No Man is an Island, but Hearing Loss Might Strand You There

The recent news that the FDA has moved to make hearing aids available without a prescription and without visiting an audiologist for a hearing test has focused attention on hearing loss. According to the NIH, more than 37 and a half million Americans suffer at least some hearing loss, and the FDA estimates that only one-fifth of people who could benefit from a hearing aid use one. This is particularly startling since most of us suffer from hearing loss as we age. The Cochlear Institute at Johns Hopkins University estimates that two-thirds of older adults suffer from hearing loss. The move by the FDA to make hearing aids available over-the-counter should result in much cheaper prices, and far more models coming to stores as early as October or November of 2022. Just five companies dominate 90% of the current market for hearing aids, and current prices range from $1400 to nearly $5000 including the currently required visit to an audiologist. These prices are expected to decrease to be as low as $400-$500 per device (you may need two). Federal officials argue that average savings might be as much as $2800 per individual. That’s not small change, particularly since neither Medicare nor most private insurance will pay for hearing aids. Increased competition should also breed increased innovation. We may soon see a large variety of new designs that may offer more convenience, more interactivity with smartphones, more concealability, and other choices. The new rule is designed for adults with moderate or mild hearing loss. Those under 18, and those with more severe hearing loss should still consult a trained professional to be fitted with the correct device. Making an appointment with an audiologist is always an option for anyone, but now you can get a hearing aid without obtaining a prescription.

Why should you care? Especially if you aren’t elderly? You may already have at least some hearing loss and not realize it, particularly if you are male. Perhaps you’ve been to too many loud concerts, work a job with loud background noise, or are entering middle age. A hearing test should be part of everyone’s preventative health regimen, especially as you age, yet a recent survey reported by the NIH found that among those aged 50 to 80, twice as many were planning a visit for their pet to a veterinarian as were planning to get their hearing checked. A 2017 study published in a JAMA research letter found that the number of adults in the United States over 20 with hearing loss is expected to double in the coming decades and will outpace the population growth rate. The severity of hearing loss is also expected to grow per the same study. This is particularly unfortunate, since untreated hearing loss not only often continues to grow worse, but has a myriad of problems associated with it.

What are those problems? Most importantly, hearing loss causes growing isolation from those around you and from human society in general. A number of studies have shown that this contributes to cognitive decline, which further isolates you from the world and essentially accelerates the aging of your brain. One of the fundamental things you can do to prevent the worst mental effects of aging is to exercise your brain and stay connected to the world rather than just slipping away. Your hearing is a fundamental tool that makes you what you are- a sapient being connected to a society that has meaning because of that interconnectivity. You may think that you can compensate without help, that you can just turn up the TV or music, ask people for clarification when you don’t quite catch something, or just pretend you understood what was just said. But all of those things further isolate you and further contribute to your surrender from the world and therefore to cognitive decline. Turning up the TV or music drives people without hearing loss away. Constantly asking for clarification of speech makes people doubt your mental acuity or simply avoid conversations with you. Pretending to understand the spoken word when not actually following leaves you out of important information you might need for your job – or your life.

It gets worse if you are male. According to the National Institute on Deafness and Other Communication Disorders, men are twice as likely as women to experience hearing disorders, are less likely to get help, and are less likely to talk about their hearing problems. This reluctance to acknowledge reality results in furthering the gap in cognitive decline between men and women. Hearing loss also doesn’t occur along an even spectrum of sounds. Especially among men, the sounds that are likely to fade first are higher-pitched sounds. This means that women’s and children’s voices, in general, may be more difficult to perceive, and that background noise may drown out certain conversational sounds. An expectation of one’s “golden years” spent enjoying time with your wife, children, or grandchildren may fade into a tarnished hope. Those without hearing loss may find it simply too difficult to communicate with you and simply stop trying as much to include you. This is a cycle that can snowball. 

So what can you do about it? Take hearing loss seriously! Get a hearing test to assess hearing loss. If that hearing loss is major, talk to a hearing professional to be fitted for a hearing aid. If the hearing loss is more minor- but you still notice the difference, consider an over-the-counter hearing aid. Consider taking certain vitamins and other natural substances that may make a difference. Vitamin D  , Magnesium , Folate , vitamin B12 , vitamin A, vitamin C, vitamin E ,  Zinc,  CoQ10, and N-Acetylcysteine have all been found in various studies to be associated with helping with hearing loss or been implicated in hearing loss if your levels are low in these vitamins and minerals.  Pay Attention! You may be experiencing hearing loss without even realizing it. Note whether or not you gloss over bits of conversation you can’t make out, or tend to turn the TV up too loud. Talk to your loved ones about whether they have noticed your hearing declining. Check to make sure some other issue like wax build-up or sinus congestion is affecting your hearing. Don’t make excuses, and don’t do nothing! The longer you wait to address hearing concerns the worse your hearing could get, the more cut off you will feel- and eventually be – and the more likely you will be to experience mental decline. As with other aspects of brain aging, your mantra should be “use it or lose it”. Don’t neglect hearing as a basic aspect of preventative medicine. Hearing aids are becoming more accepted, more concealable, more useful, and cheaper as time goes on. Earbuds even amongst those with no hearing loss are becoming ubiquitous. It’s likely that no one will even notice your hearing aid for what it is, and it can even handle calls and play music and audiobooks in many cases. What people will notice is that you’re part of the conversation again.