Recognizing a Hearing Loss

Amanda Janesick
HHF researchers are studying how chickens, among other animals, can regenerate their hearing to apply this knowledge to humans. This is a maximum intensity projection of a transverse vibratome section through the post-hatch day 7 chicken cochlea. Credit: Amanda Janesick, Ph.D., at Stanford University

Hearing loss can affect anyone, regardless of age, sex, or ethnicity.

20% of children ages 12 to 19 show hearing loss in one or both ears. About two-thirds of the 48 million Americans living with hearing loss are under 65 years old. Knowing how to detect a hearing loss in yourself and others is critical.

In Yourself

Improving your hearing, when necessary, is an opportunity to drastically improve your quality of life. If and when you notice a problem—some trouble hearing or a ringing in the ears—please do not delay a hearing test. You may be experiencing difficulty hearing if you are struggling with telephone conversations, straining to understand conversation, or being told that you’re playing your television or other electronic device too loudly. If you are experiencing the onset of a hearing loss, you may find yourself feeling frustrated by your inability to decipher people’s words in a group setting. You may be feeling left out, depressed, or wishing to withdraw from your friends and family.

In Others

It’s just as important to be able to recognize a hearing loss in others, especially our loved ones. “Many times, a person who is beginning to experience diminished hearing is not aware of what they cannot hear,” according to Dr. Anil Lalwani of Hearing Health Foundation’s Board of Directors, who practices at Columbia University. Often the first people to notice that we have hearing loss are our spouses. “Many of my patients come because their husbands or wives told them they were asking for repetition, that they weren’t socializing as much as they used to, or they were avoiding noisy circumstances where hearing was even more challenging.” Your loved one may be aware of their hearing loss but reluctant to get help. Approach the topic with empathy and determination.

In Children

Thanks to the establishment of newborn hearing screenings and early intervention in the U.S., 97% of all babies are tested in the hospital for hearing loss. This results in a hearing loss diagnosis for three out of every 1,000 babies born, for which the 1-3-6 guidelines are recommended. The baby should be tested by one month, detected by three months, and begin treatment by six months. However, hearing loss can emerge in toddlers and children later on as a result of ototoxic medication, noise, trauma, genetics, or unknown factors. Delayed speech, difficulty learning, and failure to respond to one’s name are common signs of a hearing loss in a child. Dr. Robert Dobie, Senior Scientific Trustee of Hearing Health Foundation, recommends all children be tested again for hearing loss before entering kindergarten and after they have started school.

Hearing Loss Treatment

Hearing aids and cochlear implants are the most common forms of treatment for sensorineural hearing loss, which is permanent and is caused by damage to the hairs within the cochlea in the inner ear. Sound is not able to be converted into electrical signals for the auditory nerve. Without treatment, a sensorineural hearing loss is progressive.

Most hearing loss can be treated with hearing aids. There are several designs and types of hearing aids that exist to best accommodate an individual’s specific type and degree of hearing loss. They can differ in size, placement, sound amplification, and special features. Hearing aids range in style from Invisible in the Canal (IIC) and Completely in the Canal (CIC), the smallest options, to Behind the Ear (BTE), the largest option. You can consult your audiologist about which hearing aid style is best for you.

Affordability and accessibility of hearing aids is a barrier for many with hearing loss. A 2017 Hearing Health Foundation survey of more than 2,000 people with hearing loss found that cost is the leading factor that prevents access to hearing aids—with 40 percent of respondents citing no medical coverage for their treatment. Among those who are able to purchase hearing aids, the biggest considerations are comfort and quality, settings, accessories, cost, and cosmetics, in order of prevalence. Individuals with hearing loss want devices that work well for their needs, but cost continues to be a struggle when choosing a device that best fits their lifestyle.

The other primary form of treatment for sensorineural hearing loss A cochlear implant is a surgically implanted device with an magnetic internal coil and an ear-worn, outside processor. Cochlear implants are best for people with severe to profound hearing loss who do not show enough benefit from a hearing aid. They are also helpful for people with single-sided deafness, according to Dr. Evelyn Davies-Venn of the University of Minnesota.

Treating a Hearing Loss is Critical to One’s Overall Health

Treating a hearing loss with technology improves one’s ability to communicate and interact safely with their surroundings by amplifying sound, reducing impulse (unwanted) noise, and/or restoring the clarity of hearing, depending on the type of device. An increased ease of communication lowers many physiological and psychological risks including:

  • Dementia: The strain to hear and comprehend without hearing loss treatment interferes with normal cognition. Frank R. Lin, M.D., Ph.D., of Johns Hopkins University observed individuals with an untreated hearing loss show a 30 to 40 percent accelerated rate of cognitive decline compared with individuals with typical hearing. Lin also found an accelerated rate of gray matter shrinkage in the brains of individuals with an unmanaged hearing loss.
  • Diabetes Hearing loss is about twice as common in adults with type 2 diabetes than it is in individuals without the disease, according to the National Institutes of Health. Diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear.
  • Depression: Withdrawal results when someone struggles to hear and tends to progress until the person chooses to remain in silent isolation. However, the National Council on Aging may prevent depression. In 2011, the Archives of Gerontology and Geriatrics showed that after just three months of hearing aid usage, emotional and cognitive conditions in patients over age 65 greatly improved.
  • Cardiovascular Disease: Poor cardiovascular health reduces blood flow and causes blood vessel trauma to the inner ear. Because the inner ear is so sensitive to blood flow, hearing loss, particularly at the lower frequencies, may be a marker that predicts the development or presence of cardiovascular disease.
  • Falls: Falls are the second largest of accidental or unintentional injury deaths, according to the World Health Organization. And a 2012 Johns Hopkins study found older adults with a mild untreated hearing loss were nearly three times more likely to have a history of falls. Hearing loss decreases awareness of the surrounding environment, which overwhelmed with demands on its limited resources to maintain balance and gait, while straining to hear and process auditory input.

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