According to the Hearing Health Foundation, 48 million people in the United States and 477 million people globally live with a hearing condition, underlying the importance of hearing loss advocacy and awareness.
On this year’s World Hearing Day, the World Health Organization (WHO) will launch the World Report on Hearing. This report represents a global call to action to address hearing loss and ear diseases. This year’s messaging targets both policymakers and the general public. Objectives include addressing the number of people living with unaddressed hearing losses and ear diseases, undertaking timely action to address hearing loss throughout life, and investing in cost-effective interventions that will benefit those living with hearing loss, among others.
Hearing Loss at All Ages
Hearing loss doesn’t only affect older adults: two-thirds of those living with hearing loss are younger than age 65. It’s estimated that 12.5% of children in the United States between six and 19 years old have evidence of noise-induced hearing loss. Between 40% and 50% of people between 12 and 35 years old are at risk of exposure to unsafe noise levels from personal devices and events like concerts.
Hearing loss has a profound impact on overall health. Untreated hearing loss can increase a person’s risk for experiencing cognitive decline, dementia, falls, and depression. In fact, scientists theorize that the cognitive load required by the brain to compensate for untreated hearing loss takes away resources that the brain needs to perform other functions, like short-term memory. Even mild hearing loss affecting only certain frequencies can have a negative effect on cognitive capabilities.
Using Technology to Improve Hearing Loss
For people with hearing loss, hearing aids and cochlear implants are the first lines of treatment. Hearing aids incorporate a microphone, amplifier, and speaker to increase volume and aid someone in listening, communicating, and other daily living activities. Current estimates suggest, though, that only one in five people who would benefit from a hearing aid currently use one.
People with severe or profound hearing loss or deafness use cochlear implants to improve their hearing. The cochlear implant is a small electronic device that contains a microphone, speech processor, transmitter, receiver/stimulator, and electrode array. The external portion of the device sits behind a person’s ear, while the internal piece is surgically placed under the skin. Cochlear implants do not restore normal hearing, but they do help a deaf person understand speech and other sounds.
In addition to these common devices, people with hearing loss may see improvement with implantable middle ear hearing devices or osseointegrated devices.
These devices do improve the lives of the people who use them, but they still may not be enough to help users in all settings, according to the Hearing Loss Association of America. In certain situations—like public spaces, places of worship, conference rooms, or theaters—the improvement provided by the hearing aid or implanted device simply isn’t enough.
The good news is that technological advances mean improvements are coming for hearing devices. Newer hearing aids have advanced to the point of including top-line sound processing and frequency response, Bluetooth compatibility, artificial intelligence, and smartphone-powered app support. Capabilities to mask tinnitus and provide binaural processing, which reduces the manual adjustments a user is required to make, are less flashy—but equally important.
Researchers are also studying how technology can improve cochlear implants. A study published in late 2020, for example, evaluated how contralateral routing of signal devices might improve hearing in people who received unilateral cochlear implants. Researchers showed that study participants experienced improvements in both speech understanding and noise and perceived an overall benefit to their quality of life. Investigators have also studied speech processor advancements; these technological gains have been associated with improvements in Consonant-Nucleus-Consonant and Hearing in Noise Test scores in certain settings.
Another study, published in 2020 in the Journal of the American Academy of Audiology, focused on pediatric cochlear implant recipients. According to researchers, these patients have more difficulty understanding speech in situations with background noise compared with their hearing peers. The team of researchers evaluated microphone location and beamforming technology on speech understanding. They found that the UltraZoom adaptive beamformer had higher performance.
The scientific understanding of the cochlea has also improved significantly in recent years. However, no pharmacological or biological interventions for hearing loss currently exist. Researchers have focused their studies on localized cochlear drug, gene, and cell-based therapies, with several promising—but early-stage—results thus far.
One promising drug therapy zeroes in on neurotrophic factors to repair the ribbon synapse—sites of contact between neurons specialized for the rapid transmission of signals by the calcium-triggered secretion of neurotransmitter—following noise exposure, prevent loss of primary auditory neurons, and promote regrowth of auditory neuron fibers after severe hearing loss. Specific drug delivery technologies are being evaluated, since these treatments would require high dose, long-term, localized, or cell-specific delivery to be effective. Gene therapy technologies are also being used to address the gap in cell specificity for the treatment of genetic and acquired hearing loss.
Mental Health and Hearing
Poor hearing has been widely associated with poor quality of life. In addition to cognitive decline, hearing loss has been associated with high rates of depression, anxiety, and suicidal ideation, along with other mental health conditions. Depression is a particularly insidious association; when people can’t hear, participation in social events can become a challenge, leading to loneliness and social isolation.
One 2019 study estimated that one in five people with hearing loss has comorbid depression. Despite these high rates, there is limited evidence on best practices for treating depression in these patients.
It’s clear that hearing loss impacts every part of a person’s life. Technology is improving, but there’s still room for improvement in everything from mild to severe hearing loss. Observing World Hearing Day is just one way to raise awareness and continue to push for change.
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Dixon PR, Shipp D, Smilsky K, Ling VY, LE T, Chen JM. Association of speech processor technology and speech recognition outcomes in adult cochlear implant users. Otol Neurotol. 2019;40(5):595-601. doi: 10.1097/MAO.0000000000002172
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