In a quiet room at the Johnson City Senior Center, John Blazicek puts on a pair of black headphones. The cord stretches along the table to a small machine, run by hearing aid specialist Amanda VanFossen.
“I'll start in your right ear. And then when I switch over to your left ear, you're going to hear some noises in the right ear that I just want you to ignore,” VanFossen explains. “And click the button when you hear the tone or beep sound, okay?”
The hearing screening takes less than 10 minutes. It is meant to give a baselineidea of what Blazicek’s hearing is like. He and his wife Grayce both have appointments later this month with an audiologist at Tri-City Hearing.
Blazicek said he and his wife have both noticed some changes in their hearing.
“She turns the TV up so loud,” Blazicek said. “I mean, the dog, we have a little Corgi, and she lays on the floor with her paws up on her ears.”
He said at first, his wife was a bit reluctant to get her hearing tested. But ultimately, they decided to come in together.
“I don't think she likes the effect it's having on her, because I think she's feeling now that she's not capable.”
“They're withdrawing from the environment”
Studies have found that hearing loss in older adults is a risk factor for developing dementia. But less than 30% of older people experiencing hearing loss have ever tried using a hearing aid.
VanFossen, who did Blazicek’s screening, is a hearing aid specialist for Tri-City Hearing. She said part of the problem is that hearing loss can be such a slow process that people don’t notice it right away.
“Couples come in because the spouse is saying to the other spouse, ‘You can’t hear,’ [and the other spouse responds] ‘No, you can’t hear.’ I’m just like well, actually, neither one of you can hear as well as you used to,” VanFossen said. “And that's because it's a gradual change, and they're both having a hard time realizing that their hearing is changing.”
VanFossen said even though people don’t always notice when they are losing their hearing, sometimes they do find themselves withdrawing slightly from their social lives. It is just too exhausting to struggle to hear.
“They're like, ‘I don't want to go to that place,'" VanFossen said. “Because of their hearing loss or they're in a family situation, and they're going off in another room, they're withdrawing from the environment.”
Kim Robinson, executive director of the Johnson City Senior Center, said people often come in to get their hearing tested because their family members convinced them.
“But even more so than that, they're starting to notice some social isolation,” Robinson said. “Maybe they're at a family gathering, or maybe they're at the senior center and they can't necessarily hear everything that's being said and they start to miss portions of conversations. And that can become very frustrating for them.”
Robinson said helping people maintain their social connections is a huge part of what the senior center tries to do. That’s why they have hearing screenings each month.
“Speech and sound is heard as garbled by the brain”
Alison Huang studies hearing loss, social isolation, and the development of memory disorders, such as dementia, at Johns Hopkins Bloomberg School of Public Health.
“We found that for every 10-decibel increase in hearing loss, it's associated with a 16% greater prevalence of dementia,” Huang said. “Such that having moderate or greater hearing loss is associated with having 61% greater dementia prevalence.”
There are several ways hearing loss can contribute to dementia. One is the social part of it; the harder it is to hear, the more likely we are to withdraw. That can lead to isolation, which adds to the risk of dementia.
There’s also sensory loss. When you start losing your hearing, the parts of your brain that are used to being stimulated by sound and speech can begin to atrophy. And struggling to hear can really tire out your brain. Huang calls that “cognitive overload”.
“Speech and sound is heard as garbled by the brain. So it takes the brain some extra cognitive effort to really focus on deciphering and decoding that speech and sound,” Huang said. “And that takes away cognitive resources from other tasks, like memory or an executive function.”
Huang said there are a few barriers to getting hearing treatment. There’s the stigma of having something visible in your ear. And hearing aids are expensive. The average cost is about $4,700 for a pair,and they're usually not covered by Medicare.
Patients also needed to go to an audiologist or hearing clinic to get them, until last year, when the Food and Drug Administration decided to allow the sale of over-the-counter hearing aids. They can be purchased at pharmacies or electronic stores and are often helpful for people with mild or moderate hearing loss. More complex hearing problems still usually need to be treated by an audiologist.
If you’re concerned about your hearing, Huang said, you can get it checked a couple of times a year. You can even test your own hearing and learn your “hearing number”using certain smartphone apps.
Huang hopes someday, people will know and track their hearing in the same way they’re aware of their blood pressure or vision.