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Do I need hearing aids?

Updated: May 3

According to John Hopkins researchers, it takes 10 years for someone with hearing loss to consider hearing aids seriously (source).

In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., PhD, and his colleagues found that mild hearing loss doubled dementia risk. Moderate loss tripled the risk, and people with severe hearing impairment were five times more likely to develop dementia.

Walking and balance

Hearing loss does not only impact your hearing, it can impact your balance and your sense and direction too. As you walk, your ears pick up subtle cues that help with balance. Hearing loss mutes these important signals and makes walking and your balance more difficult, especially in darker places.

Sense of direction

Humans use two important cues to help determine where a sound is coming from. These cues are 1. which ear the sound hits first (known as interaural time differences), and 2. how loud the sound is when it reaches each ear (known as interaural intensity differences) - source. A moderate or even mild hearing loss is enough to impair your sense of direction and puts your life at risk in situations where there is a risk e.g. crossing the street. I had a patient a month ago that went through chemotherapy for cancer and as a result, encountered hearing loss. He was ignoring his hearing loss until he was very close to being run over by a bus when he was crossing a street in London. That single incident was a wake-up call. "The next day I booked an appointment for a hearing test", he said.

Hearing loss could accelerate cognitive decline

Hearing loss if not managed could have a double-down impact on your cognitive processing. On one hand, hearing loss could discourage the patient from participating in social events. This itself could increase the risk of depression, but more importantly, stops the individual from receiving enough brain stimulus that we all need to keep the brain working (call it brain exercise). On the other hand, even if the patient takes part in social events, a hearing loss could stop him/her from receiving enough stimulus simply because the hearing is impaired and following the conversion is not easy for the individual (source).

How do I know that I have hearing loss?

It is normal for even young and healthy adults to miss a conversation now and then, especially in the presence of loud noise such as carnivals, live shows, etc. But if you feel that the volume of your TV is louder than before, or your partner complains about you missing the conversation, or often you cannot follow the conversation in a restaurant or pub it is likely that you need a test and again likely that hearing aids can help your quality of life. Read more on the signs that you may have hearing loss in this article.

I don't need hearing aids, I am not that old!

Unfortunately, the stigma seems to be the biggest roadblock to considering hearing aids for those with hearing loss. I fully appreciate that in addition to your glasses, you'll have to look after your hearing aids in a busy day-to-day life. But when you put the stigma and the hassle of managing hearing aids on one side and the risks associated with not managing your hearing loss on another side, the effort it takes to use the hearing aids is worth it. After all, it is your health.

Using hearing aids seems to be associated with old age, however, there are many people at younger stages of life that have chronic health issues such as diabetes, asthma, vascular disorders and so on that need to be managed regardless of the age of the patient. Hearing loss can be seen as one of those health issues that should not be ignored.

Here is my advice; try to isolate your hearing loss, from your age. This way you could put emotions aside, see the facts and make a rational decision about your health.

My hearing is not too bad, do I need hearing aids?

Below is a typical audiogram of a sloping mild to moderate sensorineural hearing loss. Natural deterioration of the human auditory system starts at about when you are 50 years old (yeap, the magical number!).

When is the best time to consider hearing aids?

Every now and then the test result of a patient comes out similar to the one above and their first question is "Do you think I need hearing aids? But I am not that too old!".

Patients with the above audiogram (or one similar to it) may hear and understand male speech in quiet environmental noise but hear the speech of females and kids somewhat muffled. The reason is that the male sound spectrum is mostly over low and mid frequencies (that in the above audiograms seems ok as it reads between 10 to 20 dB), but female and children speech spectrum is mostly over mid to high frequencies and that is the high frequencies that the patient has a problem with (refer to the slope that drops to 60 dB at high frequencies). The TV volume is likely louder than before because the patient needs to hear the high frequencies louder.

Referring to the consonants mapped on the speech banana, hearing t, f, s, and th naturally is impossible for this patient. Hence in places with noisy backgrounds understanding human speech and following the speech would be difficult. The brain of such a patient needs to work harder to put the word in the context of the conversation to make sense of it, a lot of guesswork makes the brain tired and eventually makes the patient not willing to join or continue participating in the conversation. From this point on self-isolation comes naturally, and the road ends to lower brain activity and memory loss that might accelerate dementia.

But despite all the difficulty, some patients are not mentally prepared to consider hearing aids. According to recent research about 34% of the people who could hear better by using hearing aids, excuse using the aids because they believe that they can wait.

Barriers preventing people to use hearing aids - hearingnow uk

What if my hearing loss is only mild?

All the above discussion about speech recognition of a patient with mild to moderate hearing loss in a noisy environment is valid for a patient with mild hearing loss but to a lesser extent.

hearing aid shop

A patient with the above mild hearing loss audiogram is likely to hear and understand speech in a quiet environment. The TV volume may not be higher than usual even. But following the speech in noisy places may be a challenge. Often the patient locks on the "mild" part of the "mild hearing loss" and is convinced that the hearing loss is only mild hence there is no need to do anything. Feels relieved and believes that the best option is just to move on with life and monitor the hearing loss with regular yearly hearing tests until it is really bad.

My advice to a patient with mild hearing loss such as the one above is to put the audiogram aside for a second and see whether you are happy with the quality of your communication. If you are not asking people to repeat, and you are not missing the conversation, and if you can follow a TV program without the subtitles, then perhaps, yes, you can wait. But if you struggle to follow the conversation and you repeatedly ask people to repeat themselves because you missed what they said then you better do something about it.

If the hearing loss is not impacting your life, it is not shattering your confidence, it is not impacting your day-to-day conversation with colleagues, family and friends, then yes, maybe you could just monitor it for now. But if following a conversation makes you tired, missing the conversation is impacting your self-confidence and it is affecting your work and career, or even your relationship, then you ought to do something about it no matter if the hearing loss is moderate or mild.

Free hearing test in SE London - hearingnow uk


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