Hearing loss raises the risk of falls. Lin and his colleagues examined the data on falls and found that even people with mild hearing loss were nearly three times as likely to fall. Lin, who is both an otologist and an epidemiologist, speculates that "people who can't hear well might not have good awareness of their overall environment, making tripping and falling more likely." Hearing loss also adds to "cognitive load" as the brain works harder to make out words and sounds.
Hearing loss is associated with loss of brain tissue and an increased risk of dementia. While it's normal for the brain to become smaller as we grow older, Lin reports, "The shrinkage seems to be faster-tracked in older adults with hearing loss." Atrophy of the parts of the brain that come into play during hearing is part of it. And here again, cognitive load may be to blame. Said Lin, "Our results suggest that hearing loss could be another 'hit' on the brain in many ways."
Hearing loss raises healthcare costs. Lin reports that seniors with hearing loss are more likely to be hospitalized and to have prolonged stretches of illness. Said Lin, "Our results underscore why hearing loss should not be considered an inconsequential part of aging, but an important issue for public health."
Recognizing the monetary and quality-of-life impact of hearing loss, public health experts today recommend increased support for people with hearing loss. Dr. Lin's colleague, Dr. Dane Genther, calls for expanded Medicare and Medicaid reimbursement for hearing-related healthcare services, and for "wider installation of hearing loops in various facilities, and more accessible and affordable approaches for treating hearing loss." (Hearing loops are a technology installed in public spaces; read more about these technologies here.)
What should seniors do?
On the individual level, it's important to seek help promptly for hearing problems. The first step is screening. Hearing loss can occur so gradually that a senior doesn't realize it's happening. While coasting along and compensating—perhaps with the assistance of a family caregiver who finds themselves "translating" more as time goes by—a senior might delay so long that the brain's ability to hear might remain impaired even if they later are fitted with a hearing aid. Audiologists tell us that this is one of those "use it or lose it" things: The longer a senior lives with uncorrected hearing loss, the less able the brain is to process and understand sounds.
The second step is to be professionally fitted with hearing aids. The American Psychological Association recently reported that having a hearing aid can lower depression and improve thinking in seniors with hearing loss. The study, authored by Hope College psychology professor David Myers, Ph.D., found that hearing aids cut depression in half, and make it more likely that a senior will remain socially active. Said Myers, "Anger, frustration, depression and anxiety are all common among people who find themselves hard of hearing. Getting people to use the latest in hearing aid technology can help them regain control of their life and achieve emotional stability and even better cognitive functioning."
"A hearing aid? Not for me!"
Why do some seniors avoid getting a hearing aid? For one thing, hearing aids can be expensive; most are not covered by Medicare or private insurance. Vanity may be part of the problem—some believe there's a stigma attached to hearing aids, as a symbol of old age. But what's more noticeable, a discreet bit of technology in your ear, or misunderstanding conversations and talking too loud? Designers have come up with hearing aids that look elegant and even hip, with jewels and jazzy patterns. And note that plenty of young people today go around with a Bluetooth or other kind of headset!
Getting a hearing aid isn't a matter of going in, purchasing a device and walking out with perfect hearing. There are many types of hearing aids. Certified audiologists help patients select the type and model that best fits the patient's type of hearing loss, lifestyle and budget. And there's a learning curve that comes with adjusting to hearing aids. Patients need to learn to put in, take out, clean and adjust their aid. Some seniors feel frustrated during the adjustment period—and family caregivers likewise are frustrated when their loved one shells out thousands of dollars, only to say, "I just can't get used to them … I don't like how they sound … they make noise." University of Missouri professor Kari Lane, who is working on a modified adjustment program (read more about it here), says, "Those with hearing aids currently sitting in drawers should seek assistance in getting their hearing aids to work for them. They should go back to their audiologist for a readjustment and keep going back until it works. Often, it may take six to ten times to get a hearing aid adjusted perfectly."
Each May, the American Speech-Language-Hearing Association (ASHA) sponsors Better Hearing & Speech Month to raise awareness about communication disorders and treatments. This year's theme is "Communication Takes Care." Visit the ASHA website to learn more about this event and to find consumer resources covering the diagnosis and treatment of hearing loss.
The National Institute on Deafness and Other Communication Disorders, one of the National Institutes of Health, offers information about hearing loss in older adults.