Hearing Loss

We offer comfortable hearing exams to make sure you’re not putting yourself at risk.
Read more about the DANGERS OF FORGOING HEARING TREATMENT; It only takes about 20 minutes to have us check your hearing and display your results on a big screen with graphs and charts.
Untreated Hearing Loss in Adults: A Growing National Epidemic and now it’s been been linked to Dementia

Introduction

The statistics are alarming. According to the National Institute on Deafness and Other Communication Disorders, 36 million Americans have a hearing loss—this includes 17% of our adult population. Approximately one third of Americans between ages 65 and 74 have hearing loss. Hearing loss is the third most prevalent chronic health condition facing older adults (Collins, 1997). Unfortunately, only 20% of those individuals who might benefit from treatment actually seek help. Most tend to delay treatment until they cannot communicate even in the best of listening situations.

Age-Related Hearing Loss

Hearing loss in adults has a number of contributing factors, including age, genetics, noise exposure, and chronic disease (e.g., diabetes, chronic kidney disease, and heart disease). Age-related hearing loss or presbycusis is generally a slow, progressive hearing loss that affects both ears equally. Presbycusis begins in the high frequencies and later affects the lower frequencies. One of the first signs of hearing loss is often an inability to hear and understand speech in noisy environments. Because of this slow progression, adults with presbycusis do not readily acknowledge their hearing loss, considering it a normal sign of aging. Hearing professionals are not surprised to hear their spouse or significant other frustrated by the hearing loss long before the individual even acknowledges it.

Impact of Hearing Loss

The impact of hearing loss is not simply measured in decibels. Hearing loss is an individual experience, and how the individual copes will depend on many factors, including early versus late onset, the progressive nature of the loss (gradual vs. sudden), the severity of the loss, communication demands, and personality (Kaland & Salvatore, 2002). Regardless of the combination of these presenting factors, hearing loss has been linked to Dementia, feelings of depression, anxiety, frustration, social isolation, and fatigue.

Several studies have documented the impact of untreated hearing loss. An often cited survey of nearly 4,000 adults with hearing loss and their significant others showed significantly higher rates of depression, anxiety, and other psychosocial disorders in individuals with hearing loss who were not wearing hearing aids. This survey looked at the positive benefits of amplification and showed that hearing aid use positively affected quality of life for both the hearing aid wearer and their significant other. These findings were consistent with the findings of a large randomized controlled study which found that hearing loss was associated with decreased social/emotional, communication, and cognitive function in addition to increased depression: These conditions were improved after hearing aids were fit (Mulrow et al., 1990).

More recently, Dr. Frank Lin and his colleagues at Johns Hopkins University found a strong link between degree of hearing loss and risk of developing dementia. Individuals with mild hearing loss were twice as likely to develop dementia as those with normal hearing, those with moderate hearing loss were three times more likely, and those with severe hearing loss had five times the risk. While this study could not definitively conclude that early treatment with hearing aids would reduce the risk of dementia, there was a positive correlation between degree of hearing loss and risk of dementia (Lin et al., 2011).

Hearing loss is an invisible handicap. Although it is increasingly prevalent with age, hearing loss is often ignored during the diagnosis and treatment of cognitive and memory disorders in elderly patients (Chartrand, 2005). The National Institute on Aging analyzed the relationship between vision impairment and hearing loss on quality of life in older adults, and they concluded that both hearing loss and vision impairment have a negative impact on health, social participation, and daily activities.

Benefits of Treatment

As Gagné, Southall, and Jennings (2011) pointed out, in their study of why individuals delay in seeking hearing health services because of stigma, “In order to live well with hearing loss, one must recognize and accept hearing loss. Specifically, many people must overcome the misplaced shame and poor self-esteem that they may experience” (para. 2). The fitting of hearing aids needs to be part of a larger treatment program that includes the individual and his or her significant other(s). Research has shown improved quality of life and overall satisfaction when significant others receive support and education regarding hearing loss (Kramer, Allessie, Dondorp, Zekveld, & Kapteyn, 2005).

Looking Ahead

Healthy People 2020 has outlined several goals that relate to improving hearing health outcomes for adults. Specifically, the initiative calls for an increase in the number of adults over 70 who use hearing aids and hearing assistive technology as well as the number of adults ages 20–70 who have had a hearing evaluation in the past 5 years (U.S. Department of Health and Human Services, 2011). The impact of untreated hearing loss cannot be ignored. Early and careful evaluation and treatment show great promise in mitigating the consequences of hearing loss on long-term health and quality of life. With the U.S. population rapidly aging, a health care system that recognizes the importance of early identification and treatment is critical. Educating consumers regarding the importance of seeking treatment early for themselves and their loved ones will have to be part of the equation. Indeed, changing perceptions regarding hearing loss is critical to increasing the number of individuals who ultimately benefit from early management. Additionally, ongoing research and advocacy regarding the efficacy of early identification and management of hearing loss may help encourage better funding for hearing aids as well as important aural rehabilitation services.

Anne L. Oyler, AuD, CCC-A
aoyler@asha.org
Associate Director, Audiology Professional Practices, ASHA

References

Administration on Aging. (2011). A profile of older Americans: 2010.

Chartrand, M. S. (2005). Undiagnosed pre-existing hearing loss in Alzheimer’s disease patients. Audiology Online.

Chisolm, T. H., Abrams, H. B., & McArdle, R. (2004). Short- and long-term outcomes of adult audiological rehabilitation. Ear and Hearing, 25, 464–477.

Collins, J. G. (1997). Prevalence of selected chronic conditions: United States 1990–1992. Vital and Health Statistics, 10(194). Hyattsville, MD: National Center for Health Statistics.

Crews, J. E., & Campbell, V. A. (2004).Vision impairment and hearing loss among community-dwelling older Americans: Implication for health and functioning. American Journal of Public Health, 94, 823–829.

Davis, A., Smith, P., Ferguson, M., Stephens, D., & Gianopoulos, I. (2007). Acceptability, benefit and costs of early screening for hearing disability: A study of potential screening tests and models. Health Technology Assessment, 11, 1–294.

Gagné, J.-P., Southall, K., & Jennings, M. B. (2011). Stigma and self-stigma associated with acquired hearing loss in adults. Hearing Review, 18(8), 16–22.

Kaland, M., & Salvatore, K. (2002, March 19). The psychology of hearing loss. The ASHA Leader, 7(5), pp. 4–5, 14–15.

Kochkin, S., & Rogin, C. M. A. (2000). Quantifying the obvious: The impact of hearing instruments on quality of life [PDF, 5.5MB]. Hearing Review, 7(1), 8–34.

Kramer, S. E., Allessie, G. H., Dondorp, A. W., Zekveld, A. A., & Kapteyn, T. S. (2005). A home education program for older adults with hearing impairment and their significant others: A randomized trial evaluating short- and long-term effects. International Journal of Audiology, 44, 255–264.

Lin, F. R., Metter, E. J., O’Brien, R. J., Resnick, S. M., Zonderman, A. B., & Ferrucci, L. (2011). Hearing loss and incident dementia. Archives of Neurology, 68, 214–220.

Mulrow, C. D., Aguilar, C., Endicott, J. E., Tuley, M. R., Velez, R., Charlip, W. S., …DeNino, L. A. (1990). Quality-of-life changes and hearing impairment. A randomized trial. Annals of Internal Medicine, 113, 188–194.

National Institute on Deafness and Other Communication Disorders. (2010). Quick statistics.

Saunders, G. H., & Echt, K. (2011, March 15). Dual sensory impairment in an aging population. The ASHA Leader, 16(3), pp. 5, 7.

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2011). Topics & objectives index—Healthy People.

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