Those who don't use hearing aids should make it one of their New Year's resolutions, according to new research. There hearing loss It affects about 40 million American adults, but only one in 10 people who need hearing aids use them.
The results of the study were published in The Lancet Healthy Longevity.
Hearing aids: why it is important to use them
“We found that adults with hearing loss who regularly used hearing aids had a 24 percent lower mortality risk than those who never wore them,” said Janet Choi, MD, MPH, Keck Medicine otolaryngologist and researcher principal of the study. “These findings are exciting because they suggest that hearing devices may play a protective role in people's health and prevent premature death.”
Previous research has shown that untreated hearing loss can result in a shortened lifespan (as well as other negative outcomes such as social isolation, depression and dementia).
Until now, however, very little research has been conducted into whether the use of hearing aids can reduce the risk of death. According to Choi, the study represents the most comprehensive analysis to date of the relationship between hearing loss, hearing device use and mortality in the United States.
Choi and his fellow researchers used data compiled from the National Health and Nutrition Examination Survey between 1999 and 2012 to identify nearly 10,000 adults aged 20 and older who had completed audiometric evaluations, a test used to measure hearing ability , and who had filled out questionnaires about their hearing ability. use of hearing aid. The researchers tracked their mortality status for an average follow-up period of 10 years after their assessments.
A total of 1,863 adults were identified as having hearing loss. Of these, 237 were regular hearing aid users, who were characterized as those who reported wearing the aids at least once a week, five hours a week, or half the time, and 1,483 were identified as non-users of the aids. . Subjects who reported wearing the devices less than once a month or less frequently were classified as non-habitual users.
The researchers found that the nearly 25% difference in mortality risk between regular hearing aid users and non-users remained stable, regardless of variables such as the degree of hearing loss (from mild to severe); age, ethnicity, income, education and other demographic information; and medical history.
No difference in mortality risk was found between non-habitual and non-habitual users, indicating that occasional use of hearing aids may not provide any life-extending benefit.
While the study didn't examine why hearing aids can help those who need them live longer, Choi points to recent research linking their use with reduced levels of depression and dementia.
She hypothesized that the improvements in mental and cognitive health that come from improved hearing could promote better overall health, which could improve lifespan.
She hopes this research will encourage more people to wear hearing aids, although she acknowledges that factors including cost, stigma and difficulty finding devices that fit and work well pose barriers to use.
Choi can personally identify with these challenges. She was born with hearing loss in her left ear, but she didn't wear a hearing aid until her 30s. It took her several years to find the ones that worked effectively for her.
He is currently working on an AI-based database that classifies hearing device choices and tailors them to individual patient needs. She also supports larger studies to better understand the link between regular hearing aid use and a lower risk of mortality and to promote hearing care.
Having a hearing test is associated with a lower risk of underreporting hearing loss and a greater likelihood of using hearing aids.
Choi and colleagues evaluated the association between prior hearing testing and awareness of hearing loss and hearing aid use. The analysis included 3,192 adults aged 60 years and older who completed audiometric testing in the US National Health and Nutrition Examination Survey (2005 to 2016).
The researchers found that a history of more recent hearing tests was associated with a lower risk of underreporting hearing loss (odds ratio, 0.54) and a higher likelihood of using hearing aids (odds ratio, 14, 59).
The risk of underreporting hearing loss was three times lower among those who had had a recent hearing test than among those who had not (odds ratio, 0.29) when adjusting for demographic characteristics, hearing loss hearing measured by audiometry and tinnitus.
The odds of using hearing aids were 10 times higher among those who had had a recent hearing test (odds ratio, 10.91) when the model was adjusted for the degree of self-reported hearing problems.
“These findings, however, suggest that implementation of hearing screening and subsequent evaluation by a specialist may have utility in awareness of hearing loss and utilization of hearing health services,” the authors write. A financial link to the hearing technology industry has been revealed.
The use of hearing devices can slow cognitive decline in older adults with hearing loss who are also at risk for memory and thinking problems.
A large clinical trial found that for older adults at risk for cognitive problems, wearing hearing aids for three years cut rates of cognitive decline in half.
While previous research has shown that hearing loss poses a risk for developing dementia, the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study was the first randomized, controlled clinical trial to evaluate the effect of intervention with hearing devices. The results of the study were reported at the international Alzheimer's Association conference and simultaneously published in The Lancet.
David Knopman, MD, a Mayo Clinic neurologist and study co-investigator, says the study shows positive benefits in delaying cognitive decline for people age 75 and older with hearing loss.
“Older individuals
who are at risk for cognitive decline but who are still cognitively healthy, who can still use their hearing devices, who are not going to lose them, will probably get some benefit,” Dr. Knopman said.
The ACHIEVE study, conducted at four U.S. centers, is a randomized trial of older adults ages 70 to 84 with untreated hearing loss and no substantial cognitive impairment.
Nearly 1,000 participants were recruited from two study populations: 238 adults participating in the Atherosclerosis Risk in Communities (ARIC) study and 739 healthy community volunteers.
At the start of the study, all study participants had mild to moderate hearing loss typical of older adults, but no substantial cognitive impairment.
The three-year intervention included the use of hearing aids, an auditory “toolkit” to assist with self-management, as well as ongoing education and consultation with an audiologist.
In the total study group, hearing aids did not reduce cognitive decline. However, the hearing intervention slowed cognitive decline in older adults with mild to moderate hearing loss by 48% in people who participated in the ARIC study, an ongoing observational study of heart health.
Dr. Knopman noted that hearing aids can improve the quality of life for people with hearing loss at any age.
“Hearing loss is a disability that interferes with quality of life and they should consider getting a hearing aid if it can benefit them in their daily lives, regardless of whether it has this additional long-term benefit of delay cognitive decline,” he says.
Hearing and memory are separate but strongly interconnected brain processes that help control people's daily functioning and communication, Dr. Knopman says.
“If I can't hear what you say very well, but I have a good memory, I might be able to play it back in my head, so to speak, and understand it because I have an intact short-term memory,” he explained. she says. “On the other hand, if I have short-term memory problems and my hearing isn't as good, that function will be lost.”
According to researchers in the ACHIEVE study, nearly two-thirds of adults over the age of 60 suffer from hearing loss.
Karina C. De Sousa, Ph.D., of the University of Pretoria in South Africa, and colleagues compared the clinical effectiveness of a self-fitting over-the-counter hearing aid with remote support and smartphone application with a hearing aid fitted using the best practices adapted by an audiologist.
The analysis included 64 adults with mild to moderate hearing loss who were randomly assigned to self-fitted or audiologist-fitted hearing aids. Outcome measurements were completed at baseline, two weeks, and six weeks after hearing aid fitting.
The researchers found that after two weeks, the self-fitted group had an initial advantage over the audiologist-fitted group on the self-reported Abbreviated Profile of Hearing Aid Benefit and the International Outcome Inventory for Hearing Aids, but not on speech recognition in noise. However, at six weeks, there were no significant differences between groups on any outcome measure.
“These findings suggest that a self-fitting over-the-counter hearing aid may represent an effective intervention option for individuals with mild to moderate hearing loss and produce similar clinical and self-perceived outcomes as an audiologist-fitted hearing aid,” the authors stated. write.
The authors disclosed financial ties to the financier, HearX Group. The financier provided the Lexie Lumen devices and software support.
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