An estimated 48 million Americans suffer from some form of hearing loss—the vast majority of them older adults. Almost one-third of people ages 65 to 74 report difficulty hearing, and the number rises to about half by age 75, according to the National Institute on Deafness and Other Communication Disorders.
Evidence is mounting that untreated hearing loss is a significant national health concern, and studies have linked it with other serious health problems, including depression, a decline in memory and concentration, and perhaps even dementia.
Causes of Hearing Loss
The most common type of hearing loss, called sensorineural, often stems from damage to the tiny hair cells that line the inner ear. These cells convert incoming sound waves into electrical signals that are then shuttled to the brain. The brain interprets the signals as meaningful sounds.
Although sensorineural hearing loss is often not reversible, it can be managed with hearing aids, which selectively amplify sounds. Cases of severe hearing loss or hearing loss in only one ear can be managed with cochlear implants, which electrically stimulate the auditory nerve by bypassing the damaged portions of the hearing system.
Conductive Hearing Loss
This is less common and often occurs as a result of a physical blockage or malformation in the middle or outer ear. Impacted earwax, fluid buildup in the middle ear from an infection, and certain disorders can block sound from reaching the inner ear and brain.
Removing the wax buildup in the outer ear, treating infections in the middle ear, and, in the case of malformations, having corrective surgery typically restore hearing. If not, a hearing aid may be used.
Older adults sometimes have a mix of both types of loss. For example, age-related hearing loss plus wax in the middle ear can interfere with sound conduction to the inner ear.
Understanding Hearing Aids
Once hair cells in the inner ear are dead, there’s no bringing them back. But hearing aids may significantly improve your ability to hear by making sounds louder and easier to understand.
Hearing aids have a microphone to pick up sound, an amplifier to make sound louder, and a receiver that sends the sound into the ear canal. In modern digital aids, microphones transmit sound to a computer chip, which adjusts the volume and amplifies the sound frequencies needed to help improve your hearing. (Though analog aids are less common and less complex than digital aids, they do have advantages, including fewer advanced features. That can make them more user-friendly.)
A hearing professional can program a digital aid to filter out wind and other background noise, as well as fine-tune the aid to match your specific hearing loss pattern. More and more models can sync wirelessly with your smartphone, enabling you to take calls, stream audio, and even adjust your aid’s settings using an app.
The right hearing aid for you depends on several factors, including the type and severity of your hearing loss, your lifestyle, and your manual dexterity. However, a hearing aid that one person likes might not work for someone else, even if both have almost identical audiograms (charts that show the degree of hearing loss for low-, middle-, and high-pitched sounds).
Most hearing aids will never completely remove background noise and allow you to hear only the person—or people—talking. “It’s going to bring people back to hearing, but because of the way we process sound, it’s not going to bring them back to normal hearing,” says audiologist Patricia Chute, Ed.D., provost and vice president for academic affairs at Dalton State College in Dalton, Ga.
And even within the same brand, there can be several versions of a given model. That kind of variation makes comparing hearing aid models and brands very challenging.
Tuning In to Hearing Aid Types
Digital hearing aids come in five major styles and are categorized by where on or in the ear they’re worn. In spring 2018 we asked more than 122,000 Consumer Reports members about their experiences with hearing loss and hearing aids. The majority (71 percent) of the hearing aids were mini-behind-the-ear types.