If you get an annual checkup, you probably assume that you’re doing everything you need to do to take good care of your health. But chances are your physicals have not included a test that’s crucial to your physical and mental well-being.
Shocking fact: Only about 30% of primary care physicians do a basic screening of their patients’ hearing. In fact, most adults haven’t had their hearing tested since they were in grade school! For most people with hearing loss, this means their problem (or the severity of their deficiency) goes undetected.
And don’t assume that only the oldest adults are affected. More than half of the 48 million Americans who have trouble hearing are under age 55, and most of them aren’t getting treatment.
Ignoring hearing loss is dangerous: In addition to the social isolation and depression that sometimes occur when people have trouble hearing, the condition has been linked to an increased risk for dementia. While there is more research to be done, many neuroscientists believe that if you are working hard to comprehend what’s being said, you are using up the brain’s stores of “cognitive reserve,” which would instead be devoted to analytical thinking or memory.
That’s not all. Because most age-related hearing loss occurs in the inner ear, which regulates balance, ignoring the problem increases one’s risk of falling by threefold. Hearing loss also makes driving and walking on the streets less safe because you don’t hear car horns and other traffic noises.
My story: My hearing loss began suddenly when I was 30. Like many people, I resisted getting help and didn’t get hearing aids for 20 years. That was a mistake!
Testing for hearing loss is painless and easy. My advice…
• Start now! No matter what your age, ask your primary care physician to do a hearing screening during your annual physical. Professional guidelines vary on the frequency for such testing, but I believe that it’s important enough to get screened every year—subtle changes can easily go unnoticed if you wait too long between testing.
As an initial screening, your primary care doctor will likely ask you a series of questions such as: “Does your spouse complain that the TV is too loud?” and “Do you find that people often say, ‘Oh, never mind. It’s not important.’?” The doctor may also snap his/her fingers behind your head or rub his fingers together next to your ear. If you seem to be having trouble hearing, he’ll refer you to an audiologist for diagnostic testing. (An otolaryngologist, or ear, nose and throat specialist, may also employ an audiologist who gives hearing tests.)
• Go to a true professional. Try to stick to your doctor’s referral. Lots of hearing-aid shops employ people who may not have adequate training to accurately diagnose hearing loss. You want to be sure to see an audiologist. They’re trained to diagnose, manage and treat hearing and/or balance problems. An audiologist can also fit you with hearing aids.
When you go to an audiologist, you’ll be asked about your general health history, work history, exposure to noise and use of certain medications—drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics and loop diuretics (commonly used to treat heart failure) can cause temporary hearing loss…and repeated doses of other drugs, including the cancer drug cisplatin (Platinol), can cause permanent hearing loss. The audiologist will then take you to a soundproof room for the following tests…
• Pure-tone test. This test provides a baseline of the softest level at which you can hear sounds. What happens: You put on headphones, and the audiologist activates tones at different pitches and loudness. You respond by raising a finger or pressing a button when the tone is heard. The test is given in one ear at a time. If the test is normal, the audiologist will probably send you home. If not, other tests follow.
• Bone-conduction test. This test helps identify whether hearing loss originates from the inner, middle or outer ear. What happens: You will be fit with a headset that has a vibrator placed on the bone behind the ear. This bypasses the ear canal (outer and middle ear) and sends vibrations directly to the cochlea (inner ear). Again, the audiologist will activate tones at different intervals.
If the result is normal or better than the pure-tone test, it suggests the problem is in the middle or outer ear—sound is not getting through to the cochlea. If the result is worse than the pure-tone test, it points to a problem in the cochlea.
• Speech perception test. What happens: While hiding his mouth (so there’s no cheating by lipreading), the audiologist reads a list of common two-syllable words (or a recording is played) to determine the lowest level at which you can correctly identify 50% of the words spoken. If you cannot hear 50% of the sounds, the volume is turned up until you can. The test is given in quiet or with noisy background sounds. It helps to determine the extent of hearing loss and the need for a hearing aid.
• Tympanometry test. This test helps detect problems in the middle ear. It can reveal tumors, fluid buildup, impacted earwax or a perforated eardrum—all of which can lead to hearing loss. What happens: The audiologist uses a probe that changes the air pressure in the ear canal and causes a healthy eardrum to easily move back and forth. Important: While you’re being tested, stay still and do not speak or swallow to make sure your results are accurate.
If your audiologist recommends hearing aids, don’t panic. Unlike the bulky devices you may have seen in the past, today’s hearing aids are comfortable, highly effective—and most are small enough to not be seen when looking at the wearer’s face. But they are also expensive—up to $4,000 per aid—and are not covered by insurance.
For people with mild-to-moderate-hearing loss, personal sound amplification products (PSAPs) are a less expensive option (up to $700 a pair). They help in specific situations, such as a noisy restaurant, crowded airport or large lecture hall.
