Hearing loss is frustrating. It can lead to social isolation, depression and dementia. Regrettably, it is a growing health concern. The World Health Organization1 reports there are 466 million who have a disabling hearing loss, and they estimate this will increase to more than 900 million by 2050.
There are 37.5 million Americans over age 18 who have trouble hearing.2 But the phrase "trouble hearing" may refer to anything from slight hearing loss to a disabling condition. Statistics tell us that the rate of disabling loss increases with age.
Among people ages 45 to 54, only 2% have a disabling loss but the rate is significantly higher (nearly 25%) in the population of those ages 65 to 74 years. Half of those over the age of 75 have a disabling hearing loss. These statistics are concerning since they also increase the risk of developing dementia. Dr. Ronan Factora from Cleveland Clinic talks about this:3
"The cause behind this link is unclear. But one theory is that hearing loss tends to cause some people to withdraw from conversations and participate less in activities. As a result, you become less social and less engaged."
It was estimated that in 2018, 5.7 million Americans were living with dementia.4 The Lancet International Commission on Dementia Prevention and Care evaluated many of the modifiable risks, including high blood pressure, obesity, depression, diabetes and physical inactivity. Although the numbers of people who have dementia are rising, they found encouraging news:5
"We have brought together all this evidence and have calculated that around one third of dementia may theoretically be preventable."
The Commission found in all the risk factors they analyzed, hearing loss was the6 "largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation."
Hearing Aids May Protect Your Brain From Memory Loss
Fewer than 30% of individuals over 70 years of age who have a hearing loss will wear hearing aids.7 This is unfortunate because hearing aids also help protect brain functioning.
Data gathered by the University of Exeter and King's College London were presented in Los Angeles at the Alzheimer's Association International Conference.8 The data provide evidence that wearing an effective hearing aid could reduce the risk of developing dementia.
During the study, the scientists gathered 25,000 online participants who were older than 50. They split them into two groups. One group wore hearing aids and the other group didn't.
Both took cognitive tests every year for two years. At the end of the study, the scientists found the people who routinely wore hearing aids had better scores on tests that analyzed working memory and attention span than the participants who did not. One of the researchers, Clive Ballard, said:9
"We know that we could reduce dementia risk by a third if we all took action from mid life. This research is part of an essential body of work to find out what really works to keep our brains healthy.
This is an early finding and needs more investigation, yet it has exciting potential. The message here is that if you're advised you need a hearing aid, find one that works for you. At the very least it will improve your hearing and it could help keep your brain sharp too."
How Loud Noise Damages Hearing
Hearing is a complex function in which sound waves are converted into neurological signals that are transmitted and interpreted by your brain.10 During this journey, sound waves pass through the cochlea, where movements of small reed-like fibers create an electrical impulse. The movement from the hair cells sends an electrical impulse through the cochlear nerve, which in turn transmits the information to the cerebral cortex in your brain for interpretation.
At any point along this journey, damage to structures can change how you interpret sound, and even whether you can hear. Loud noise from chronic exposure or a single incident can affect one or both ears and the effect may be permanent or temporary.11 You might find you have difficulty understanding people when they speak, especially in a noisy room or on the telephone.12
When the hair cells in the cochlea are damaged it injures your hearing. By the time you notice it, 30% to 50% of these delicate cells may be destroyed. Repeated exposure destroys more hair cells, which increases hearing loss. Loud noises may also damage the auditory nerve. It all has a cumulative effect that may predict how well you'll hear as you get older.
The WHO recommends13 you protect your hearing by limiting the amount of time you spend exposed to loud sounds. The Hearing Health Foundation compiled a chart of approximate decibel (dB) levels to help you compare noise levels using common sounds in your environment:14
- 30 dB — whisper
- 60 dB — normal conversation
- 90 to 100 dB — lawnmower, shop tools or truck traffic (90 dBs); wear protection and limit exposure to no more than eight hours. Snowmobile and pneumatic drill (100 dBs); limit to no more than two hours each day
- 115 dB — car horn and rock concert should be limited to 15 minutes maximum without protection
- 140 dB — gunshot or jet engine; noise causes pain with short exposure and will injure hearing
Tinnitus May Be a Signal of Hearing Damage
Tinnitus is the perception of noise or ringing in your ears. It is often chronic and it's estimated that it affects between 8% and 25.3% of people in the U.S.15 The condition can be disabling and can functionally impair your ability to sleep and concentrate.
It can also be caused by some of the same things that increase your risk for hearing loss, like exposure to loud noise or damage from a severe ear infection. Tinnitus can be triggered by smoking, medication side effects, arthritis or injuries to the head and neck.
If you have this condition, your experience may be different from that of other people who have it.16 Some say it sounds like high-pitched hissing or screeching; others say it sounds musical. You might hear it in one ear or both. Some people find it happens if they are in a completely quiet room, which makes sleeping difficult.
One of the most common causes of tinnitus is noise-induced hearing loss.17 After ensuring you have eliminated exposure to loud noises, there are some treatments you can consider that will help lessen the impact on your life.
Hearing aids may be helpful as they can be adjusted to control external sound. As you begin to hear better, it may reduce your perception of tinnitus. A relatively new strategy is called acoustic neural stimulation. It delivers sound that stimulates neural changes. The goal is to desensitize the brain to neural inputs that trigger tinnitus.
If you've had long-standing severe hearing loss with tinnitus, a cochlear implant may help bypass the damaged portion and control the symptoms. Wearable or tabletop sound generators are another option that help to mask the symptoms of tinnitus.
Ear Wax Buildup May Block Sound
A temporary problem that can trigger tinnitus or hearing loss is the buildup of earwax, also referred to as cerumen. It is not truly made of wax, but rather dead skin cells combined with secretions produced in the outer ear canal.18 Earwax plays an important role in protecting the skin inside your canal and providing natural antimicrobial action to help prevent bacterial infections.
As it makes its way down the canal, it picks up debris. If you use a cotton swab or any other small object to try and clean your ear canal, it can push the wax up against your eardrum and cause a temporary hearing loss. Another risk you take when you use something small in the ear canal is a traumatic perforation — a hole — in the eardrum.19
Researchers estimate there are 4,852 visits to the emergency room every year in the U.S. as the result of an injury to the eardrum. In most cases cotton tipped applicators were the culprit. When earwax builds up it reduces the amount of sound waves able to reach the eardrum, which is how it reduces hearing. You might also have an earache, a feeling of fullness, dizziness or tinnitus.20
The simplest and most effective way to get a buildup of wax out is to first soften the wax in your ear canal by adding a couple of drops of olive oil, coconut oil or water. Lie on your side with a towel under your head to catch anything that spills. Give the oil a few minutes to soften the wax and then add a capful of 3% hydrogen peroxide.
You will probably hear some bubbling and feel slight tingling. After five minutes, hold a paper towel in your hand and tip your head to let the solution and excess wax drain out. Repeat this for the other side.
While it is safe to use this method to remove excess wax, you shouldn't clean your ears frequently. There are other mistakes you might be making with ear hygiene that I discuss in "How To Clean Your Ears Without a Cotton Swab."
Active Strategies to Protect Your Hearing at All Ages
The cost of hearing loss is measured in financial burden, loss of health and social isolation. Psychologist Mark Hammel damaged his hearing in his 20s while serving in the Israeli Army. It wasn't until he was 57 that he got his first pair of hearing aids. He poignantly described his experience:21
"It was very joyful, but also very sad, when I contemplated how much I had missed all those years. I could hear well enough sitting face to face with someone in a quiet room, but in public, with background noise, I knew people were talking, but I had no idea what they were saying. I just stood there nodding my head and smiling.
Eventually, I stopped going to social gatherings. Even driving, I couldn't hear what my daughter was saying in the back seat. I live in the country, and I couldn't hear the birds singing. People with hearing loss often don't realize what they're missing. So much of what makes us human is social contact, interaction with other human beings. When that's cut off, it comes with a very high cost."
You can protect your hearing by reducing your everyday exposure to loud noises, such as music, noisy work environments and even items around the house and yard, such as lawn mowers. Nutritional imbalances may also play a role in hearing loss.
I discuss a number of dietary strategies in "How to Prevent Hearing Loss and Improve Your Hearing With Nutrition." Protecting your ears from noise pollution is a foundational principle to preventing hearing loss. The following suggestions may also help protect your hearing:
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Turn down the volume on personal audio devices. |
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Try a decibel meter app for your smartphone, which will flash a warning if the volume is turned up to a potentially damaging level. Use carefully fitted noise-canceling earphones/headphones, which may allow you to listen comfortably at a lower volume. |
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Wear earplugs when you visit noisy venues, and if you work in a noisy environment, be sure to wear ear protection at all times. |
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Limit the amount of time you spend engaged in noisy activities. |
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Take regular listening breaks when using personal audio devices. |
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Restrict the daily use of personal audio devices to less than one hour. |
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If you live in a noisy area, you may want to consider moving. If that's not an option, consider adding acoustical tile to your ceiling and walls to buffer the noise. Double-paneled windows, insulation, heavy curtains and rugs can also help. |
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Use sound-blocking headphones to eliminate occasional sound disturbances such as that from traffic or lawnmowers. |
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Wear ear protection when using your lawnmower or leaf blower. |
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