Best Treatments for Older Patients with Hearing Loss
A variety of auditory rehabilitation devices and strategies exist to help patients with hearing loss. The best choices for an individual patient depend on a variety of factors, including the nature and extent of hearing loss and the patient’s social, occupational, and lifestyle demands, Dr. Hansen said.
Explore This IssueSeptember 2019
For the vast majority of older patients with hearing loss, hearing aids are the most appropriate option. However, for those with very poor word understanding and unsatisfactory performance with hearing aids, cochlear implants can be considered, Dr. Breen said. Candidacy for cochlear implants is primarily based on results from aided speech testing, where physicians measure word and sentence understanding, while patients use their optimally-fit hearing aids.
Despite the benefits of cochlear implants, fewer than 10% of patients in the U.S. who could benefit actually receive one, Dr. Hansen said. Additionally, most adults who ultimately receive cochlear implants do so after a delay of several years from the time they were first identified as good candidates. Many studies confirm that the best outcomes with cochlear implants result when they are placed shortly after hearing loss occurs (JAMA Otolaryngol Head Neck Surg. 2015;141:442–450; Clin Interv Aging. 2018;13:701–712; Sci Rep. 2017;7:16900). “While normal acoustic hearing continues to decline with age, hearing with a cochlear implant tends to improve or at least remains steady over time,”
Hearing loss has only recently been recognized as a potential risk factor for dementia and cognitive decline. “What we know from observational studies in humans is that the relationship appears to be strong and consistent across different populations,” Dr. Deal said. “Many risk factors for dementia occur in early life or midlife. I think what’s key is that although we don’t know yet if hearing loss causes dementia, if it does, it is something that we can treat in late life—with the potential to have a great impact on delaying dementia.”
Karen Appold is a freelance medical writer based in Pennsylvania.