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The Risk of Untreated Hearing Loss

'Take on Today' episode talks about the issue of hearing loss and remembers George H.W. Bush

Take on Today Podcast

AARP

Bob Edwards: Hello. I'm Bob Edwards with an AARP take on today.

This week America paid tribute to its 41st president, George H.W. Bush left a lifelong legacy of public service.

In a statement, AARP CEO Jo Ann Jenkins remembered President Bush for signing into law to bills the greatly improved older Americans' lives. The first is the Americans with Disabilities Act passed in 1990. The second is the Older Workers Benefit Protection Act which Bush signed the same year to strengthen protections against discrimination.

As President Bush turned 75, 80, 85 and then 90 he marked milestone birthdays by skydiving. His first, parachute jump wasn't by choice. It resulted in his fighter plane being shot down in World War II. But Jenkins says Bush's later in life jumps, showed his passion for life.

Tune in next week to hear Pulitzer Prize winning historian Doris Kearns Goodwin talk about the 41st president and how presidents find their purpose after leaving office.

Bob Edwards: A lot of people experience hearing loss as they get older.

In fact, there are an estimated 38 million Americans with hearing loss, including two thirds of adults older than 70 and less than 20 percent use hearing aids.

So if it's no big deal, why worry?

According to new research published in the Journal of the American Medical Association, untreated hearing loss is associated with a greater risk of depression, dementia, heart attack, and falls, and that's not all.

The study also revealed that it leads to higher hospitalization rates and health care costs. Joining us today to discuss the importance of treating hearing loss is Charlotte Yeh. Chief Medical Officer for AARP Services Incorporated and coauthor of this study. Thanks for joining us Charlotte.

Charlotte Yeh: Thank you for having me.

Bob Edwards: Before we start, tell me about your cane.

Charlotte Yeh: So I'd like to say as we age, things don't always work the way you wish they worked. And a few years ago I got hit by car and had to relearn how to walk and I had a cane and I used to go out with my cane and thinking, I'm so excited 'cause I'm outside walking.

And people would go, oh, you poor thing. Johnny don't bump into that little old lady, you must feel terrible. And I got home and felt really, really sad and thought, oh, I must look terrible.

So I started putting ribbons and flowers on my cane and it became a statement of the holiday of the month. And when I went out with my cane, same person, same disability, but the reaction was 180 degrees different.

It was like, oh my God, that is the coolest thing. Can I tell you about my mom? This is the most wonderful thing. Can I take a picture so I can show my family? And all of a sudden people were full of smiles and excitement and the cane became my accessory, not my assistive device.

Bob Edwards: Hearing aids are not as easy to decorate. Do you think hearing aids would be more popular if they looked better?

Charlotte Yeh: What's interesting, and especially based on our new studies, people could think, oh, I'm going to be so old with my hearing aid. Well, based on our new studies and what we're learning about hearing aids, you were old without a hearing aid. And as far as I'm concerned, everybody's wearing things in their ears, dongles and earbuds and hearables. So having something in your ear could be quite fashionable.

And in fact there's a woman in Canada who makes the blingiest most rhinestone covered earrings I've ever seen that are hearing aids. I think you can go ahead and flaunt it just like my cane.

Bob Edwards: You were a coauthor of this study. What surprised you the most in the findings?

Charlotte Yeh: Well there were really two parts to it. We looked and we studied people ages 50 and older and looked at their claims history over a 10 year period with and without hearing aids. And the first which reinforced what we already had hands-off. It turns out that if you do not correct your hearing, you're 50 percent, roughly 50 percent more likely to have dementia after 10 years. You're about 40 percent more likely to have depression and almost 30 percent more likely to have falls than people with normal hearing. That is a huge quality of life. And how we want to age that potentially, we can't prove it, but potentially, could be avoidable.

Charlotte Yeh: The really big news is for the first time we were able to demonstrate with this research data that in fact, not correcting your hearing actually costs you more in healthcare dollars. About 46 percent higher healthcare costs, over $22,000 over 10 years, about 50 percent of the time you're more likely to be in the hospital and you're 44 percent more likely to be readmitted to a hospital. And I don't know about you, but if I don't have to be in the hospital, I'm much happier.

Bob Edwards: So, you want to deal with this thing now or have more troubles down the road?

Charlotte Yeh: Absolutely. And in a way that's really meaningful because we know if you can't hear well, the isolation, the loneliness, the difficulty in communication, hearing your grandchild is just so powerful. And we believe that may be one of the mechanisms as to why people have more dementia, depression, falls and higher healthcare costs if you can't communicate. And in fact, there was a study in the UK, by the Lancet Commission on dementia, and they said potentially as much as 9 percent of dementia cases could be avoidable by correcting hearing loss.

Bob Edwards: The study found that untreated hearing loss doesn't just impact your physical health, but also your financial health. Tell us about that.

Charlotte Yeh: Right. I mean the talk about out of pocket expenses? So, while a lot of this money, the additional hospitalization and readmissions and healthcare costs could be covered by insurance or Medicare, it also increases your own out of pocket expense. And those few 100 dollars that you could save. You could do good things with like gifts for your grandkids. So it does matter. And by the way, if we can help save medicare dollars, that's going to help our overall economy as well.

Bob Edwards: Literally tens of millions of Americans experience hearing loss. Why is this so common?

Charlotte Yeh: Very common. And I think there are probably two major reasons. One is, and this is really why Medicare never covered hearing aids in 1965. Everyone says, why doesn't Medicare cover it? Because in 1965, it was thought that normal aging was accompanied by hearing loss that was just normal. So, You don't have health insurance to fix something that is normal. So, there is really true that as you age, there is a certain percent of people who have what we call age related hearing loss. It does diminish over time.

But there's another second really big factor that goes into hearing loss, which is noise. In fact, in the military the highest disability is actually hearing loss and a lot of it came back from people who were flying in the planes, the machinery, the sounds, anything over 85 decibels for more than 15 minutes begins to damage hearing cells that you cannot recover from.

Charlotte Yeh: It's also noise. We've come a long way in the occupational world and in the military world to protect hearing. But think about everyday living, sports stadiums, music, concerts, restaurants, ear buds in your ears that are so loud that people 10 feet away can hear your earbuds. We are at risk of continuing to have serious hearing loss as we age just from noise.

Bob Edwards: Why do so many people not seek treatment for hearing loss?

Charlotte Yeh: There is this huge stigma. I don't want hearing aids or I don't want people to know I can't hear because it makes me old. And as I said, you were old without hearing aids. Increased risk of dementia, depression, falls, all the signs of aging. Loneliness perhaps could be influenced by checking your hearing. And in fact AARP did a study back in 2011. I realized that it's a few years ago, but I don't think the stigma has changed all that much, that more people, 50 and older reported having colonoscopies than getting their hearing tests. Like is that crazy? There are way more people with hearing loss than there are people with colon cancer as important as that is.

Bob Edwards: My mom had trouble with this. I said, mom, you're 90. It's okay. Where are the hearing aids?

Charlotte Yeh: It's really important. I mean, I could tell you the story of my dad. My dad, like many other men, and it is more common in men, like many other men. I don't have a hearing loss. I don't have a problem. For years we used to say, dad, you're turning up the TV. You're saying what all the time. You're getting confused when we say things. You've got to get your ears checked. No, no, I'm fine. I'm fine. 'Cause know he didn't want to be old. So he'd turn up the TV louder. And finally, and this was after probably like the average person waited 10 years. Finally when my mother got locked out of the house and he didn't hear her ring the doorbell for half an hour because he couldn't hear it. He finally agreed, maybe he needs hearing aids.

Charlotte Yeh: Now, in that 10 year period my dad started to have a more shuffling walk. He was a very outgoing person. He was sitting in the corner when we would have family get togethers and parties. He wasn't talking with everyone else. And he kind of walked around with a chip on his shoulder. So I thought he was starting to get dementia and I'm a physician. Well, he got his hearing aids. Two months later there was a family reunion. There's my dad sitting in the middle of the breakfast table, regaling people with stories. My mother's punching him. You're talking too loud. He is laughing and giggling and then he got up from the table and he had the big, strong, purposeful stride of the day that I remembered and I thought, oh my God, this wasn't dementia. He just couldn't hear. And My mother says for the first time, your dad's not angry anymore.

Bob Edwards: Wow. So he was working the room?

Charlotte Yeh: Yeah. He really was so. And it happened so gradually that you don't really appreciate it over time. I had another friend in their 70s so I said, he kept saying, I think I might have hearing problems, but I think I'll wait. And I said, no, no, no, no, no. Go get it checked. He ended up getting hearing aids and he said he put them in in the first time he walked out doors. He said, what is that sound? He goes, oh my God, those are birds. I didn't realize I hadn't heard birds in years. And then he walked into the men's room and he hears this waterfall and he goes what is that? And he goes, oh my God, that's me. I haven't heard that in years. It's so gradual. You don't even know what you've lost. And that's why I think it's so important to get tested and we can't promise that you won't get dementia or depression or fall. But how simple could it be that maybe it could prevent that and actually put money back in your pocket?

Bob Edwards: Well, how can people get their hearing tested?

Charlotte Yeh: There are many ways, of course, one you can speak to your doctor, you can go to an audiologist or a hearing specialist or an ear nose throat specialist to get truly a formal hearing test to find out exactly what is your hearing loss and how best it can be treated. If you're just not sure you, there are hearing tests you can do on your computer or over the phone. And in fact, if you go to AARP's website of the hearing resource center, there's a link that you can actually find out about an NIH studied hearing tests that at least gives you a screening to tell you, yes, you've got some hearing loss and it's worth checking into.

Bob Edwards: I imagine there have been significant technology advancements in hearing tests and treatments and aids.

Charlotte Yeh: Absolutely. So why I think hearing is now coming to the forefront and it's so exciting, is one, we now know that there are major consequences if you have uncorrected hearing loos. The dementia, depression, higher healthcare costs. Second, it's hugely prevalent. But secondly, in the year since 1965 when Medicare was passed technology, we all seen it around this has grown enormously. So the hearing aid manufacturers have a bigger array of hearing aid technology. And secondly, in consumer electronic world, there are what they call personal sound amplification products. So these are much less expensive, but technology that can be very similar to hearing aids that can help amplify the parts of the hearing that you have difficulty with. And coming soon, several years ago, a lot of credit to Congress for passing legislation called Over-the-Counter Hearing Aid legislation.

Charlotte Yeh: The FDA is now in the process of setting up regulations and rules to allow hearing aids to be sold over the counter for those who want to do it themselves and it can come at a much cheaper price. The technology has dropped the prices and increased our choices. It's really terrific and exciting.

Bob Edwards: How should you discuss this with parents or family members or friends who might be resisting help or treatment?

Charlotte Yeh: Well, I found one of the most effective ways talking to my dad or talking to my friends is when I started saying, "Hey, don't you want to live a great life? You want to enjoy life as you age, you gotta get your hearing checked because nobody wants to look forward to a life of loneliness. We worry about our brain health, hearing loss is associated with dementia and by the way, it's going to cost more money, more days in the hospital. Are you kidding? Why wouldn't you?" And I think we need to have those conversations and especially about what you gain, not what you lose. You gain the ability to talk to your grandkids. You gain the ability to talk on the telephone. You gain the ability to be part of the conversation. You gain the ability to work longer and be more productive and you can work past 65 and have purpose in your life.

Charlotte Yeh: There are so many reasons and most people actually wait seven to 10 years. And here's the other piece, you want to do it early because our brains are always growing and changing. Well, if you stopped hearing, your brain loses the ability to convert that sound into speech. And over time that's why you get, you know, one of the reasons we believe there may be cognitive decline, is because you're not getting the input. So if you wait 10 years or more to get your hearing aid, your brain may have forgotten how to hear. And then the adjustment to hearing aids and the amplification becomes that much harder.

Charlotte Yeh: Think of when you move into an apartment next to a train track and it rattles and the first night you go, I'm never going to sleep. It's too much noise and a month later you don't hear it anymore because your brain learns to adjust. Well, if you haven't heard for 10 years like my friend who hadn't heard birds in 10 years like, oh my God, what is that? And he had to relearn what sound of birds were like. Relearn how to convert sounds into speech. So to me, early detection, early screening, early solutions can really make a difference in your life.

Bob Edwards: Any additional tips or resources that are helpful for people who may need treatment?

Charlotte Yeh: I would say the AARP hearing resource center, which is on the AARP website is a great tip sheet, it has a lot of advice there. Like just how do you talk to someone? How do you know if you've got hearing loss? Watch out for certain drugs that may cause hearing loss. How to protect your ears from loud noises. So you protect what hearing you do have. It's a great, great resource and a link to the hearing tests that normally might cost five dollars, but it's an AARP member you can get the five dollars waved. The three things you ought to remember out of all of this, get your hearing checked. It's really worth it. If you have friends and family that are saying, that you suspect hearing loss, talk to them, tell them about it because you want to have them stay engaged and vibrant and live.

Charlotte Yeh: And the third is you really want to protect your hearing. It's so important that once you lose those hearing cells, you don't get them back. So protect what you have. Your teenage kids, with the sound turned up way loud, or going to rock concerts. Wear something to protect your ears. And then I think finally, if it turns out you do have hearing difficulty and you could benefit from a hearing aid, there are so many kinds of devices. So make sure you look at the marketplace to find a device that's right for you. Make sure that you pick one that's for your lifestyle. There's some hearing aids nowadays you can hook up to your smartphone and adjust it to where you are. There are some hearing aids that have big batteries that are easy to change, others are rechargeable.

Charlotte Yeh: The choices to match your life are great. Does it have telecoil so that you can go to concerts and music halls that have looped technology that allow you to hear anywhere. And then finally, do it early and if you don't and you find it's hard to adjust to the hearing aid, you can talk to your audiologist or hearing specialist. But there is rehabilitation, there are services, there are ways you can train your brain to hear again but it can take time. But the bottom line is it's really cool to hear and you want to keep it.

Bob Edwards: Thank you so much.

Charlotte Yeh: You're welcome.

Bob Edwards: Charlotte Yeh is Chief Medical Officer for a AARP Services incorporated and coauthor of a new study on untreated hearing loss published in the Journal of the American Medical Association.

The collaborative effort among Johns Hopkins University AARP Services Incorporated Optum Labs and University of California San Francisco, found that untreated hearing loss leads to higher total healthcare costs, more hospital stays and higher risk of being readmitted to the hospital compared to those without hearing loss.

To learn more, visit the AARP hearing resource center at aarp.org and nationalhearingtest.org.

For more, visit aaarp.org/podcast.

Become a subscriber and be sure to rate our podcast on iTunes, Stitcher, and other podcast apps.

Thanks for listening. I'm Bob Edwards.

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Nearly 40 million Americans experience hearing loss, and less than 20 percent use hearing aids. Find out the importance of treating hearing loss, from Charlotte Yeh, chief medical officer for AARP Services Inc. And AARP remembers President George H.W. Bush and his legacy of public service.

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