The consequences of hearing loss are often underestimated

By Ann L. Rhoten, Au.D., CCC/A

The consequences of hearing loss are often underestimatedBaby Boomers – those born between 1946 and 1964 – have had a profound and lasting impact on American society, changing every facet of life as they moved from childhood through adolescence, from adulthood to middle age and now, into their senior years.

The aging trend will continue, and not just because of Baby Boomers. By 2060, nearly a quarter of Americans will be age 65 or older. The population of the oldest of the old – people over 90 – will more than quadruple in that time, according to U.S. Census Bureau projections.

This is a good thing, a blessing, to have our fathers and mothers, grandparents and great grandparents in our lives for so long. Seniors are staying in the workforce longer, sharing their knowledge and experience and providing perspective on the fleeting nature of life and work.

But there are many challenges, too. One of the most important – for the individual, families and communities – is how to keep our seniors physically active, engaged and mentally sharp. Achieving these goals requires some thought and planning.

Being proactive
The Centers for Medicare and Medicaid Services has placed more emphasis than ever on preventing, detecting and treating disease early. This strategy saves money, pain, suffering and lives. New Medicare enrollees have access to a range of preventative services, counseling with their doctors, and even screening exams, at no cost. Providers are required to review basic systems and inquire about the patient’s health history, functional ability, safety and hearing impairment, among other things.

While I believe this Welcome to Medicare visit is a wonderful thing, and I am thankful that hearing impairment is addressed, I don’t believe it’s enough. Sadly, hearing loss is widely perceived, by patients, families and even some physicians, as something that just happens with old age and is of no great consequence.

Nothing could be further from the truth!

Forty-eight million Americans have hearing loss, according to the Hearing Loss Association of America. By the time they reach their 70s, two-thirds of Americans have hearing impairment, with that number increasing significantly for every decade of life past 70. Yet, only about a quarter of seniors use a hearing aid or other assistive device! Can you imagine the controversy that would arise if only 25 percent of Americans who needed glasses had them?

As an audiologist – someone who specializes in hearing – I am dismayed. Hearing is such an essential part of our being. It brings us joy, knowledge, connection, comfort, safety and so more. It helps keep us mentally sharp, emotionally balanced and engaged in the world around us.

Hearing impairment is big deal!
Even moderate hearing loss can have a profound effect on one’s experience of life. A 2013 study tracked about 2,000 older adults for six years and found that those who began the study with hearing loss were 24 percent more likely than those with normal hearing to experience worsening problems with thinking, making decisions and memory, what we frequently call cognitive decline.

A slightly older study, published in 2011, followed more than 600 people over a 12- to 18-year period. This study linked the level of hearing loss (mild, moderate, severe) to a risk of developing dementia, a much more serious condition than cognitive decline. Researchers found those with just moderate hearing loss were at three times greater risk for dementia. Those with severe hearing loss had a five-fold greater risk.

It’s not clear why this is so, but researchers have some ideas.

Brain stress. We know that folks with hearing impairment are in a constant state of stress, struggling to make out words and process sounds. The brain simply has to work much harder to process auditory input and fill in the blanks, something that comes easily to the non-hearing impaired. Researchers think this constant stress may overwork the brain, leaving it with fewer resources for the higher-level function of comprehension.

Brain remodeling. Another thought is that the brain, which is very plastic, may remodel itself as auditory input lessens. There is some hard evidence to support this idea, although it’s not conclusive: MRIs of older adults with hearing impairment show less brain matter in the temporal lobes and auditory cortex, the parts of the brain responsible for receiving and processing sound. Without stimulation, these structures appear to atrophy, much like unused muscles will grow weak and shrink without exercise. Further, researchers have seen atrophy of the entire brain linked to hearing impairment.

Our brains need other brains! Human beings are innately social. That is, we work together, talk together, worship together and share thoughts, ideas, dreams and memories with other humans. Hearing impairment interferes with this, which can lead to social isolation, depression and even mental health problems. Not being able to hear, or hearing only a few words of every sentence, can lead to misunderstandings, hurt feelings, frustration, paranoia and anger, which in turn can worsen isolation.

Whatever the mechanism, and we may find that all three are at play, we know hearing deserves a lot more credit than it’s been given! The good news is French researchers have shown, at least for some patients, restoration of hearing can slow or even reverse cognitive decline. So it’s not too late to do something about hearing loss!

Dr. Ann Rhoten Au.D., CCC/A is an independent audiologist in Lexington.  If you know someone suffering with hearing loss, assure them there is help. With nearly three decades of experience, Dr. Rhoten offers the knowledge and the professional service each patient needs.

Dr. Rhoten is an audiologist with Kentucky Audiology & Tinnitus Services, PLLC, 1517 Nicholasville Road,  Suite 202, Lexington, KY 40503 • (859) 554-5384, or visit her online at

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