holly hosford-dunn phd academy village, january 23 2013
TRANSCRIPT
Myths & Misconceptions About Hearing, Aging, and Hearing
AidsHolly Hosford-Dunn PhD
Academy Village, January 23 2013
Myths
◦ #1: Hearing Losses are All Alike
◦ #2: Don’t Need Hearing Aids for Mild Hearing Losses
◦ #3 & #4: Hearing Aids Don’t Work & They’re all the Same
Misconceptions
◦ #1: Hearing Declines with Age
◦ #2: Don’t Get Hearing Aids Til You Really Need Them
◦ #3: Hearing Aids Keep Going Up in Price
HearingHealthMatters.org
tucsonaudiology.wordpress.com
Hearing Declines with Age
Misconception #1
What Makes Us Think This?
Observational Data◦ ~30 million hearing impaired individuals in US◦ 70% ≥ 55 years
Professional Terminology◦ Presbycusis: Hearing Loss ≥ 65 years◦ #1 most prevalent chronic condition in males◦ #4 most prevalent condition in females
Hearing Declines with Age
Misconception #1: Hearing declines with age
Cardiovascular Disease (CVD)◦ nature and extent difficult to estimate Rosenhall
et al 2006
Noise
◦ totally intertwined◦ Occupational◦ Recreational◦ Military
Yes, but… Lifestyle and Noise Are Confounding Variables
Misconception #1: hearing declines iwth age
Presbycusis or Noise or Both?
Hearing thresholds increase with age, especially at high frequencies
Hearing loss increases with age, especially at high frequencies
Misconception #1: Hearing declines with age
Threshold goes up 1 dB/year at >60 (Lee et al)
Quick Math ◦ 20 dB high frequency loss at age 80 d.t. age◦ But data show HL in 80-90 dB range◦ 60 to 70 dB of “age-related” hearing loss d.t.
environmental factors
Closer to the Truth
Misconception #1: hearing declines with age
Hearing Declines Mainly from Environmental Exposures, NOT Age Itself
TAKE HOME: Lose the Ageist Language
◦ “I hear well for my age” is not defensible
◦ Protect your hearing
CorrectingMisconception #1
1. All Hearing Losses Are Alike.
2. People with Mild Hearing
Losses Don’t Need Hearing
Aids.
Myths #1& #2
What Makes Us Think That?◦ The audiogram
a bunch of averages A bunch of frequencies Measures audibility Categorized
Myth 1: All Hearing Losses Are AlikeMyth 2: Mild Hearing Loss ≠ Hearing Aids
Myths 1 & 2: all hearing losses are alike; you don't need hearing aids for mild losses.
What’s an Audiogram?
0 = normal, equalized, averaged
Mild or moderate loss?
Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.
Speech depends on perceptual processing
Perception is a brain process
The Ear is Hooked Up To The Brain
QED: Everybody is different, even if they have the same audiogram
Yes… but what about speech?
Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.
Audibility is a prerequisite◦ Necessary, but not Sufficient
Speech recognition in noise ◦ decreases with age, even if audiogram is normal
◦ Is worse for Olds than Youngs with mild hearing loss (Dubno et al, 1984)
◦ Is worse in the evenings for Olds (Veneman et al, 2012)
Closer to the Truth
Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.
Just because you hear doesn’t mean◦ You hear what you need to◦ You understand what you hear
TAKE HOME: Lose the Ageist Language
◦ “I hear well for my age” is not defensible
◦ Exercise your auditory processing as much and often as you can
Correcting Myths #1and #2
Misconception #2
Don’t Get Hearing Aids
Until You REALLY Need
Them!
What Makes Us Think This?
◦ Fear of Dependency It’s actually the other way around – use it or lose it
◦ “Prescription” Device … Take it Like a Pill
◦ Stigma Makes you look old…so don’t get them till you are! Disappearing fast thanks to iPhones & Bluetooth
Don’t Get Hearing Aids till You Really Need Them
Misconception #2: Don't get hearing aids until you really need them.
OK, but when is that exactly?
Misconception #2: Don't get hearing aids until you really need them.
◦ Get fitted earlier rather than later When your spouse complains Make it easy on your brain and your memory
◦ Don’t lose it and then try to get it back Fix it before it becomes a problem
◦ Make them part of your routine while it’s easy When memory slips, it’s hard to learn new routines
Closer to the Truth
Misconception #2: Don't get hearing aids until you really need them.
◦ Hearing Aids are For the Young at Heart – those who are not only in the game but winning the game
TAKE HOME: Lose the Ageist Language
◦ Hearing Aids don’t make you look old
◦ Not hearing makes you old
Correcting Misconception #2
Myth #3: Hearing Aids Don’t Work Myth #4: Hearing Aids Are All the Same
Why do we think this?We don’t. This is deliberate ignorance used for
purposes of denial and avoidance.
Who thinks this?People who waited too long.People who don’t want help and don’t want to take
responsibility. They’re not here today.
Myths #3 & 4
Hearing Aids Keep Going Up in Price
“Every time a new feature comes out, the price goes up.”
Misconception #3
What Makes Us Think That?
◦ Anchor price is $6000
◦ Nominal value of currency
◦ Heuristics – we believe what others say
◦ Technological advances
Moore’s Law
Koomey’s Law
◦ Equated with pills instead of learning & exercise
Hearing Aids Keep Going Up in Price
Misconception 3: Hearing aids keep going up in price
Relative Price ($6K * CPI increase)◦ Increased 34%
Nominal Price (actual Dollars)◦ Decreased 25%
45% more purchasing power now than you did in 1997
Price is Going Down…. Any Way You Slice It
1997 20110
1000
2000
3000
4000
5000
6000
7000
8000
9000
6000
8410
6000
4500
Relative Price of Binaural Hearing Aids
Purchasing Power Then and Now
Relative ValueNominal Price
Year
US
Doll
ar
Un
its
Misconception 3: Hearing aids keep going up in price
◦ Hearing Aids Are Getting Better and Cheaper Easier to operate Functional in more diverse environments Work better for complex signals
Speech Speech in noise
◦ Good Hearing Aids Are expensive ½ as expensive and twice as effective as 15 years ago Require training, effort, and regular maintenance
Closer to the Truth
Audiogram isn’t it! Age isn’t it! Hearing Aids aren’t it! Price isn’t it!
Brain + Ear + Age + Exercise = It
Closest to the Truth
Stimulate your Ears
◦ to Stimulate your Brain
to Maintain Functionality
to Age Healthily and Happily
Thanks for inviting me today
TAKE HOME