Photo Credit: Mark Paton
by Daniel Fink, MD, Chair, The Quiet Coalition
My recent blog attracted an email from someone affiliated with the National Council on Aging, a nonprofit agency advocating for older Americans with service providers and policy makers. She noted that “approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing,” and also let us know about NCOA’s guide to the best, most affordable hearing aids available.
As you know, The Quiet Coalition does not accept contributions from industry and does not endorse products, but NCOA has done the research so we are sharing that with our readers. NCOA itself does not receive a commission for purchases made using the links in its review, but has informed us that its partners may earn a commission from this.
The New York Times Wirecutter site also recently recommended hearing aids. Wirecutter does however explicitly state, “We independently review everything we recommend. When you buy through our links, we may earn a commission.” Both guides did recommend the same product first.
Many experts are excited about the FDA’s approval of over-the-counter hearing aids, but as I have written, I am a skeptic. From speaking with audiologists, I have learned that fitting the right hearing aid to the right patient is as much art as it is science. There is a well known problem of hearing aid non-usage, known in the hearing aid industry as the “hearing aid in the drawer”problem. When my patients obtained hearing aids but returned to the office not wearing them, they answered my queries by saying, “Doc, the hearing aids are great in a quiet place. I can hear the clock on the wall ticking. I can hear the birds singing in my yard. But when I’m in a noisy restaurant, everything is too loud and I still can’t understand what people are saying.”
The hearing aid non-usage studies were done with older hearing aids, so maybe the newer models are better. My cynical guess however, is that if the “hearing aid in the drawer” problem had been solved, its success would have been published by now.
Everyone should understand that hearing aids don’t restore normal hearing. They deliver amplified sound to dead or damaged cochlear hair cells, and then that sound is transmitted over damaged neural pathways to a damaged auditory processing cortex. Hearing aids unfortunately aren’t like reading glasses for presbyopia–they do not correct for the damage that’s already been done.
My advice: protect your ears from loud noise and you won’t need hearing aids. Hearing loss with age is not a part of normal physiological aging, but largely represents noise-induced hearing loss. I presented a paper about this at the 12th Congress of the International Commission on Biological Effects of Noise in Zurich in 2017, which was published in The Hearing Journal a year ago.
If something sounds loud, it’s too loud, and your hearing is at risk. This advice pertains even if one already has hearing loss, because additional noise exposure will only cause further auditory damage. Turn down the volume, insert ear plugs, or leave the noisy environment to protect your ears.
