The annual dog costume contest was starting at my block party. I walked out of my house without my hearing aids and cheered on the winners, a husky dressed as a bumblebee and a labradoodle in a wizard’s robe.

Afterwards, I talked to a few friends until one admitted he could barely hear me. I live in a quiet world and without hearing aids I tend to be even quieter. It was a good reminder to wear my hearing aids.

I’m not the only one who needs a reminder. The vast majority of people who could benefit from hearing aids do not use them. It’s a behavior that public health officials want to reverse.

Studies have found that hearing aids help slow cognitive decline. These findings come at a time when public health officials are calling hearing loss in the elderly a global health problem that must be addressed.

Understanding who experiences hearing loss

A person is usually considered to have hearing loss if they have a 35 dB loss or more. In the US, about 13% of people age 12 and older have hearing loss in both ears.

Hearing loss is less common in young people. Five percent of Americans between the ages of 45 and 54 have “disabling hearing loss.” But as people age, impaired hearing becomes more common. Fifty-five percent of people age 75 and older have “disabling hearing loss.”

Many people who could benefit from hearing aids do not use or even own them. Although more than half of people aged 70 and over need hearing aids, less than 30% of people who need hearing aids have ever used one.

Younger people with hearing loss are even less likely to use hearing aids. Only 16% of people age 69 or younger who need hearing aids actually use them.

Why don’t people wear hearing aids?

There are many reasons why people who need hearing aids simply don’t wear them. In a 2024 study in International Journal of Audiology, researchers interviewed 332 people from Australia, the UK and the US with hearing loss.

All participants were at least 50 years old and had self-reported hearing loss. Despite knowing they had hearing loss, 65% did not wear hearing aids. Of these non-users, about 31% said they could not afford hearing aids. A third of non-users claimed they didn’t think they needed them because no one had ever said they had a problem. Non-users also said they did not think they would want to wear a hearing aid. Some said it would make them feel old.

Read more: Is it bad to listen to music all the time? Here’s how songs can help or hurt

The challenges of living with untreated hearing loss

Like the non-users in the study, people with gradual hearing loss may not be aware that their abilities have changed. However, other studies have found that many people who actually own hearing aids keep them in a drawer rather than wearing them when needed.

In a 2013 study in International Journal of Audiologyresearchers conducted a literature review and analyzed the reasons why hearing aid users chose to leave their devices at home. They found that there was no single reason why these non-users never adapted to the technology.

Some reported finding the devices too uncomfortable to wear or difficult to maintain. Others said they didn’t find them helpful or claimed they didn’t feel they needed them.

The link between hearing loss, dementia and hearing fatigue

In recent years, studies have found that people with hearing loss are more likely to become socially isolated, which increases their risk of dementia.

In 2023, the National Institutes of Health funded a clinical trial at Johns Hopkins University, which followed 1,000 people between the ages of 70 and 84 for three years.

The study found that among older adults who were at increased risk of dementia, the use of hearing aids reduced the rate of cognitive decline by nearly 50 percent.

Study participants who wore hearing aids reported an improved ability to communicate. Without this ability, people tend to isolate themselves. And when they do engage with others, they find the experience exhausting. Audiology researchers call it “listening fatigue.”

“You actually have cognitive fatigue, and it can translate into physical fatigue if you’re listening hard,” says Stephen Camarata, professor of speech and hearing sciences at Vanderbilt University.

Problematically, studies have found that listening fatigue can cause people with hearing loss to avoid specific social situations or environments that they believe may be tiring.

Read more: Navigating hearing loss and new over-the-counter solutions

Struggling to hear

In a 2020 study in International Journal of AudiologyCamarata and his colleagues conducted focus groups with 43 adults who have some form of hearing loss. Participants described environmental situations that made hearing fatigue likely. A noisy restaurant, for example, made it difficult for a person to hear. Similarly, listening as a member of a large audience or having to listen for a long time was also tiring. Participants also said that certain speakers were difficult to understand.

In difficult listening situations, participants described feeling physically and mentally tired. Listening fatigue made it hard for them to focus and get the most out of the experience. Participants also reported feeling frustrated.

In response, participants admitted to avoiding social situations or withdrawing when listening became challenging. But others have developed coping strategies to help them in hard-to-hear situations.

Coping strategies for listening fatigue

Listening fatigue is subjective and what tires one person may not tire another. This means that coping strategies must also be subjective, says Camarata.

“It’s subjective fatigue, so whatever strategy you think you have that works is a good strategy,” he says.

For example, in his team’s studies with children, Camarata saw how they often take breaks from hearing during the school day, discreetly turning off their listening devices for a short period of time. Others rest in advance if they know they have plans that may drain their cognitive energy.

Although treatment studies are still ongoing, rest is on researchers’ radar as a possible solution.

“Listening breaks and microbreaks appear to be a promising treatment area,” says Camarata.

Read more: How the brain processes music for those with hearing loss

Article source

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Emilie Lucchesi has written for some of the biggest newspapers in the country, including The New York Times, Chicago Tribune and Los Angeles Times. She holds a bachelor’s degree in journalism from the University of Missouri and a master’s degree from DePaul University. She also holds a Ph.D. in communication from the University of Illinois-Chicago with an emphasis on media framing, message construction, and stigma communication. Emilie has written three non-fiction books. Her third, A Light in the Dark: Surviving More Than Ted Bundy, is out October 3, 2023, from Chicago Review Press and is a collaboration with survivor Kathy Kleiner Rubin.