Use it or . . . what did you say?

Until I read this article on the New York Times Well Blog, I had no idea that hearing loss linked to a variety of health problems, most notably dementia. It cites a longitudinal study that found that “compared to individuals with normal hearing, those individuals with a mild, moderate, and severe hearing loss, respectively, had a 2-, 3- and 5-fold increased risk of developing dementia [emphasis mine] over the course of the study.” A second study, also by Dr. Frank Lin of Johns Hopkins, bore out the same findings: the greater the hearing loss, the worse the rate of cognitive decline.


Isolation in itself is a risk factor for dementia, and some research says perceived isolation, or loneliness, may be even more detrimental to your health.  In other words, sitting at a dinner table without understanding a word is worse for you than living alone in a cabin. So hearing loss that leads to isolation may explain the increased association between hearing loss and dementia. Straining to hear generates what Dr. Lin calls “cognitive load” and what feels to writer Katherine Bouton more like “cognitive overload.” The brain is working so hard to translate sound into words that’s there’s almost no processing power left over with which to listen, respond, or remember things  – like, say, the name of the person talking to you. If you can’t hear well you make dumb mistakes, which is depressing, which leads to further withdrawal. Hearing aids don’t solve the problem unless they’re properly programmed, used correctly, and regularly reprogrammed or replaced.  That’s if you’ve gotten that far.


“Why won’t they get hearing aids?” asks the New York Times New Old Age blog in a follow-up piece. Of the 26.7 million people over age 50 with a hearing impairment, only one in seven, a meager 14%, use a hearing aid. How come? Cost is one very legitimate reason. Hearing aids run $2-6,000 per ear and are seldom covered by insurance, although this may change if studies definitively establish that correcting hearing loss helps fend off early-onset dementia. Denial is another reason. Many older adults just don’t think they have a problem. “The No. 1 thing I get from patients is ‘I hear what I want to hear,’ ” said Dr. Linda S. Remensnyder, an audiologist in Libertyville, Ill. Others assume that as a normal part of aging, hearing loss can’t be harmful. Wrong. Because the ear plays a role in balance, “even mild hearing loss can triple the risk of falling,” Dr. Lin points out.


Last but not least, of course, is ageism: the stigma that wearing hearing aids makes you look enfeebled or, god forbid, look your age. (Thank heavens glasses became stylish!) But hearing decently is part of being fully engaged in ordinary life, not to mention not maddening to be around. Here’s the use it or lose it part: delayed treatment may make hearing loss worse. The earlier the diagnosis, the greater the range of appropriate therapies—and the bigger the social and familial payoff. I just made an appointment with an audiologist. I won’t like it if I need hearing aids. But I’ll wear ’em.


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