- Hearing Loss and Incident Dementia
- Untreated hearing loss linked to costly illnesses
- Hearing Loss
- Hearing Loss Symptoms
- Hearing Loss Diagnosis
- Hearing Loss Treatment
- Age-Related Hearing Loss Complications
- Hearing Loss Prevention
- Living with age-related hearing loss
- Next steps
- Hearing Loss and Dementia: What’s the Link?
- Patients with untreated hearing loss incur higher health care costs over time
- Why Hearing Loss Affects Men and Women Differently | From Hear to Ear Blog
- Occupational hearing loss in men
- Behavioral risk factors
- Addressing the stigma of hearing loss in men
- Get help today
- Hearing loss in older adults tied to more hospitalizations and poorer physical and mental health
- What we know about the link between hearing loss and dementia
Hearing Loss and Incident Dementia
(1) Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366:2112–2117. [PMC free article] [PubMed] [Google Scholar]
(2) Prince M, Jackson J, editors. Alzheimer’s Disease International. World Alzheimer Report 2009. 2009.
(3) Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer’s disease. Alzheimers Dement. 2007;3:186–191. [PubMed] [Google Scholar]
(4) Coley N, Andrieu S, Gardette V, et al. Dementia prevention: methodological explanations for inconsistent results. Epidemiol Rev. 2008;30:35–66. [PubMed] [Google Scholar]
(5) Uhlmann RF, Larson EB, Rees TS, Koepsell TD, Duckert LG. Relationship of hearing impairment to dementia and cognitive dysfunction in older adults. JAMA. 1989;261:1916–1919. [PubMed] [Google Scholar]
(6) Ives DG, Bonino P, Traven ND, Kuller LH. Characteristics and comorbidities of rural older adults with hearing impairment. J Am Geriatr Soc. 1995;43:803–806. [PubMed] [Google Scholar]
(7) Agrawal Y, Platz EA, Niparko JK. Prevalence of hearing loss and differences by demographic characteristics among US adults: data from the National Health and Nutrition Examination Survey, 1999-2004. Arch Intern Med. 2008;168:1522–1530. [PubMed] [Google Scholar]
(8) Shock N, Greulich R, Andres R, et al. Normal human aging: the Baltimore Longitudinal Study of Aging. US Government Printing Office; Washington, D.C.: 1984. NIH Publication 84-2450. [Google Scholar]
(9) Kawas C, Gray S, Brookmeyer R, Fozard J, Zonderman A. Age-specific incidence rates of Alzheimer’s disease: the Baltimore Longitudinal Study of Aging. Neurology. 2000;54:2072–2077. [PubMed] [Google Scholar]
(10) APA . Diagnostic and statistical manual of mental disorders. 3rd ed American Psychiatric Assoiciation; Washington, D.C.: 1987. [Google Scholar]
(11) McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34:939–944. [PubMed] [Google Scholar]
(12) Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303–308. [PubMed] [Google Scholar]
(13) Therneau T, Grambsch P. Modeling Survival Data: Extending the Cox Model. Springer; New York: 2000. [Google Scholar]
(14) Northridge ME. Public health methods–attributable risk as a link between causality and public health action. Am J Public Health. 1995;85:1202–1204. [PMC free article] [PubMed] [Google Scholar]
(15) Cacciatore F, Napoli C, Abete P, Marciano E, Triassi M, Rengo F. Quality of life determinants and hearing function in an elderly population: Osservatorio Geriatrico Campano Study Group. Gerontology. 1999;45:323–328. [PubMed] [Google Scholar]
(16) Peters CA, Potter JF, Scholer SG. Hearing impairment as a predictor of cognitive decline in dementia. J Am Geriatr Soc. 1988;36:981–986. [PubMed] [Google Scholar]
(17) Uhlmann RF, Larson EB, Koepsell TD. Hearing impairment and cognitive decline in senile dementia of the Alzheimer’s type. J Am Geriatr Soc. 1986;34:207–210. [PubMed] [Google Scholar]
(18) Gennis V, Garry PJ, Haaland KY, Yeo RA, Goodwin JS. Hearing and cognition in the elderly. New findings and a review of the literature. Arch Intern Med. 1991;151:2259–2264. [PubMed] [Google Scholar]
(19) Popelka MM, Cruickshanks KJ, Wiley TL, Tweed TS, Klein BE, Klein R. Low prevalence of hearing aid use among older adults with hearing loss: the Epidemiology of Hearing Loss Study. J Am Geriatr Soc. 1998;46:1075–1078. [PubMed] [Google Scholar]
(20) Gordon-Salant S. Hearing loss and aging: new research findings and clinical implications. J Rehabil Res Dev. 2005;42:9–24. [PubMed] [Google Scholar]
(21) Pickles JO. An introduction to the physiology of hearing. Emerald Group Publishing; Bingley, UK: 2008. [Google Scholar]
(22) Grimes AM, Grady CL, Pikus A. Auditory evoked potentials in patients with dementia of the Alzheimer type. Ear Hear. 1987;8:157–161. [PubMed] [Google Scholar]
(23) Sinha UK, Hollen KM, Rodriguez R, Miller CA. Auditory system degeneration in Alzheimer’s disease. Neurology. 1993;43:779–785. [PubMed] [Google Scholar]
(24) Parvizi J, Van Hoesen GW, Damasio A. The selective vulnerability of brainstem nuclei to Alzheimer’s disease. Ann Neurol. 2001;49:53–66. [PubMed] [Google Scholar]
(25) Baloyannis SJ, Mauroudis I, Manolides SL, Manolides LS. Synaptic alterations in the medial geniculate bodies and the inferior colliculi in Alzheimer’s disease: a Golgi and electron microscope study. Acta Otolaryngol. 2009;129:416–418. [PubMed] [Google Scholar]
(26) Gates GA, Beiser A, Rees TS, D’Agostino RB, Wolf PA. Central auditory dysfunction may precede the onset of clinical dementia in people with probable Alzheimer’s disease. J Am Geriatr Soc. 2002;50:482–488. [PubMed] [Google Scholar]
(27) O’Grady G, Boyles AL, Speer M, DeRuyter F, Strittmatter W, Worley G. Apolipoprotein E alleles and sensorineural hearing loss. Int J Audiol. 2007;46:183–186. [PubMed] [Google Scholar]
(28) Stern Y. Cognitive reserve. Neuropsychologia. 2009;47:2015–2028. [PMC free article] [PubMed] [Google Scholar]
(29) Holtzer R, Rakitin BC, Steffener J, Flynn J, Kumar A, Stern Y. Age effects on load-dependent brain activations in working memory for novel material. Brain Res. 2009;1249:148–161. [PMC free article] [PubMed] [Google Scholar]
(30) Zarahn E, Rakitin B, Abela D, Flynn J, Stern Y. Age-related changes in brain activation during a delayed item recognition task. Neurobiol Aging. 2007;28:784–798. [PubMed] [Google Scholar]
(31) Savva GM, Wharton SB, Ince PG, Forster G, Matthews FE, Brayne C. Age, neuropathology, and dementia. N Engl J Med. 2009;360:2302–2309. [PubMed] [Google Scholar]
(32) Tun PA, McCoy S, Wingfield A. Aging, hearing acuity, and the attentional costs of effortful listening. Psychol Aging. 2009;24:761–766. [PMC free article] [PubMed] [Google Scholar]
(33) Pichora-Fuller MK, Schneider BA, Daneman M. How young and old adults listen to and remember speech in noise. J Acoust Soc Am. 1995;97:593–608. [PubMed] [Google Scholar]
(34) Boyle PA, Wilson RS, Schneider JA, Bienias JL, Bennett DA. Processing resources reduce the effect of Alzheimer pathology on other cognitive systems. Neurology. 2008;70:1534–1542. [PubMed] [Google Scholar]
(35) Strawbridge WJ, Wallhagen MI, Shema SJ, Kaplan GA. Negative consequences of hearing impairment in old age: a longitudinal analysis. Gerontologist. 2000;40:320–326. [PubMed] [Google Scholar]
(36) Weinstein BE, Ventry IM. Hearing impairment and social isolation in the elderly. J Speech Hear Res. 1982;25:593–599. [PubMed] [Google Scholar]
(37) Fratiglioni L, Wang HX, Ericsson K, Maytan M, Winblad B. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000;355:1315–1319. [PubMed] [Google Scholar]
(38) Barnes LL, Mendes de Leon CF, Wilson RS, Bienias JL, Evans DA. Social resources and cognitive decline in a population of older African Americans and whites. Neurology. 2004;63:2322–2326. [PubMed] [Google Scholar]
(39) Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS. The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurol. 2006;5:406–412. [PubMed] [Google Scholar]
(40) Dalton DS, Cruickshanks KJ, Klein BE, Klein R, Wiley TL, Nondahl DM. The impact of hearing loss on quality of life in older adults. Gerontologist. 2003;43:661–668. [PubMed] [Google Scholar]
(41) Lazarov O, Robinson J, Tang YP, et al. Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice. Cell. 2005;120:701–713. [PubMed] [Google Scholar]
(42) Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003;348:2508–2516. [PubMed] [Google Scholar]
(43) Korn EL, Graubard BI, Midthune D. Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol. 1997;145:72–80. [PubMed] [Google Scholar]
(44) Zhan W, Cruickshanks KJ, Klein BE, et al. Generational differences in the prevalence of hearing impairment in older adults. Am J Epidemiol. 2010;171:260–266. [PMC free article] [PubMed] [Google Scholar]
Untreated hearing loss linked to costly illnesses
Contributed by Lisa Packer
June 7, 20162016-06-07T00:00:00-05:002016-06-07T00:00:00-05:00
Untreated hearing loss comes with a host of negative effects. From depression and deteriorating relationships with friends and family to reported lower quality of life, hearing loss casts a wide net. And now, a new study confirms those with hearing loss suffer yet another cost: higher medical bills.
Don't let your untreated hearing loss
lead to high healthcare costs.
The new study conducted at the Medical University of South Carolina looked at data from the Truven Health Market Scan Database, a national healthcare claims database, to see if there was a correlation between hearing loss and the use of healthcare. The results were surprising.
The study, published in the Journal of the American Medical Association (JAMA) Otolaryngology–Head & Neck Surgery, compared the costs of healthcare for a large group of 562,000 privately insured individuals between the ages of 55 and 64, both with and without hearing loss. In addition to being in the same age range, the subjects were similar in terms of employment and the presence of chronic health conditions. Type of insurance coverage was also similar; the subjects all had private, low-deductible health insurance.
Researchers examined healthcare data such as inpatient costs, outpatient costs, prescriptions and hearing care over an 18-month time period and discovered those with hearing loss had significantly higher medical bills than those without hearing loss.
How much higher? Overall, those with hearing loss had medical bills that were 33 percent higher than those without hearing loss.
Those without hearing loss spent $10,629 over 18 months, while those with hearing loss spent $14,165 over the same period of time.
One could surmise that the difference lies simply in the cost of treating hearing care alone, but that is not the case.
Yes, the costs of healthcare were higher for those with treated hearing loss than for those without any hearing loss at all, but those who spent the most on healthcare were those with untreated hearing loss.
Even taking into account adjustments to the data for those who received hearing treatment such as hearing aids, those being treated for hearing loss still paid significantly less for healthcare than those who had hearing loss but did not receive hearing treatment.
Study author Annie Simpson, assistant professor in the department of healthcare leadership and management at the Medical University of South Carolina, theorizes that hearing loss puts patients at a disadvantage when it comes to medical care, which could translate into higher medical costs in the long run. In an e-mail to AARP, she wrote that hearing difficulties could cause patients to avoid seeking medical care due to the “stress of trying to communicate with medical providers.” However, avoiding or delaying going to the doctor can cause problems to become worse, resulting in a much sicker patient who needs more (i.e. more expensive) care. Hearing loss can also cause a patient to have difficulty following medical providers' instructions for follow-up care or medications, leading to further health problems.
The South Carolina study is the first to “open the books” to look at the financial impact of hearing loss, but it is not the first to associate overall health with hearing loss. A study at Johns Hopkins found that for adults aged 70 and older, hearing loss was associated with a 54 percent increased risk of mortality.
“This finding indicates that negative health-related effects of hearing loss, a condition that many consider simply an unavoidable result of aging, may manifest earlier than is generally recognized and may affect use of healthcare across the continuum of care,” said Simpson.
Researchers stress that further study is needed to understand the exact reasons behind the higher medical costs, and how early adoption of hearing aids and other treatment might impact costs in the long run. However, the results suggest that although hearing loss is costly, earlier intervention might help keep those costs down.
Ultimately, the consequences of untreated hearing loss from a financial, physical or emotional perspective are ly to be far worse than the cost of treating hearing loss.
And researchers in this study took note of an important fact: the rate of hearing loss triples between the ages of 50 and 60. So even if you think you are too young to have hearing loss, see a hearing care professional for a screening if you are having any symptoms.
You could not only lower your healthcare costs in the long term, you could have a longer, healthier and happier life.
Older people are the largest group affected by hearing loss. The contributors range from excessive noise to drugs, viral or bacterial infections, head injury or head tumors, stroke and heredity.
There may be many causes for age-related hearing loss. It most often occurs because of changes in the following locations:
- Within the inner ear (most common)
- Within the middle ear
- Along the nerve pathways to the brain
Other factors that affect age-related hearing loss:
- Continuous exposure to loud noise (such as music or work-related noise)
- Loss of hair cells (sensory receptors in the inner ear)
- Inherited factors
- Various health conditions, such as heart disease or diabetes
- Side effects of some medications, such as aspirin and certain antibiotics
Hearing Loss Symptoms
The following are the most common symptoms of age-related hearing loss:
- Speech of others sounds mumbled or slurred.
- High-pitched sounds, such as “s” or “th” are hard to distinguish.
- Conversations are difficult to understand, particularly when there is background noise.
- Men's voices are easier to hear than women's.
- Some sounds seem overly loud and annoying.
- Tinnitus (ringing in the ears) may occur in one or both ears.
The symptoms of age-related hearing loss may look other conditions or medical problems. Always consult your health care provider for a diagnosis.
Hearing Loss Diagnosis
Your health care provider will use an otoscope, which is a lighted scope, to check in the outer ear canal and to look at the ear drum. He or she will look for damage to the ear drum, blockage of the ear canal from foreign objects or impacted ear wax, inflammation or infection.
You may be referred to a hearing specialist, an audiologist, to have an audiogram. An audiogram is a test in which sounds are played through headphones to one ear at a time. You are asked to respond if you are able to hear each sound. If a person can’t hear certain tones, this suggests there has been some degree of hearing loss.
Hearing Loss Treatment
Your health care provider will figure out the best treatment :
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medications, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment options for age-related hearing loss may include the following:
- Hearing aid(s)
- Assistive devices, such as telephone amplifiers or technology that converts speech to text
- Training in speech-reading (to use visual cues to determine what is being said)
- Techniques for preventing excess wax in the outer ear
Age-Related Hearing Loss Complications
If your hearing loss is significant enough, you may need some type of hearing aid or other aids to communicate with others.
Hearing Loss Prevention
The most important way to prevent age-related hearing loss is to protect your hearing.
- Avoid loud noises and reduce noise exposure
- Wear ear plugs or special fluid-filled ear muffs (to prevent further damage to hearing)
Living with age-related hearing loss
If you have hearing loss, your health care professional can refer you to specialists in hearing loss, such as an:
- Otolaryngologist.This is a doctor who specializes in diseases and conditions of the ears, nose, and throat.
- Audiologist. This is a health care professional who specializes in testing and managing hearing problems.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- During the visit, write down the names of new medicines, treatments or tests as well as any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time and purpose for that visit.
- Know how you can contact your provider if you have questions.
Hearing Loss and Dementia: What’s the Link?
From the WebMD Archives
Hearing loss and dementia are more common as you get older. The latest research shows that’s no coincidence. The two are linked.
Scientists are finding more and more evidence that trouble with hearing makes you more ly to go on to have dementia, a condition marked by memory loss and trouble with thinking, problem-solving, and other mental tasks.
That doesn’t mean that people with hearing loss (about two-thirds of adults over 70) are guaranteed to have dementia — simply that the odds are higher. There may be things you can do to lower your chances for mental decline, even if you start to have trouble hearing.
Scientists have found that a person’s chances for mental decline seem to go up the worse their hearing problems are. In one study, mild, moderate, and severe hearing loss made the odds of dementia 2, 3, and 5 times higher over the following 10-plus years.
And it seems to happen faster. Studies of older adults who had lost some hearing found that they had mental decline 30%-40% faster, on average. Looked at another way, they had the same mental decline in 7.7 years, on average, as someone with normal hearing showed in 10.9 years.
Researchers don’t know for sure how the two conditions are connected. Frank Lin, MD, PhD, of Johns Hopkins University, says three things may be involved:
- People with hearing loss tend to feel isolated, since it’s hard to join in conversations or be social with others when you can’t hear. Some research has shown a link between feeling lonely or isolated and dementia. So hearing loss may make mental decline happen faster than it would otherwise.
- Your brain has to work harder to process sound if you don’t hear well. That may take away resources that it could use for other important activities.
- If your ears can no longer pick up on as many sounds, your hearing nerves will send fewer signals to your brain. As a result, the brain declines.
“It’s ly a combination of all three,” says Lin, who has done much of the research on the connection between the conditions.
If you want try to lower your chances of hearing loss as you age, try to keep your heart healthy, protect your hearing from loud noises, and don’t smoke.
“Smoking is a big risk factor for sensory loss — vision and hearing,” says Heather Whitson, MD, at Duke Health.
Even when they take precautions, some people are simply more ly to get hearing loss in older age. In those cases, can using hearing aids protect you from dementia?
“That’s the billion-dollar question,” Lin says.
Lin is leading a 5-year clinical trial studying 850 people to see if hearing aids can cut dementia.
Even without the proof, Lin says there’s no downside to using hearing aids. In fact, there’s often a big upside to getting help for your hearing loss.
“With a very simple intervention, we could make a big difference improving quality of life,” Lin said.
In a pilot study, people with dementia started wearing inexpensive, over-the-counter devices to boost their hearing. A month later, their caregivers reported improved communication, more laughter, and more storytelling.
“If you’re an older adult with hearing loss, it would make sense to treat that hearing loss,” says Richard Gurgel, MD, of the University of Utah.
If you think your hearing has gotten worse with age, Gurgel recommends a hearing screening. The relatively quick, painless test can help you notice how your hearing changes as you get older and if a hearing aid would help you.
Frank Lin, MD, PhD, associate professor of otolaryngology-head & neck surgery, geriatric medicine, mental health, and epidemiology, Johns Hopkins University.
Heather Whitson, MD, associate professor of medicine (geriatrics) and ophthalmology senior fellow, Duke University Aging Center, Duke University Medical Center, and Durham VA Geriatric Research, Education, and Clinical Center (GRECC).
Richard Gurgel, MD, assistant professor of otolaryngology, University of Utah.
JAMA Internal Medicine: “Hearing Loss and Cognitive Decline in Older Adults.”
ACTA Otorhinolaryngologica Italica: “A review of new insights on the association between hearing loss and cognitive decline in ageing.”
JAMA Otolaryngology-Head and Neck Surgery: “Improvement of Cognitive Function After Cochlear Implantation in Elderly Patients.”
Aging and Mental Health: “Hearing Loss and Dementia — Who’s Listening?”
American Journal of Geriatric Psychiatry: “Hearing Care Intervention for Persons with Dementia: A Pilot Study.”
Fisher Center for Alzheimer’s Research Foundation: “Feeling Lonely Increases Alzheimer’s Risk.”
Trends in Cognitive Science: “Perceived Social Isolation and Cognition.”
© 2017 WebMD, LLC. All rights reserved.
Patients with untreated hearing loss incur higher health care costs over time
Older adults with untreated hearing loss incur substantially higher total health care costs compared to those who don't have hearing loss—an average of 46 percent, totaling $22,434 per person over a decade, according to a new longitudinal study led by researchers at the Johns Hopkins Bloomberg School of Public Health.
This is one of the largest studies to look at this issue, following many individuals for a full 10 years.
Compared to the patients without hearing loss, patients with the condition generated nearly 26 percent more in total health care costs within two years, a gap that widened to 46 percent by 10 years, amounting to $22,434 per individual ($20,403 incurred by the health plan, $2,030 by the individual in out-of-pocket costs). The study did not include patients with hearing loss who had evidence of hearing aid use.
The findings, published in JAMA Otolaryngology-Head and Neck Surgery, add to a growing body of research from Johns Hopkins and elsewhere showing the detriments of untreated hearing loss, which include a higher risk of dementia and cognitive decline, falls, depression, and lower quality of life. In a companion paper published in the same issue, a study led by Bloomberg School researchers suggests a link between untreated hearing loss and significantly greater morbidity, affirming early studies.
“Knowing that untreated hearing loss dramatically drives up health care utilization and costs will hopefully be a call to action among health systems and insurers to find ways to better serve these patients.”
Nicholas S. Reed
Instructor of audiology
Hearing loss affects 38 million Americans, a number that's expected to double by 2060, with current aging population trends. An estimated one in three people in the U.S. between ages 65 and 74 currently has hearing loss, and two-thirds of adults age 70 and older have a clinically significant hearing loss.
It's unclear how hearing loss has translated into longitudinal trends of health care utilization and costs, particularly for those whose hearing loss remains untreated, says study lead Nicholas S.
Reed, a member of the core faculty of the Cochlear Center for Hearing and Public Health at the Bloomberg School and an instructor of audiology in the Department of Otolaryngology-Head and Neck Surgery at the Johns Hopkins University School of Medicine.
To investigate these questions, Reed and his colleagues mined information from the OptumLabs Data Warehouse, a large de-identified health care dataset including administrative claims from 1999 to 2016 for people enrolled in large private U.S. health plans and Medicare Advantage plans.
The researchers used diagnosis codes to identify more than 77,000 patients with ly age-related untreated hearing loss, excluding those whose claims data indicated they used a hearing aid or whose hearing loss was secondary to a medical condition or toxic agent such as chemotherapy.
The research team then matched each of these patients with other patients in the claims database on more than 25 factors including demographic characteristics, baseline health conditions, and measures of health care utilization, such as inpatient hospitalizations and readmissions within 30 days, emergency department visits, days with at least one outpatient visit, and health care costs. The researchers analyzed health care cost and utilization outcomes and trends at two-, five- and 10-year follow-up points.
At the 10-year mark, patients with untreated hearing loss experienced about 50 percent more hospital stays, had about a 44 percent higher risk for hospital readmission within 30 days, were 17 percent more ly to have an emergency department visit, and had about 52 more outpatient visits compared to those without hearing loss.
When the researchers calculated how much of the extra $22,434 in total health care costs were ly due solely to hearing loss-related services, the total was only about $600 over 10 years.
The study results do not indicate exactly why untreated hearing loss drives up health care utilization. Reed and his colleagues have a few ideas. One of them is hearing loss' relationship with other serious health issues.
“We need to better understand these relationships to determine if treatment for hearing loss could potentially reduce risk and help maintain health in older adults.”
Assistant scientist, Department of Epidemiology
In the companion paper, using the same OptumLabs dataset, Jennifer A. Deal assistant scientist in the Bloomberg School's Department of Epidemiology, and her colleagues show that untreated hearing loss is independently associated with significantly greater morbidity.
For example, compared to those without hearing loss, those with untreated hearing loss had 3.2 more dementia diagnoses, 3.6 more falls, and 6.9 more depression diagnoses per 100 people over 10 years.
Over 10 years, those with untreated hearing loss had an estimated 50 percent greater risk of dementia, 40 percent greater risk of depression, and almost 30 percent higher risk for falls compared to those without hearing loss.
“We don't yet know if treating hearing loss could help prevent these problems,” Deal says.
“But it's important for us to figure out, because over two-thirds of adults age 70 years and older have clinically significant hearing loss that may impact everyday quality of life.
We need to better understand these relationships to determine if treatment for hearing loss could potentially reduce risk and help maintain health in older adults.”
Deal also noted that the depression finding is important. “There aren't a lot of studies using objectively measured hearing loss showing this association, even though it seems pretty intuitive,” she says.
Another possibility for the link between hearing loss and greater health care cost and utilization is that hearing loss might hamper patient-provider communication, says Reed.
Patients who cannot hear their doctors may have trouble communicating their symptoms, participating in conversations to develop a recommended plan for their health, or following discharge instructions—key elements in participating in their own care.
To help improve communication for patients with hearing loss at Johns Hopkins Bayview Medical Center, Reed and others developed a multi-element pilot program to provide extra training to doctors, improve signage, or provide hearing amplification devices. The researchers are currently collecting outcomes data associated with these interventions to determine whether they result in better care.
Across the United States, adults with hearing loss will be able to access hearing amplification devices more easily in 2020, when a federal law authorizing certain types of over-the-counter hearing aids will go into effect.
“Knowing that untreated hearing loss dramatically drives up health care utilization and costs will hopefully be a call to action among health systems and insurers to find ways to better serve these patients,” says Reed.
The project was done in collaboration with AARP, the University of California San Francisco, and OptumLabs.
Posted in Health
hearing loss, health care costs
Why Hearing Loss Affects Men and Women Differently | From Hear to Ear Blog
Hearing loss can happen to anyone, no matter your age or background. That being said, certain groups of people are more ly to develop hearing loss on average.
Men in particular are at a greater risk of developing hearing loss than women, a phenomenon that has intrigued audiologists for years.
In fact, a study by Johns Hopkins University in 2008 found the risk of hearing loss for men is five times greater than it is for women.
Age and race both play a factor in this data, as the gap between men and women usually begins around age thirty, with white men displaying the highest prevalence of hearing loss.
Occupational hearing loss in men
Contrary to what you may think, this disparity is not the result of a difference in biology. If you consider the types of jobs that are typically performed by men, many of them involve regular exposure to extreme noise from their equipment and environment.
While the law requires that workers be provided ear protection in conditions where unsafe volumes are present, a large number of men still neglect to take care of their hearing on the job. If you feel your workplace is posing a threat to your hearing or are concerned that your hearing loss is not being accommodated, please consult our article on how to discuss your condition at work.
Behavioral risk factors
Since men and women are both born with the same level of hearing, audiologists have concluded that behavioral factors play a huge role in establishing the hearing loss gap.
Smoking and certain health conditions such as high blood pressure or heart disease are known to cause hearing loss. These issues are more common in men, confirming the findings in many studies.
In another study by the American Journal of Medicine, regular use of NSAIDs and other pain relievers aspirin and acetaminophen can lead to early hearing loss in men under 60.
Addressing the stigma of hearing loss in men
Despite these risk factors, men are still more ly to avoid being fitted with a hearing aid than women. This could be the result of a stigma against hearing aid use or a fear that wearing a medical instrument will be seen as a sign of weakness.
These fears couldn’t be further from the truth, as there is no more shame in correcting hearing loss with hearing aids than correcting a vision problem with eyeglasses.
In addition, addressing hearing loss early is known to help prevent the early onset of dementia and Alzheimer’s disease while also protecting from falls and feelings of depression or anxiety.
Many people don’t realize that there are different types of hearing loss. Some affect the ear’s ability to hear higher frequencies, while others muffle or silence lower ones.
Male hearing loss typically robs the ear of high-frequency hearing first, while the opposite is true for women. The result? Men have a hard time understanding consonant sounds that contain higher pitches, and women struggle to understand the deep, rounder sounds of vowels.
With these hidden factors at play, it’s no wonder so many couples have trouble communicating!
Get help today
Hearing loss in men doesn’t have to be an epidemic. Consulting a hearing care professional at the first sign of hearing loss is the most effective way to treat your condition and prevent it from worsening. If you are worried about your hearing or that of a loved one, please use our online locator to schedule an appointment with a hearing care professional in your area today.
Hearing loss in older adults tied to more hospitalizations and poorer physical and mental health
Older adults with hearing loss are more ly than peers with normal hearing to require hospitalization and suffer from periods of inactivity and depression, according to results of a new study by experts at Johns Hopkins.
The Johns Hopkins team's analysis of the health survey data from 1,140 men and women aged 70 and older with hearing loss found that those with hearing deficits were 32 percent more ly to have been admitted to a hospital than 529 older men and women with normal hearing. All study participants had volunteered to have their hearing tested over a four-year period, as part of a larger, ongoing study, the National Health and Nutrition Examination Survey, or NHANES.
The latest NHANES findings, to be published in the Journal of the American Medical Association online June 11, are believed to be the first to show the broader, economic and long-term effects of hearing loss on general health.
“Hearing loss may have a profoundly detrimental effect on older people's physical and mental well-being, and even health care resources,” says senior study investigator and Johns Hopkins otologist and epidemiologist Frank Lin, M.D., Ph.D.
“Our results underscore why hearing loss should not be considered an inconsequential part of aging, but an important issue for public health,” says Lin, an assistant professor at the Johns Hopkins University School of Medicine and the university's Bloomberg School of Public Health.
According to Lin, as many as 27 million Americans over age 50, including two-thirds of men and women aged 70 years and older, suffer from some form of hearing loss.
Among the study's other key findings were that older adults with hearing loss were 36 percent more ly to have prolonged stretches of illness or injury (lasting more than 10 days), and 57 percent more ly to have deep episodes of stress, depression or bad mood (for more than 10 days). NHANES participants answered detailed questionnaires about their physical and mental well-being.
“Health policymakers really have to consider hearing loss and its broader health impact when making decisions, particularly for older people,” says Dane Genther, M.D.
, lead study investigator and a Johns Hopkins resident in otolaryngology — head and neck surgery.
Genther supports expanded Medicare and Medicaid reimbursement for hearing-related health care services, wider installation of hearing loops in various facilities, and more accessible and affordable approaches for treating hearing loss.
Lin says social isolation resulting from hearing loss may explain the physical and mental declines — as well as the cognitive deficits — that afflict older adults.
This, in turn, may lead to more illness and hospitalization, he says.
His team already has further research under way to see if treating hearing loss with counseling and hearing aids can reduce people's risk of cognitive decline and dementia.
NHANES participants were tested for hearing loss from 2005 to 2006, and again from 2009 to 2010. For the test, study volunteers individually listened to a range of soft and loud sounds, from 0 decibels to 100 decibels, in a soundproof room. Hearing specialists define such a deficit as recognizing only those sounds louder than 25 decibels.
Funding support for this study and the NHANES study was provided by the National Institutes of Health (NIH), and the Centers for Disease Control and Prevention.
Corresponding grant numbers are T32-DC000027-24 and 1K23-DC011279.
Additional research support was provided by the Eleanor Schwartz Charitable Foundation and a Triological Society and American College of Surgeons Clinician-Scientist Award.
In addition to Lin and Genther, other Johns Hopkins researchers involved in this study were Kevin Frick, Ph.D.; David Chen, B.S.; and Joshua Betz, M.S.
Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.
What we know about the link between hearing loss and dementia
My father is going deaf, but he refuses to wear a hearing aid. Is there any way to make him come to his senses?
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Your father is certainly not alone. Many older adults, especially men, resist treatment for hearing loss. Unfortunately, they may be doing themselves far more harm than just missing out on conversations with family and friends.
A growing body of evidence has linked hearing loss with an elevated risk of dementia, including Alzheimer's disease.
In 2011, researchers at Johns Hopkins University in Baltimore published a landmark paper in the journal Archives of Neurology.
For their study, they recruited 639 older adults, one-quarter of whom had some hearing loss. When they were initially enrolled, none of the volunteers had dementia. After being followed for 15 years, those with hearing loss were significantly more ly to have gone on to develop the mind-robbing disease.
“When we first saw the results of our study, we actually didn't quite believe them because the association was so strong,” says Dr. Frank Lin, an associate professor of otolaryngology and epidemiology at Johns Hopkins.
And, in particular, those with the severest hearing loss were at the greatest risk of getting dementia.
In recent years, other research teams have made similar observations, confirming the original findings.
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Experts believe hearing loss contributes to mental decline in several ways.
For one thing, the struggle to hear puts a huge extra burden – or cognitive load – on the brain.
“As you lose hearing, you have to work harder and harder to understand sounds, and that takes away resources that your brain could use for other functions such as memory,” says Claude Alain, a senior scientist at Baycrest's Rotman Research Institute in Toronto.
Hearing impairment may also trigger structural changes in the brain itself. “It could be a case of use it or lose it,” speculates Dr. Sandra Black, a cognitive neurologist at Sunnybrook Health Sciences Centre in Toronto.
She adds that a lack of stimulation may cause key parts of the brain – especially those involved in auditory processing – to literally wither away.
Furthermore, hearing problems often lead to social isolation, which is a well-known risk factor for dementia. “Imagine if you can't hear a conversation, you're going to become less engaged and more withdrawn,” Black says. “You stop living life to the fullest.”
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All these factors combined might accelerate the onset of dementia.
That possibility, of course, raises an important question. Could the use of hearing aids, and other measures to boost auditory perception, help prevent dementia – or at least slow its advance?
Right now, scientists can't say for sure. But Lin, and his American research colleagues, have obtained $16-million (U.S.) in funding from the National Institutes of Health to do a definitive study.
They plan to recruit 850 volunteers, aged 70 to 84, with mild to moderate hearing loss. Half of them will be equipped with hearing aids. The balance will be given a course on healthy aging. After five years, the two groups will be compared to see if one of them shows more resistance to dementia.
Meanwhile, numerous research teams are looking at other strategies to reinforce the brain's ability to process sound. For instance, some are investigating whether music lessons or joining a choir could help fine-tune people's hearing. “These are good exercises to train the listening brain,” Alain says.
The medical community has a lot of hope riding on these research studies. After all, hearing loss is extremely common and so is dementia. About one-quarter of people over 50 years of age have some degree of hearing loss. Over the age of 70, that figure climbs to two-thirds.
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Age-related hearing loss usually happens at a fairly gradual pace. Yet few bother to get their hearing tested even as they find it increasingly difficult to discern speech in restaurants, social gatherings and other noisy places, Alain says.
In contrast, he adds, most people willingly don eyeglasses or contact lenses as soon as their vision becomes the least bit blurry.
For some inexplicable reason, there is a stigma attached to hearing aids. That's a shame, because they could be real mind savers.
Indeed, that's something you could tell your father that may make him receptive to using one.
Paul Taylor is a patient navigation advisor at Sunnybrook Health Sciences Centre. He is a former health editor of The Globe and Mail. You can find him on @epaultaylor and online at Sunnybrook's Your Health Matters.