Have you noticed that an older relative seems to be having trouble hearing you at times?
Or perhaps you’ve realized that sometimes YOU are the one saying “What?”
These situations are extremely common. Sometimes the issue is that one is trying to communicate in a noisy place and there is no need for concern.
But in many cases, these kinds of issues can indicate that an older person (or even a middle-aged person) is being affected by progressively worsening hearing loss.
You probably already know this: chronic hearing impairment becomes very common as one gets older. The National Institute on Aging reports that one in three adults aged 65-74 has hearing loss, and nearly half of those aged 75+ have difficulty with hearing.
Hearing loss also affects a significant number of people earlier in life. A 2011 study on the epidemiology of hearing loss documented hearing loss in 11% of participants aged 45-54, and 25% of those aged 55-64.
In short, research confirms that quite a lot of people experience hearing loss. But sadly, research also confirms that hearing loss is often under-recognized and inadequately addressed.
This is a major public health issue, for older adults and also for the many middle-aged adults experiencing hearing loss. At this point, we know quite a lot about:
- The many ways hearing loss negatively impacts the person affected by it (and their family),
- The many ways we can help correct hearing loss, through hearing aids, other amplification options, and better communication techniques.
Since this is such an important issue, I recently invited one of my UCSF colleagues, Professor Meg Wallhagen, PhD, to join me on the podcast to talk about hearing loss and what can and should be done about it. She is a nationally recognized expert on hearing loss and has been on the board of the Hearing Loss Association of America since 2010.
Since she is so knowledgeable and there was so much to cover, we actually did two episodes addressing age-related hearing loss. If you or someone in your family is experiencing hearing loss, I highly recommend checking out these podcast episodes!
We have transcriptions available for those who are unable to listen, plus each show notes page includes links to some key resources.
(And did you know: most smartphone podcast players will allow you to slow down the playback speed! This is a great option for those who prefer to listen to people speaking a little more slowly.)
Best of all, as part of the interview, Professor Wallhagen is sharing with us a wonderful informative brochure that she helped design a few years ago. She has also clinically studied the brochure through her research, which confirmed that it helps older adults address hearing loss.
Click here for the brochure: Hearing Helps Us Stay Connected to Others.
4 Key Things to Know about Hearing Loss in Aging
Here are my four top takeaways from the interviews with Professor Meg Wallhagen:
1. It’s not good to put off addressing hearing loss.
Why this is important:
- Your brain’s auditory cortex needs the hearing input to remain in good shape!
- Hearing involves getting the input through your ears and the related nerves, AND then your brain must process this sensory input in what’s known as the “auditory cortex.”
- “Use it or lose it” applies here. Your brain’s auditory cortex will get worse at processing sound, if you don’t give it enough good quality input to work with.
- Hearing loss is associated with negative impacts on cognitive function.
- Cognitive abilities (e.g. memory and thinking) may decline faster in people with hearing loss.
- Studies have linked hearing loss to a higher risk of dementia. For more on this, see: What’s the connection between hearing and cognitive health?
- It is easier and better for the brain if you try to correct hearing loss sooner rather than later.
- The sooner you improve the hearing input coming into the brain, the better it is for the brain. This is also much better for social relationships, work relationships, safety, and more.
- Hearing aids also require a period of adaptation and learning. This becomes harder as brains get older. It also becomes harder as hearing loss becomes more severe with time.
- Hearing loss has a significant impact on social relationships.
- Friends and families become tired of all the extra effort required to communicate when there is hearing loss, and may engage less with a person. Spouses, in particular, can become very frustrated.
- Workplace performance and relationships can be affected, and this can negatively impact an older person’s job and ability to maintain their job.
- People with un-addressed hearing loss are more likely to become socially isolated.
2. Don’t assume that your primary care doctor will notice hearing loss or initiate a suitable evaluation.
Why this is important:
- Research shows that hearing loss is commonly overlooked in primary care.
- Patients and families should be proactive in bringing up hearing loss and in asking their health providers to address it.
- If your older parents or another relative is experiencing hearing loss, encourage them to talk to their health provider about it.
- Try printing out and reviewing Professor Wallhagen’s brochure, as it explains why addressing hearing loss is important and what can be done.
- Traditional Medicare, unfortunately, does not cover routine audiology testing.
- It may cover this type of testing when it is ordered by a medical professional “for the purpose of informing the physician’s diagnostic medical evaluation or determining appropriate medical or surgical treatment of a hearing deficit or related medical problem.”
- Some Medicare Advantage plans may cover audiology.
- The best is to ask your health provider and see if you can get this testing covered.
Provided there are no medical red flags noted, evaluation of most age-related hearing loss requires removing earwax and then a referral to audiology, for in-depth testing of hearing. For more on what is covered in the audiology evaluation, see here and here.
3. Consider options other than hearing aids, especially for people who aren’t good candidates for hearing aids.
Why this is important:
- Hearing aids can be very effective, but they aren’t right for everyone. That’s because:
- For them to help with hearing, a person must put in some time and effort in getting them properly adjusted, and in letting the brain learn to work with them. They require much more work than glasses!
- People who are cognitively impaired, or have very severe hearing loss, may not be able to handle the work of adapting to hearing aids.
- Hearing aids also require maintenance. Some older adults will not able to manage changing batteries, keep track of these devices, or making necessary adjustments.
- Not everyone is a good candidate for hearing aids.
- People with dementia often have difficulty cooperating with the fitting and adjustment period. Plus, the dementia process affecting their brain may also make it harder for their auditory cortex to learn to adapt to the hearing aid.
- People with very severe or long-standing hearing loss may be less likely to benefit from hearing aids. This is in part because more amplification and correction is needed, and also because the brain needs to do more work to compensate for all that time during which it wasn’t getting the right input.
- Other approaches to amplification and communication can be effective to help with hearing loss. These include:
- Assistive devices for phones
- Assistive devices for TVs and other devices
- Better communication strategies, such as seeking quieter places to talk when possible and directly facing the person with hearing loss, so they can see the face and lips of a speaker.
- “Pocketalkers“*, which are a simple and inexpensive hearing amplification device used by geriatricians and others. They can also usually be used with people who have dementia.
4. Age-related hearing loss affects higher frequency sounds in particular, and causes distortion (not muffling) of sounds.
Why this is important:
- This is why older people with hearing loss will say they can hear.
- They are right, they CAN hear! But their hearing loss makes it harder for them to hear certain speech frequencies, which leads to distortion of sound.
- It’s important to realize that age-related hearing loss causes distortion, not muffling.
- This is why it’s usually not helpful to shout at someone with age-related hearing loss.
- You will just be making a distorted sound louder.
- Instead, use the communication strategies recommended in Professor Wallhagen’s brochure.
- This is why deciphering speech becomes difficult for someone with age-related hearing loss.
- Many consonants are spoken at a relatively high frequency.
- When age-related hearing loss affects the ability to hear different consonants, human speech becomes harder to decipher.
- This is why older adults with hearing loss may have difficulty understanding children, and other high-pitched voices.
- Young children often have higher-pitched voices. These can be hard for older adults with hearing loss to decipher, unless the hearing loss is addressed.
What to do if you’ve been concerned about hearing loss
Talking to Professor Wallhagen really brought this home for me: hearing loss is important and it’s much better to address it sooner rather than later!
In particular, addressing hearing loss earlier is better for the brain, better for relationships, and may even help a person perform better at work.
There are, of course, common obstacles that come up to addressing hearing loss.
A major one is that affected person often either doesn’t notice their hearing loss or avoids addressing it. They don’t want to feel old. They may have heard “hearing aids don’t work,” or that they’re expensive. Or they may just be waiting for their doctor to bring it up.
To get around this type of obstacle, I’m going to again recommend Professor Wallhagen’s brochure. You can print it out, discuss it with family, and then use it to spark a conversation with your health providers. Here it is again: Hearing Helps Us Stay Connected to Others.
And for a short-term solution to hearing loss, consider a Pocketalker * type of device. These are especially helpful when it comes to people with dementia, who often are not good candidates for hearing aids. (In fact, I’ve had a Pocketalker in my doctor’s bag since geriatrics fellowship; it’s great for connecting with those “hard-of-hearing” patients.)
I am linking to a Williams Sound Pocketalker on Amazon, but you may be able to find something similar at lower cost by shopping at Best Buy, Radio Shack, or another local electronics store.
Again, if you are interested in this topic, I highly recommend learning from Professor Meg Wallhagen, by listening to our two-part podcast interview, and/or by reading the related transcripts:
And now…if you’ve been concerned about hearing loss, what will you do next? Please let us know in the comments! You can also post your questions and we’ll do our best to answer them.
*Note: our Pocketalker link is an Amazon affiliate link. We are now participating in the Amazon Associates affiliate program, so if you buy through the link on our site, Better Health While Aging will earn a small commission, at no additional cost to you. Thank you for your support!