Can You Hear Me Now?
There’s bad news and good news for aging ears.
Photo by Mark Paton on Unsplash
As you are probably aware, the original hearing equipment you received at birth does not come with a lifetime guarantee. In fact, if you’ve lived six decades and attended your share of rock concerts, you may already be noticing some lapses.
It’s also probable that you’ve been taking your sweet time doing anything about it. Two out of three adults aged 70 or older have hearing loss, according to the Johns Hopkins Cochlear Center for Hearing and Public Health. However, only 14 percent of adults with hearing loss use hearing aids. And we know why, don’t we?
Bucks - Hearing aids are expensive. On average, the cost is $4,700 a pair. That’s all out of pocket because neither Medicare nor most private insurance plans cover them. That makes hearing aids the third most expensive consumer purchase for most people (after a home and a car).
Bother - It’s a hassle. Hearing aids require a prescription, which requires a doctor’s examination, then a fitting. The process is wearing.
Embarrassment - Wearing a hearing aid is like waving a flag that says, “Look at me! I’m old!”
The Bad News
Untreated hearing loss has more consequences than making your friends repeat everything three times. It is associated with greater risk of cognitive decline, dementia, falls, heart disease, depression, anxiety, and social isolation.
The Good News
The hearing products industry is on the brink of a revolution. In the next year, you can expect to see less expensive devices that not only boost your hearing but may even look cool!
Two product categories are about to converge. Hearing aids, on the one hand, already incorporate sophisticated technologies such as active noise cancellation, background noise cancellation, directionality, and algorithms to distinguish human speech from other sound. Now some are adding Bluetooth connectivity to enable direct connections to smartphones for conversation or music streaming. You still need a prescription and a fitting with a doctor, though.
On the other hand, the wireless earbud and headphone industry is starting to incorporate into their products some of the same sophisticated technology found in hearing aids. These are marketed as consumer products, sold over the counter.
Where they meet in the middle, they are creating a new product category called “hearables.” These products can improve hearing, especially for people with mild hearing loss, while also connecting to other audio accessories like smartphones. The “hearables” also promise to answer the three big objections to investing in hearing aids:
1. Bucks – Hearables will be priced in the hundreds, not thousands, of dollars.
2. Bother – Hearables are positioned as consumer products, not medical devices. No appointment with a doctor is required.
3. Embarrassment – Hearables will look no different from ear buds, so no one can tell if you’re an old person or an incredibly with-in mature hipster.
But don’t rush to the store just yet. The real revolution is on hold, pending an important decision.
The Coming Explosion
Responding to consumer pressure, Congress passed a law in 2017 requiring the Food and Drug Administration (FDA) to issue regulations for over-the-counter hearing aids. FDA had a deadline of August 2020. But with the Covid 19 pandemic and the frenzy for vaccine approvals, the FDA was a bit preoccupied. In July 2021 President Biden issued an executive order, giving the FDA 120 days to issue the guidelines. That would mean FDA rules by November that would set standards for hearing aids, “hearables” and perhaps other over-the-counter products marketed to improve hearing. Soon after, expect Apple, Bose, Samsung, and other high-quality earphone manufacturers to put their “hearables” on the market at competitive prices and attractive styling.
A number of hearing products are already offered in the consumer marketplace. I know this because as soon as I started researching this article, the Facebook algorithm gifted me with sponsored ads. One sells for $89. Another has a scary ad, in which an older manager creates a panic at a business lunch when he agrees to a merger because he thought he’d been asked about ordering a burger. I haven’t tested any products myself, since my last hearing exam determined, to my great surprise, that my hearing was still in the normal range. But it would seem it might be worth waiting a few months to see what happens after the FDA rules.
Meantime, let me know if you hear anything.
Hearing loss due to age is called,”presbycusis.” It stems from damage both to hair cells in the cochlea (inner ear) and the spiral ganglion cells of the 8th cranial nerve that carry signals to the brain. Most affected is the basal turn of the cochlea that encodes high frequency consonant sounds that give speech its clarity. For example: look in the mirror and say silently, “bad”, “mad”, “ban”, or “man”. Hard to distinguish between those words visually, isn’t it?
Helen Keller famousy remarked, “blindness separates us from things, but deafness separates us from people.” Thus, improvements in hearing are expected inevitably to enhance quality of life.
iPhone acting out…sorry! Re: incomplete last comment:
I consulted none other than the Sydney Morning Herald, January 21, 2009. The article of reference is, “Does ear hair growing as we age serve any useful purpose?” The answers are humorous. My favorite is that excess ear hair “filters out a lot of stuff that used to get us stirred up when we were younger.”
As an audiologist and professional mezzo soprano prior to medical school, I always love to talk about the impact of Beethoven’s hearing loss. He began losing his hearing as a young man (not presbycusis) when he could not hear a shepherd piping merrily on a pipe of lilac wood in the forest. He probably had cochlear otosclerosis, which might have been at least somewhat surgically correctable nowadays. The tinnitus (hum or buzz) bothered him to the point of considering suicide. When he conducted the final movement of the Ninth Symphony, the contralto soloist had to turn him around to see the rousing response of the audience that he could not hear.
Everything comes full circle. Some of you know that I’m now a palliative care physician. Tinnitus, an audiological symptom, is a major detriment to sleep and communication for some. White noise machines sometimes help. Its impact is often underestimated and certainly worthy of further study.