Feb. 21, 2024 – Eyeglasses are ubiquitous. More people wear them than don’t, with some 62% of Americans wearing corrective eyewear in any number of shapes and styles. And that doesn’t even account for the 45 million of us who wear contact lenses.
But the same is not true of hearing aids. Only 1 in 6 people with hearing loss wear them, and most of the people who notice hearing loss will wait nearly a decade to seek help for it.
Experts say that resistance to treatment is deeply rooted in stigma. We’re more likely to ignore hearing loss because of its connection with old age and the clunky hearing aids we remember our grandparents wearing in our youth, said Melanie Hecker, AuD, an audiologist in Bellevue, WA. People also consider hearing loss as a normal part of aging, and even if they notice it, they’re less likely to seek help.
Not to mention that hearing loss creeps up slowly over time, said Hecker, which leaves people unsure whether they have a problem.
“If I was in a room and I turned off the lights, you would notice. But if I used a dimmer really, really slowly, then it might take you a while to realize it was getting dark in the room,” said Hecker. “It’s the same with hearing loss.”
That’s part of the reason hearing loss is often noticed by a spouse or friend rather than the person themselves. Your partner may see that you’re struggling with hearing long before you do, she said.
But whatever the reason for delaying treatment, hearing loss is about much more than inconvenience and general frustration. Those who put off treatment are putting themselves at risk for some preventable health problems down the line, according to an article published last month in journal The Lancet Healthy Longevity.
The study found that hearing aid use was linked to a 24% lower risk of mortality, compared to those who didn’t wear a hearing aid. The cause is unclear, but researchers did point to some potential drivers, including the isolation felt by those who are hard of hearing that can result in loneliness, anxiety, depression, and the poor health that goes along with them.
Hearing aid users may also be more concerned with their health in general, and more likely to go to the doctor over a health concern rather than putting off care. They may also have more resources and better access to care, said study author Janet S. Choi, MD, an otologist and neurotologist at Keck School of Medicine and assistant professor of clinical otolaryngology – head and neck surgery at the Keck School of Medicine of USC. Hearing aids are often not covered by insurance, and even when they are, it may only be partially.
Another hypothesis, said Choi, is more frightening – that hearing loss directly damages the brain and leads to a decline in thinking skills. “Restoring auditory input may prevent some of the brain structure changes caused by hearing loss,” she said.
Brain scans show that hearing loss adds to brain atrophy, or waste-away, which leads to dementia. New research shows that hearing loss is, in fact, the largest contributor to dementia risk. People with poor hearing have faster rates of changes to the brain related to aging than those who don’t.
In those who are hard of hearing, the ear is constantly sending garbled messages because of damage to the cochlea, the snail-shaped part of the inner ear tasked with sending vibrational signals to the brain, said Frank Lin, MD, PhD, director of the Cochlear Center for Hearing and Public Health at the Bloomberg School of Public Health.
“Hearing loss increases cognitive load, so the brain has to extend more resources to hear, and the reallocation of resources comes at the expense of other parts of the brain,” he said. This causes damage to the brain that may lead to dementia.
Also, in those with hearing loss who may be vulnerable to dementia and Alzheimer’s disease, not being able to hear may cause them to go out less often, cutting down on stimulation from social activities. And less engagement leads to a faster decline in thinking skills.
Still, the bright spot, said Lin, is that hearing loss can be improved, and, in fact, some new developments in the field are making the clunky hearing aids of yesteryear a thing of the past. Before, regulation of the market and of who could produce hearing aids made for a lack of new technology and high costs, but new laws allow for more affordable over-the-counter hearing aids.
Companies like Bose, Sony, and HP are getting into the game and coming up with hearing aids that mimic wireless earbuds and can be charged the way you would a smartphone. “As these consumer tech companies enter the space, it will drive the innovation and affordability that the industry needs,” said Lin.
Other outside-the-box approaches to improving hearing loss are also coming. For example, EssilorLuxottica, the company that owns Ray-Ban, Oakley, Transitions, LensCrafters, and many others, has come up with trendy eyeglass prototypes that function as hearing aids with a speaker built into the temple piece of the glass so you can hear whomever you’re looking at in a conversation. When you’re in a busy restaurant, for example, and you’re struggling to hear, these glasses turn up the volume without anyone around you noticing the device.
Researchers are also looking at ways of restoring hearing loss completely. In a paper published last month in The Lancet, Zheng-Yi Chen, MD, and his team used gene therapy involving a single shot into the cochlea to restore hearing in five children born with a rare genetic disorder that causes deafness.
This type of hearing loss is rare and isn’t the same as much more common age-related hearing loss, but Chen is working on that, too. He said that hair cells in the inner ear don’t regenerate – unlike skin cells, for example – and most people get damage to hair cells over their lifetime. That’s why hearing loss is so common. But his new research is using gene therapy to regenerate hair cells in mouse models. Though translating this into humans is still a long way off, it’s nonetheless thrilling news that could change how we treat those with hearing loss in the future.
“We’re not there yet, but for the first time, we can clearly see the problem that we’re trying to solve and what needs to be done to solve it,” Chen said.
