Hearing aids may help you live longer, but barriers to their use persist

(NEW YORK) — Regular use of hearing aids is associated with decreased death rates in U.S. adults with hearing loss, a new study out of USC found.

The findings highlight the importance of encouraging people to use hearing aids and of ensuring everyone who needs hearing aids can get them, according to the study’s authors.

“Hearing is so important for just maintaining health across our life course,” said Dr. Frank Lin, director of the Cochlear Center for Hearing and Public Health at Johns Hopkins and an author on the study.

The World Health Organization estimates that by 2050, seven million people — 1 out of every 14 people — will have hearing loss severe enough to require treatment. The most common causes of hearing loss are exposure to loud noises and natural aging-related degeneration, both of which affect the inner hair cells of the ear, according to the Centers for Disease Control and Prevention.

Everyone will develop some degree of hearing loss during their life, said Lin: “It’s inevitable.”

The research team studied 10,000 adults from the National Health and Examination Survey (NHANES), a collection of data from the CDC. Out of the 1,700 adults with hearing loss, only 13% used hearing aids regularly, which the study defined as at least once a week or at least five hours a week. After 10 years, compared to people who had irregularly or never used hearing aids, 24% fewer of the regular hearing aid users had died. That was the case even when taking into account things like income, medical history and other demographic differences.

“I always had tremendous interest in how hearing loss impacts a lot of health outcomes, and also wanted to see if hearing aids can actually modify it,” said Dr. Janet Choi, an otolaryngology-head and neck surgeon who specializes in ear-related disorders, and the lead researcher of the study. Choi herself was born with hearing loss and started wearing hearing aids as an adult.

The study can’t explain why hearing aid use was linked with reduced deaths, but Choi says it may be because hearing aids help mitigate risk for other conditions like depression, dementia and social isolation.

Previous studies have linked hearing loss and social isolation, which can increase risk for heart disease, dementia and depression. The study was not able to examine these specific medical conditions, but is the first large study to investigate whether hearing aid use, as an intervention for hearing loss, could prevent death.

Regular hearing aid users tended to belong to a higher socioeconomic class, self-identify as white, and have fewer medical conditions, the study found. Cost can be prohibitive, as one pair can cost as much as $4,500 and needs to be replaced every few years, said Lin. While some private insurers cover hearing aids, Medicaid coverage varies by state and most Medicare plans do not cover hearing aids at all.

“This type of hearing care is essentially all out of pocket. For an average American, it could be your third-largest material purchase after a house and a car,” he said.

Other barriers to hearing aids might include lack of access to care, according to Choi. Getting a well-fitting pair of hearing aids includes multiple visits to the otolaryngologist, audiologist, and the hearing aid center, all of which come with their own transportation and language barriers.

In some cases, primary care physicians may not be recommending enough patients to go see a hearing specialist, according to Dr. Doug Backous, president of the American Academy of Otolaryngology-Head and Neck Surgery.

“It’s probably the most under-screened symptom in a primary care office,” he said.

On top of that, there remains a lot of stigma around using hearing aids.

“A lot of people come to me with hearing loss and communication difficulties but they’re not willing to try hearing aids, they’ll say, ‘I don’t think I’m there yet’ or ‘I don’t want to look old’,” Choi said.

Strategies to increasing hearing aid use are multifactorial, from training more audiologists to implementing accessible hearing assessments, according to both Lin and Backous. One promising breakthrough is the availability of over the counter (OTC) hearing aids, which first became available in 2022 after a new FDA rule went into effect.

Advocates like Dr. Lin hope that OTC hearing aids will remove prescription barriers, help drive down prices in a more competitive market, and lead to more innovative features. Others are more skeptical.

“I think they’re a good entry point,” Backous said.

He hopes that OTC hearing aids will ultimately raise awareness to see a specialist for a more comprehensive hearing assessment, and a prescription for custom-fit hearing aids.

As the U.S. population ages, and as more younger Americans turn to hearing aids, Choi says she feels that her research may add to the case for hearing aids as a protective medical treatment against worsening disease or death. But there’s still more to learn — such as if hearing aids benefit younger adults with mild hearing loss who may not yet realize it.

“There are a lot of unanswered questions still in our field,” Choi said.