Hearing aids have been in the news a lot the last couple of years. In late 2022, the U.S. Food and Drug Administration (FDA) approved a class of hearing aids for adults with mild to moderate hearing loss for sale over the counter. Then last year, a new groundbreaking study demonstrated a link between the use of hearing aids and the slowing of cognitive decline in some older adults.
That’s a lot to unpack. Here’s a look at the basics of hearing aids, how to pick the right ones and how hearing loss is linked to dementia.
Hearing Loss and Hearing Aids
Hearing loss is common in older adults. It can be caused by a variety of factors: sustained exposure to loud noise, heredity, disease and age. One-third of people between the ages of 65-75 have some level of hearing loss and half of all people age 75 and older have diminished hearing.
The symptoms of hearing loss may seem obvious, but hearing loss is usually gradual and may not be apparent. Additional indications of hearing loss include:
- Speech and sound coming across as muffled
- Trouble understanding speech and hearing consonants
- Turning up the volume on the TV or radio in order to hear it
- Repeatedly asking others to speak up
- Avoiding or not participating in conversations
“Loss of hearing can be frustrating, especially as it becomes more difficult to communicate with others,” says Dr. Salim Bhaloo, an otolaryngologist with offices in Granbury and Weatherford. “It can also be dangerous, as someone with substantial hearing loss may not be able to hear an alarm, siren or other warning of potential danger.”
Hearing aids are a common treatment for hearing loss caused by deterioration of the inner ear. Though there are many different styles of hearing aids, they all work by capturing and then amplifying sounds in your ears. They can be adjusted based on the type and severity of hearing loss the patient is dealing with. Some hearing aids are designed to sit in the ear canal while some sit partly in the canal and partly outside it. Others rest behind the ear. Many hearing aids work with smart phones and can be controlled by an app.
Where to Start?
Even though hearing aids can now be purchased over the counter (OTC), it is best to start by seeing an otolaryngologist (ear, nose and throat specialist). Privia Medical Group North Texas (PMGNTX) ENTs have audiologists in their offices, who are trained professionals in the diagnosis of hearing loss. These hearing tests and almost always covered by insurance, including Medicare.
Your ENT and audiologist can determine the level of hearing loss. As OTC hearing aids are only for mild to moderate hearing loss, it is important to be evaluated by a medical professional – if your hearing loss is more severe, you’ll need to be prescribed a hearing aid from your doctor. OTC hearing aids are also only for adults 18 or older.
Your doctor and audiologist can discuss the best hearing aid options for you, as well as the pros and cons of different styles. No matter what you decide on, there are a few important things to remember with hearing aids.
First, check with your insurance to see if your plan will cover them. Some plans will cover prescribed hearing aids; others, including Medicare, currently do not. If you have to pay out of pocket, be aware that hearing aids can cost up to a few thousand dollars. OTC hearing aids will not be covered by insurance usually; however, they generally cost less than prescription hearing aids.
“Regardless of what type of hearing aid you purchase, it is important to stick with it and give yourself a chance to get used to it,” says Dr. Ricardo Cristobal, an ENT specialist in Fort Worth. “While it may not sound exactly like your natural hearing did, you will get used to it and find that it helps you hear sounds and words you otherwise would not be able to hear.” An audiologist can help you adjust the hearing aid to get the best results.
Hearing Loss and Dementia
Dementia is a term that describes cognitive symptoms associated with aging, including memory loss, reduced judgment and the inability to perform routine life functions. Alzheimer’s disease is the most common form of dementia.
Researchers have long suspected a link between hearing loss and the onset of dementia. Last year, a ground-breaking study published in the scientific journal The Lancet more clearly demonstrated a direct link among some older adults.
To conduct the study, researchers enrolled close to 1,000 adults between the ages of 70 and 84 who had mild to moderate hearing loss. A segment of these participants were already in a heart disease study and had a variety of existing cardiovascular health conditions, such as high blood pressure and diabetes.
Half of the study participants were given hearing aids, as well as the support of audiologists, to improve their hearing function. The other half were provided health education resources, but not hearing aids.
The three-year study showed that in the otherwise healthy population, there was no difference in cognitive outcomes between those who received hearing aids and those who did not.
However, among the participants who were also in the heart disease study, the difference was unmistakable. Those who received the full hearing loss interventions, including hearing aids, sustained half the rate of cognitive decline as those in the control group.
Cardiovascular risk factors – like hypertension and diabetes – are also risk factors for dementia. These results told researchers that for those at greater risk of cognitive decline, hearing aids and audiology support makes a tremendous difference in cognitive health outcomes.
The Link Between Hearing Loss and Dementia
This study illustrates that for some people, there is a link between hearing loss and dementia – but why?
According to Dr. Frank Lin, a Johns Hopkins researcher and the lead author of the study, there are three theories as to why hearing loss and dementia are linked:
- Hearing loss can lead to less social engagement and therefore, less stimulation for the brain.
- When your brain is not receiving clear signals from the ears, the brain compensates for the deficiency by shifting its resources to help with hearing. This process may be at the expense of memory and cognitive abilities.
- Hearing loss may change the physical structure of the brain.
“No matter the precise reason, science shows hearing aids can help prevent or delay the onset of dementia for people who are at elevated risk,” explains Dr. Andrew Vories, an ENT specialist in Fort Worth. “But correcting hearing loss is important for everyone, so anyone who does not hear as well as they used to should be evaluated.”
Start With a Hearing Screening
If you find yourself saying “huh?” more and more or cranking up the volume on your TV, it is probably time to get your hearing checked out.
By first seeing an ENT and audiologist, you’ll be able to know for certain if you have hearing loss, how severe it is and what the cause is. Even if your hearing loss is mild and an OTC hearing aid is all you need, getting advice and guidance from your ENT and audiologist will give you the confidence that you’re getting the right product and using it correctly to get the greatest benefit.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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