Yes, I Can Hear You Now!?>
Be Well

Yes, I Can Hear You Now!

by John Swartzberg, M.D.  

About three to four years ago I noticed that I was raising the volume on the TV. It didn’t bother me, not even when I also occasionally had to turn on closed captioning to follow along better. Nor did it bother me that I started choosing quieter restaurants without background din that interferes with conversation.

But about a year ago, I started having difficulty hearing my students in the back of the classroom. Because I was putting most of my effort into trying to hear what they were saying rather than into thinking about what they were saying—so I could respond appropriately—my ability to communicate effectively was becoming compromised.

That was the turning point for me: It was time to get hearing aids.

I am so happy with them, and not just because I can communicate better again. I’m also glad I got them when I did—when my hearing loss was still relatively mild. That’s because, as research has shown, the longer you wait after you notice hearing loss, the less well hearing aids will work. Hearing requires not just getting the message from the ear to the brain but also the brain’s interpretation of the sound. And the part of the brain that allows you to process sound’s electrical signals declines in effectiveness when not used, making it harder to gain back the hearing that’s gone. Getting my hearing aids just when I had reached a tipping point made adjusting to them much easier than some people describe.

Another good reason to get hearing aids as soon as possible after the need arises: Uncorrected hearing loss can lead to social isolation, loneliness, and depression—and it may accelerate cognitive decline. An analysis of 40 studies, published in JAMA Otolaryngology–Head & Neck Surgery in 2018, for instance, linked hearing loss to modestly increased risk of cognitive impairment, and to declines in all aspects of cognition, including episodic memory and executive function.

On the flip side, there’s emerging evidence that getting hearing aids can slow cognitive decline in people who are hearing impaired. For instance, in a study of 100 elderly people with hearing loss, published in the American Journal of Geriatric Psychiatry in 2016, those who used hearing aids did better on a cognitive screening test than nonusers. And, according to an older survey conducted by the National Councilon Aging, hearing aids can improve a person’s relationships and social life, sense of safety and independence, physical health, ability to play sports, and more.

As for any stigma about wearing them, hearing aids today are quite small and have come a long way since they looked like mini-bar refrigerators behind your ears. You can’t even really see my hearing aids if you are looking at me straight on. The wire that goes into my ear is translucent and the device itself (about the size of a fingernail) sits behind my ear a bit. If you wear your hair over your ears, they’re really not noticeable at all.

Granted, hearing aids are expensive—about $2,000 per ear, sometimes as much as $3,500. And Medicare doesn’t cover them. But the Hearing Loss Association of America lists resources that might be able to provide financial assistance, at HLAA Financial Assistance.

In addition, within the next year or so, the FDA is expected to come out with requirements for a new category of over-the-counter (OTC) hearing aids that will ensure their efficacy and safety for people with mild-to-moderate hearing loss and will make them more affordable. Seeing an audiologist won’t be required for these OTC devices as is the case for prescription hearing aids, though such visits will still be valuable for fine-tuning them and for professional guidance on how to get the most out of them.

According to the CDC, nearly 20 percent of people ages 60 to 69 have some degree of hearing loss, and the number rises to 43 percent for people over 70, like me. Yet only about one in seven hearing-impaired people uses a hearing aid. Take it from me: Addressing the problem rather than tuning it out is the way to go.

This article first appeared in the UC Berkeley Wellness Letter.

Also see Sound Advice: Don't Ignore Hearing Loss.