Harvard Men's Health Watch

Now hear this: You may need hearing aids

These tiny devices can improve your communication, your relationships, and even your brain function, but only if you use them.

Age-related hearing loss affects about a quarter of people ages 65 to 74 and half of those ages 75 and older, according to the National Institute on Deafness and Other Communication Disorders. Over all, though, it tends to be more male-oriented.

“By middle age, many men also have hearing nerve damage from long exposure to noises like power tools, music, and guns,” says Dr. Steven Rauch, an otologist with Harvard-affiliated Massachusetts Eye and Ear. Some career choices—like construction, manufacturing, or military service—also contribute.

Recognizing hearing loss

The easiest solution to hearing loss is to wear a hearing aid. In fact, some estimates suggest that by age 65, about one-third of men need hearing aids. However, only half of this group wears them. Why the resistance?

“Men tend to avoid hearing aids because of their negative image,” says Dr. Rauch. “Hearing aids symbolize declining health and that their best years are behind them.”

Yet these men, he says, should consider that going without a hearing aid can project an equally negative image, because “their hearing loss can be mistaken for confusion or cognitive decline.”

While some men can get by without a hearing aid, they need to consider the potential impact hearing loss has on their life, relationships, and even thinking skills. “Left untreated, hearing loss is associated with higher risks for social isolation, depression, and reduced physical activity,” says Dr. Rauch.

Get tested

The first step to knowing whether you need hearing aids is to get your hearing checked by a certified audiologist. (Ask your doctor for a recommendation.) Hearing tests measure how loud a sound needs to be for you to hear it and how clear the sound is to you.

People with normal hearing can hear sounds less than 25 decibels (dB). If the softest sounds you can hear are 30 dB or louder, you may be missing a significant amount of what is said to you and are probably a candidate for a hearing aid.

It’s important to note that hearing aids are only amplifiers. “They are an excellent remedy for patients with a loudness problem, but can’t help with clarity,” says Dr. Rauch.

If you have a clarity problem like trouble understanding speech in a noisy environment, there are other methods that may help improve communication. For example, when speaking with someone, sit face-to-face and reduce background noise, like the TV, or distractions, like reading the paper. Be fully focused and engaged.

“Ask the person not to shout, but to speak more slowly and more clearly in order to hyperenunciate words,” says Dr. Rauch.

Age-related hearing loss and noise-induced hearing loss tend to affect both ears equally. If hearing loss occurs in one ear but not the other, it could be a result of a stroke, infection, or tumor and requires further medical evaluation, says Dr. Rauch.

People with single-sided hearing loss, or hearing loss that is different in each ear, are less likely to benefit from wearing a hearing aid just in the bad ear compared with both ears. “These people seem to have trouble fusing the electronic sound of a hearing aid with the normal sound in the opposite ear,” says Dr. Rauch.

Time to adjust

After you get fitted for a hearing aid it often takes times to adjust. “If you’ve had a gradual progressive hearing loss over a period of years, your brain is out of practice processing and filtering the full spectrum of normal sounds, so it needs time to adapt,” says Dr. Rauch.

Wear your hearing aids for about an hour daily to start and then gradually increase your time over a few weeks. You don’t have to wear them all the time, either—you can put them in only when you need to. But the more you use them, the quicker you will adjust.

Also, be aware that not everyone finds hearing aids comfortable. “They make everything louder—voices, noises, sounds—and some people may find it overwhelming in places with a lot of stimuli, like restaurants and crowds,” says Dr. Rauch. “They are usually more helpful in quieter environments.”

Shopping tips

The results of your hearing test will help your audiologist recommend the right kind of hearing aid, but here are some other factors to know about your purchase:

  • If you have severe hearing loss, you may need a larger hearing aid.
  • A single aid can cost from $3,000 to $4,000, although most vendors offer a discount for the second one.
  • Medicare and many other insurance plans don’t cover hearing aids, but the Veterans Health Administration might. (Check with your provider.)
  • Some state laws require that you can return hearing aids after 30 days if you don’t like them (you only pay a small reprocessing fee).
  • Hearing aids last about five years.
  • Avoid any marketing hype and focus on comfort, ease of use, cost, and how well it works for you.
  • Ask your friends who are satisfied with their aids and their hearing aid vendor for a recommendation.

For many men, hearing aids can be a life-changer—for them and the people around them as well. “Instead of worrying about ‘looking old,’ realize that hearing aids are a gift for you, your wife, your friends, and everyone else you interact with,” says Dr. Rauch. “They make everyone’s lives better.”

You can find additional advice on diagnosing and treating hearing loss, as well as guidance on choosing a hearing aid, in Hearing Loss, a Special Health Report from Harvard Medical School, available for purchase at www.health.harvard.edu/hl.

Better hearing equals a better brain

A study in the Jan. 27, 2016, American Journal of Audiology found a link between use of hearing aids and improved brain function in people with hearing loss.

The study examined people with hearing loss who had never used hearing aids. They were tested to measure their working memory (the ability to process information) and selective attention. The subjects then wore hearing aids for an average of eight hours a day for six months. Afterward, test results for the group showed that working memory had improved by 14% and selective attention by 20%.

The connection, according to the researchers, is that hearing loss can interfere with cognitive abilities because so much brain effort is put toward understanding speech.

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