By Elizabeth O'Brien, Retirement reporter
Evening news commercials contain a medicine chest’s worth of midlife ailments, from erectile dysfunction to high cholesterol. One condition receives less attention despite its prevalence: hearing loss.
There’s no drug for age-related hearing loss, which affects about one in three U.S. adults between the ages of 65 and 74, and nearly half of those older than 75, according to the National Institutes of Health. The primary treatment is a hearing aid or other device, which can carry a significant financial cost as well as a stigma.
Hearing loss also gets short shrift at the doctor’s office. Just 23% of adults age 20-plus reported receiving a hearing screening during a physical exam during the past year, according to the large-scale MarkeTrak IX survey conducted in late 2014. “We screen the hearing of every baby that leaves the hospital, but we don’t screen the hearing of people approaching retirement age,” said Dave Fabry, vice president, audiology and professional relations at Starkey Hearing Technologies, a hearing aid manufacturer based in Eden Prairie, Minn. “Hearing loss is really underappreciated.”
Research suggests more urgency is warranted. Studies have linked hearing loss to an increased risk of dementia, falls, and depression. There’s an economic impact, too: reports from the Better Hearing Institute have found that hearing loss reduces household income, but the use of hearing aids can help mitigate the loss by between 65% to 100%, depending on the severity of the impairment. What’s more, to the extent that hearing loss nudges workers out of their jobs before they’re ready to retire, it can also lead to reduced nest eggs.
Medically known as presbycusis, age-related hearing loss typically begins in the late 50s or early 60s, said Michelle Montes, clinical audiologist at Penn Medicine. Most commonly, it occurs when tiny nerve cells in the inner ear become damaged; once damaged, they do not grow back, and hearing becomes impaired. Loss can progress gradually enough that the affected individual doesn’t recognize it at first.
A person’s lifetime exposure to noise can affect the age at which his hearing starts to diminish in adulthood, and for that reason it’s hard to completely distinguish age-related hearing loss from loss due to long-term noise exposure.
While the boomers might have been the first generation to pump rock and roll directly into their ears and to attend stadium concerts en masse, it’s their children who will likely suffer more from recreational exposure to loud noise, Montes said. In other words, today’s omnipresent listening devices mean millennials will likely experience greater hearing loss at a younger age than their parents’ generation.
Establish a baseline
Since everyone’s background is different, it’s good to have a baseline hearing test done at age 50, regardless of hearing complaints, said Gayla L. Poling, director of diagnostic audiology at the Mayo Clinic in Rochester, Minn. If changes are noted, those with a loud work environment or hobby may be able to take steps to reduce further damage.
The first place where people often struggle with their hearing is a cocktail party, experts say. For those with even mild hearing loss, it can be hard to extract speech from all the background noise, especially as conversations develop quickly with little context to draw on, Fabry said.
The first tones that people lose are higher-pitched. Since they hear the base tones, they know someone’s talking, but they can’t make out the consonants that segment a stream of sounds into words. “The classic line is, ‘I can hear you, but I can’t understand you,’” said Craig Newman, an audiologist at the Cleveland Clinic.
People often cope for years before seeking treatment. There’s no cure for presbycusis, and waiting won’t accelerate the hearing loss, Fabry said. Yet on top of quality of life issues, the fact that hearing loss could contribute to dementia and other serious issues is all the more reason why people should not postpone seeking help, he noted.
(Age-related hearing loss is generally gradual and progresses equally in both ears. Sudden hearing loss, which can happen to people at any age and affect just one ear, should be considered a medical emergency and treated as soon as possible, experts say.)
Some primary care doctors send patients with hearing loss to an ear, nose and throat doctor to rule out any medical problems affecting their hearing. Other patients might get referred directly to an audiologist, a healthcare professional who is not a medical doctor but has received extensive post-graduate training, often at the doctorate level, to diagnose and treat hearing difficulties.
The audiologist will determine the extent of the hearing loss and see whether the patient is a candidate for a hearing aid. Two people might get identical scores on a hearing test but have very different needs — the person who frequently attends conferences for work might benefit from an aid, for example, while the person who mainly needs to hear the television better might benefit from a simple amplification device, Poling said. (There are devices that help the hearing impaired person without blaring the volume for others in the house.)
When it comes to hearing aids, the general rule is “you get what you pay for,” Montes said. The cost ranges widely, anywhere from around $800 to $4,000 per ear, with each pair generally lasting no longer than five years. Medicare doesn’t cover hearing aids, nor do many private insurance plans. People with health savings accounts can use those funds to pay for hearing aids, batteries, repair and maintenance.
The good news is that technology continues to improve rapidly. Hearing aids with Bluetooth connectivity enable users to connect to phones, televisions and tablets. What’s more, improved battery technology has helped aids becomes increasingly unobtrusive.
Phonak, a Swiss hearing aid manufacturer, makes an extended-wear aid called Lyric that sits completely within the ear and can be worn continuously for the life of the battery, around two to three months. (The wearer can shower but not be submerged in water). The average age that people start wearing Lyric is around 55 to 56, younger than the industry average of about 63 or 64, said Martin Grieder, group vice president of Phonak.
Much of the new technology, from aids to table microphones, is sleek, and industry professionals hope their design and interconnected functionality will ease the stigma of hearing devices.
Boomers can embrace them just as they do their smart phones, Fabry said: “We can’t assume that as a person approaches 65, they can’t handle the technology.”