Hearing loss is a public health problem that affects more and more people in the world. The WHO predicts that by 2050, some 2.5 billion people – that is, one in four – will have some degree of hearing loss. If a few years ago it was a problem that mainly affected older people, now the average age has begun to drop, due to prolonged exposure to noise, especially in large cities. However, although many have hearing problems, only approximately 39% use hearing aids to improve their hearing, according to data from the National Association of Hearing Care Professionals of Spain (ANA).
“It is a very big mistake not to use hearing aids, since their use could significantly improve life expectancy,” says Dr. Janet Choi, an otolaryngologist at the Keck Institute of Medicine at the University of Southern California. Choi is the author of a study published this Thursday in the journal The Lancet Healthy Longevity which analyzes the association between hearing aid use and mortality in the United States. In fact, adults with hearing loss who regularly use hearing aids have a 25% lower risk of mortality than those who never use them. “These are promising results because they suggest that hearing aids can play a protective role in people's health and prevent premature deaths,” explains Choi.
Previous studies have indicated that untreated hearing loss can lead to decreased longevity, in addition to other adverse effects such as social isolation and depression. In fact, deafness is the main risk factor for dementia in middle age. However, there has been little research into whether hearing aid use could lower the risk of death. According to the authors, this study is the most comprehensive analysis to date of how hearing loss and hearing aid use affect mortality in the United States, where only one in 10 people who need these devices use them.
“There are many barriers associated with hearing aids. Cost and lack of health insurance coverage are important factors. But there is also a lot of stigma associated with hearing loss and its use,” acknowledges Choi, who was born with hearing loss in her left ear, but did not use a device until she was in her 30s, when she finally found devices that worked effectively for her. “Many people consider hearing loss as a disability that they do not want to show to others that they are wearing hearing aids. But I think this is a condition where you get more help and have a better quality of life when you share with your family and friends that you have hearing loss,” she insists.
For this study, Choi and his team analyzed data collected by the National Health and Nutrition Examination Survey, conducted between 1999 and 2012. They focused on approximately 10,000 adults over the age of 20 who had taken audiometry tests, which serve to calculate hearing ability, and who responded to a survey about their hearing aid use. Among them, they identified a total of 1,863 adults with hearing loss. However, only 237 people reported being regular hearing aid users, meaning they used these devices at least once a week, for five hours or for half the time they were awake. The remaining group stated that they had never used these devices, or that they used them less than once a month.
Based on this data, and after monitoring the mortality rate of participants for a decade, the researchers found that people who had used hearing aids regularly had a 25% lower risk of dying than those who never used them. They also found that there is no difference in the risk of death between those who use hearing aids occasionally and those who never use them, suggesting that using hearing aids only sometimes may not be enough to live longer.
Cognitive impairment
Although the study does not explore the reasons why hearing aids could help those who need them improve their life expectancies, numerous recent studies associate the use of these devices with a reduction in levels of depression and dementia. “The improvements in mental and cognitive health that come with better hearing can promote more robust overall health, which in turn could prolong life expectancy,” notes the author. Another possible explanation is the relationship between hearing loss and frailty syndrome, a disease associated with aging and characterized by a marked vulnerability in the elderly who suffer from physical and cognitive deterioration.
Along these lines, Dr. Luis Lassaletta, president of the Otology commission of the Spanish Society of Otorhinolaryngology, recognizes the relevance of this study for its ability to relate hearing loss with the greater fragility of those who suffer from it. “In older people, hearing loss represents a deterioration in many aspects of their quality of life and especially their cognitive state,” insists Lassaletta. “This study suggests that, depending on the degree of loss, it is possible to reverse this deterioration with hearing aids or cochlear implants not only to improve quality of life, but also to improve or reduce mortality.”
However, the authors of the study acknowledge, there are certain limitations and biases that have not been possible to eliminate and that may affect the results of the research. For example, the socioeconomic level of the participants, which is a relevant factor when it comes to being able to afford a hearing aid. “It is reasonable to assume that the most advantaged classes use hearing aids more frequently due to their high cost, especially in countries without a public health system like the United States,” acknowledges Jacinto García Lorenzo, head of the Otorhinolaryngology Service at the Hospital del Mar in Barcelona. who is cautious about the results of the study. “Even so, the general line of the research confirms something that we already know, which is that the use of hearing aids improves the auditory connection with the outside world, and, therefore, also improves the quality of life of the people who use them. ”, he states.
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