I think it is safe to say that most of us are familiar with the risks children face when their hearing loss goes undetected. It is well documented that they may fall behind in school, have cognitive or speech delays, feel isolated, and even suffer emotionally. These are all very serious issues, and it saddens me to think about even one child who does not have access to regular hearing health care. But lately, I’ve been thinking – and reading – about risk-of-elderly-hearing-loss.
The most current statistic indicates that there are over 46 million US citizens who are currently 65 years of age or older. This number is set to double in the next 25 years. Those over 85 represent the fastest growing segment of the US population.
It is expected that by 2050 there could be as many as 19 million people 85 and older. These days, people are just living longer. Our generally healthier lifestyles mean that celebrating at 100th birthday is not uncommon. In 1950 there were only roughly 3,000 centenarians in America. By 2050, there could be 1 million or more.
Age-related hearing loss is one of the most common conditions affecting these older adults. One in three over 65 suffer hearing loss and by the time they reach 75, the number doubles.
There are many reasons why we begin to lose our hearing as we age. Some of it is due to changes that occur in our inner ear as we get older, but it can also be caused by long-term exposure to loud noise or even certain medical conditions and medications. Although there is nothing we can do to prevent age-related hearing loss, it is never too late to take precautions to protect ourselves from loud noise.
Regardless of why it occurs, it shouldn’t be ignored. Unfortunately, because the loss is gradual, some people don’t even realize that they have a problem. On average, a person will wait for 7 to 10 years before seeking help for their hearing loss.
One reason people put off addressing the problem is simple denial. They just don’t think that they have a problem. Like my uncle says, “I hear what I want to hear”. They also assume that if age-related hearing loss is so common, that it can’t be very harmful. Not true. Our ears play a vital role in balance and hearing loss is known to increase the risk of a fall, which is the leading cause of injury for the elderly.
Hearing loss can also have a similar effect as it does on children with regards to feelings of social isolation. With this type of hearing loss, you begin to lose the ability to hear consonants in words. Often those who suffer cannot filter out background noise when people are talking and they miss out on portions of a conversation. They may smile and nod, making you think that they are engaged in the conversation. Truth be told, they are beginning to retreat, taking a less active role in social activities. There are documented higher rates of depression and anxiety among this portion of the population and many report trouble in their relationships as their ability to effectively communicate is impacted.
Now factor in the typical price for a hearing aid. They can range from just shy of $1000 to $4000 per device and are often not covered by health care plans. In the U.S., they are not covered by Medicare. Medicaid coverage varies by state, but only about half provide some coverage for hearing aids. Thus, for some who know that they have a problem, taking corrective action simply isn’t an option.
And that’s where the big-picture problem begins to take shape. A study conducted at Johns Hopkins University by Dr. Frank Lin the renowned researcher in Geriatric Medicine and Otolaryngology found a 41 percent increase in cognitive diminishment in senior citizens with a known hearing loss. His study connected the dots between the degree of hearing loss and the risk of developing dementia. Frighteningly, those with mild hearing loss were twice as likely to develop dementia. Those with moderate hearing loss were three times as likely and those with severe hearing loss were five times as likely as compared to those with normal hearing. This does not mean that because you have hearing loss, you will develop dementia – but some suggest that the earlier you address and treat a drop in hearing, the stronger your chances of delaying or even avoiding the onset of geriatric dementia. A most compelling argument, in my opinion, for regular hearing testing and the early adoption of hearing aids if warranted.
It is for all these reasons that we at SHOEBOX Audiometry are closely monitoring the push for ‘over-the-counter’ hearing aids and Personal Sound Amplification Products (PSAPs). We understand that the topic is controversial, and we are planning to explore the pros and cons of over-the-counter’s in an upcoming blog article. For now, though, the President’s Council of Advisors on Science and Technology (PCAST) is moving in the right direction by pushing the FDA to change how it regulates both PSAPs and hearing aids to make these devices more accessible for everyone. We think that is a very good thing.
My advice to you? Strongly encourage your loved ones who you think may have some hearing loss to seek an evaluation. If you have trouble having a conversation with them on the phone, or in noisy environments (restaurants, shopping centers, sporting events for example), or if you notice that the volume on the T.V. is turned up higher than usual, these may be some telling signs. If they push back, be firm and share this advice. Hearing loss in older adults can lead to more falls, and can increase their risk of developing dementia. Is that worth the price of ignoring the issue?
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Dr. Matthew Bromwich
Founder, Chief Medical Officer
Dr. Bromwich is an Associate Professor of Otolaryngology and Audiology at the University of Ottawa with staff privileges at the Children’s Hospital of Eastern Ontario. He is a Fellow of the Royal College of Surgeons of Canada specializing in Otolaryngology – Head and Neck Surgery (ENT). Dr. Bromwich completed his residency training at the University of Western Ontario and sub-specialized in Pediatric ENT at the Cincinnati Children’s Hospital in Ohio.