There are a hundred reasons to put off buying hearing aids, and there are just as many reasons to NOT put off wearing them or to have a relative wear them. This article will look at 2 of those reasons; the statistics of income and cognitive function.
Income and Hearing Loss
I was watching a re-run of an episode of Seinfeld, a show I stopped watching a long time ago, but this one caught my attention again, for the same reason it did when I first saw it several years ago. The guest star was Rob Schneider, generally a pretty funny guy, although that is arguable, and his character was a new employee at the J. Peterman company, where the character of Elaine was employed. Bob, Rob Schneider’s character, was hard of hearing, from the contents of the episode; I would judge that he would have been severely hard of hearing, perhaps even profoundly. The gist of this back story is that Elaine feels Bob is faking his hearing loss and wants to try to prove it. Schneider really hammed up the character, to the point where it was, as you would expect, comical. Constantly fiddling with his hearing aid, never getting any sonic cues, even to the point where it seemed he ignored visual cues. But Bob was a bit of a buffoon, and it is this depiction that bothered me, (no reflection on Schneider’s acting skills). It’s the stereotype, and that episode probably did more damage to people with hearing loss than anything the general public could ever do.
I have said before that I am a statistics guy. I love reading them and the interpretations of those statistics and bringing them to light in forums like this one. That being said, I recently read an article published by the Better Hearing Institute titled: “Want a Better Salary? Get a Hearing Aid!”. Of course, it applied to people with hearing loss, but it used data extrapolated from the continuing study by Dr. Sergei Kochkin called MarkeTrac. This study is republished and updated every four years, they are currently in their 25th year, and tracks the efficacy, sales, proliferation and differentiation of the hearing aid marketplace. They sample people from all over the world, but with a major focus on North America, and specifically the US, which is the largest market outside of Asia. They cover all kinds of topics from which hearing loss is most prevalent, to how much of an effect wearing them has on peoples’ lives. One particular article focused on the work environment. There were several outcomes, but the one I wanted to point out is this: In the average North American workplace, close to 12% of the employees would have some form of hearing loss. Of that 12%, a little more than one third of them wore hearing aids while the other 66% did not. In general, those who wore hearing aids had higher household incomes. Even more interesting is the fact that as the degree of hearing loss got worse, the bigger the divide between those who wore hearing aids and those who don’t. “The model demonstrates that income drops as a function of hearing loss, but more sharply for people with severe hearing losses.”, (Kochkin, 2010). Kochkin went on to talk about how allowing a federal funding model in the US could very well generate more revenue for the government. The idea being that if they pay for hearing aids every 5 years and people earn, for example, $11,000 more per year, (the average difference between people with aided severe hearing losses and unaided severe hearing losses), the government could recoup their investment inside of a few years and have some of that revenue left over. Even if they allowed for an income tax deduction for the full value, they would still be further ahead.
There are hundreds of reasons to treat a hearing loss, even a mild one. This is one of them and one that might strike a chord with some people who have been putting of the decision because of what other people might think, particularly at your workplace. Take the Seinfeld episode for the comedic value it had, but not for the unrealistic depiction of a person wearing hearing aids. You probably won’t know they’re wearing them anyway!
Cognitive Function.
In 1989 a group of 5 physicians underwent a study that correlated hearing loss to various forms of dementia, (Uhlmann, R. F. Et. Al., 1989), and published their findings in the Journal of the American Medical Association, (JAMA). The research looked at 100 people from various states who all had very similar forms of dementia from a variety of causes, including those diagnosed with Alzheimer’s disease. Each of the subjects had some form of hearing loss, and while they were not all the same, they were all within the same bracket, and compared them to a control group of the same number, age and education level. The amount of hearing loss was recorded and using several test for cognitive function, they came up with a rating scale.
I could use the rest of this article to go over the methodology and measurement aspects of the study, but the real meat of the article was the conclusion which found that in patients suffering from any form of dementia, their cognitive function decreased as untreated hearing loss increased. In other words, the more severe the hearing loss, the worse the cognitive abilities became.
Here’s the clincher, it was only slightly better for those who had no signs of cognitive dysfunction. Better, but only about 3-5%, as outlined in the comments after the conclusion:
“This study was designed to test the
hypothesis that hearing impairment
contributes to cognitive dysfunction in
older adults. In our study population,
we found that hearing impairment was
more prevalent in demented than non¬
demented patients and that the risk of
dementia increased with progressively
greater amounts of hearing loss. In ad¬
dition, hearing loss was correlated with
poorer cognitive functioning in nonde¬
mented as well as demented patients.
These associations were statistically
significant even after controlling for po¬
tential confounders. Thus, the findings
ofthis study lend support to the hypoth¬
esis that hearing impairment contrib¬
utes to cognitive dysfunction in older
adults.” (Uhlmann et al. 1989).
They also pointed out, however, that there was nothing to imply that hearing loss was the cause of such dysfunction, merely a factor contributing to the fact that it hearing loss made the problem worse.
Some clinicians have hypothesized that this is a result of a person turning inward as the hearing loss gets worse. We see that every day in our clinic, people who, afraid of being left out, choose to do that pre-emptively, and stay at home in a more controlled environment. Many researchers believe this is a primary cause of the worsening of dementia.
So does treating the hearing loss prevent or slow down the process? By treatment, we simply mean wearing hearing aids, which is the only known treatment for sensorineural hearing loss, and another group of physicians studied the effects of treating the loss on cognitive function, (Allen, N.H. et al, 2003). The results Indicated that “Forty‐two percent of subjects showed an improvement on an independently rated measure of change. The hearing aids were well accepted. Both (care providers) and subjects reported overall reduction in disability from hearing impairment”, (Allen et al. 2003). Bear in mind that 20% of the people studied did not have anything worse than a mild hearing loss and several of those were able to achieve better results once the ears were flushed of wax and debris which were occluding the ear canal.
But they did point out, however, that wearing hearing aids did not improve cognitive functions, but made the issue of communicating with patients much easier and reduced overall psychiatric issues associated with whatever form of dementia the patient was suffering from.
So the short answer is this: patients with hearing loss, who also suffer from dementia, can prolong their cognitive health by treating the hearing loss. Symptoms of dementia are not improved by wearing hearing aids, (in patients with hearing loss), however communication is facilitated and therefore engaging the patient is significantly easier for both family and care providers. The same studies also showed that those who do NOT have dementia, but were senior citizens with hearing loss, also had marked reduction in the loss of cognitive function, but the statistics indicated that these numbers were slightly lower, which is to be expected, since they are not showing signs of dementia.