The MDHearingAid AIR was the focus of research presented at the Combined Section Meeting of the Triological Society Jan 22-24, 2015, San Diego, CA.. Dr. Seilesh Babu, nationally known neurotologist, presented original research conducted on the AIR entitled “Can a Low-Cost Digital Hearing Aid Help Unaided Patients with Typical Hearing Losses?”
Can a Low-Cost Digital Hearing Aid Help Unaided Patients with Typical Hearing Losses?
by Seilesh Babu, MD – Michigan Ear Institute & Providence Hospital, Southfield, MI
Hearing loss affects approximately 34 million people in the United States, but hearing aid adoption rates have historically remained low at 24%1. One major factor for this finding is that the average cost of a single hearing aid stands at $19042, and insurance coverage for hearing aids is approximately 30% (excluding VA fittings)1. Numerous medical studies have linked untreated hearing loss in the elderly with a higher risk of social isolation, depression, anxiety, and symptoms consistent with Alzheimer’s dementia3-6.
Outcome Objective: To analyze the technical specifications of a low-cost (<$400) digital hearing aid and to determine if it can achieve adequate user satisfaction scores for those with mild to moderately-severe hearing loss.
MATERIALS AND METHODS
The MDHearingAid AIR was evaluated using a Fonix 6500c Hearing Aid Analyzer, measured according to the American National Standards Institute (ANSI) S3.22-1996 hearing aid specification standard (ANSI, 1996). The measurements included saturated sound pressure level curve, high-frequency average full-on gain, frequency response, total harmonic distortion, equivalent input noise level, and input-output curve.
A retrospective study was then conducted over a 6 month period on patients with mild to moderately-severe hearing loss from a private practice setting. Satisfaction surveys were sent to patients using this hearing device. They were asked to wear the device for a minimum of 30 days and complete 2 self-reported surveys: International Outcome Inventory – Hearing Aids (IOI-HA)7 and Satisfaction with Amplification in Daily Living (SADL)8.
The low cost hearing aid met gain and output targets previously described in the literature9. 230 respondents completed the surveys. The device exceeded the mean score for all 7 items in the IOI-HA and met or exceeded the mean scores for all 5 categories of SADL.
Despite significant evidence supporting medical, social, financial, and emotional benefit of wearing hearing aids, adoption has been historically low. 76% of non-users point to financial constraints as a primary cause. Prior studies have shown that inexpensive hearing aids can provide similar self-reported benefit scores to expensive, conventional hearing aids10. Parving found a lack of difference in benefit and satisfaction scores between low-cost hearing aids and higher cost digital hearing aids in a study with 14,325 respondents11.
The MDHearingAid resulted in a favorable technical specifications and user satisfaction scores in a cohort of patients with mild to moderately-severe hearing loss. Affordable hearing devices provide a potential opportunity for greater numbers of persons with hearing loss to access amplification and reap the medical, social, and emotional benefits from improved communicative abilities.
Conclusion: A low-cost hearing aid was found to be electroacoustically adequate and a reasonable solution to meet the needs of those value- and cost-conscious patients who were not using amplification via a custom hearing device due to cost.
1 MarkeTrak VIII, Sergei Kochkin, PhD
2 The HR 2006 Dispenser Survey by Karl E. Strom
3 The National Council on the Aging survey, May 1999
4 Lin, FR, et al. Hearing Loss and Incident Dementia Arch Neurol. 68(2):214-220, Feb 2011
5 Mick P, Kawachi I, Lin FR. The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg. 2014 Mar;150(3):378-84
6 Mener DJ, Betz J, Genther DJ, Chen D, Lin FR. Hearing loss and depression in older adults. J Am Geriatr Soc. 2013 Sep;61(9):1627-9
7 Cox RM, Alexander GC, Beyer CM. Norms for the international outcome inventory for hearing aids. J Am Acad Audiol. 2003 Oct;14(8):403-13
8 Cox, R, Alexander, G. Validation of the SADL Questionnaire. Ear & Hearing 22(2):151-160, April 2001
9 Callaway, SL , Punch, JL. An electoacousitc analysis of Over-the-Counter Hearing Aids. Am J Aud. 17:(14-24, June 2008
10 McPherson B, Wong, ET. Effectiveness of an affordable hearing aid with elderly persons. Disability and Rehabilitation 27, 601-609, June 2005
11 Parving A. The hearing aid revolution: Fact or fiction? Acta Otolaryngologica, 123, 245-248, Jan 2003
Hearing and memory loss have long been considered inescapable side effects of aging, but could hearing loss actually predict Alzheimer’s Disease and dementia?
Over time, researchers have noticed a positive correlation between early Alzheimer’s Disease and hearing loss. A recent longitudinal study at Johns Hopkins suggests, that for those over 60 over one-third of the risk of developing dementia (including Alzheimer’s) could be attributable to hearing loss, if a causal link could be found.
To fully understand how hearing loss and Alzheimer’s are related, it’s necessary to take a look at each individually. Hearing loss, which the World Health Organization defines as not being able to hear sounds of 25 decibels or less in the speech frequencies, affects 48 million people in the United States – a number that jumps to one out of every three people once you hit age 65. Hearing loss especially affects veterans of the war in Iraq and Afghanistan (60% of these veterans experience hearing loss upon return), and men are more likely to experience hearing loss than women. As people age, they become more likely to experience hearing loss.
Alzheimer ‘s Disease, meanwhile, is a form of dementia that disrupts memory, thinking, cognition, and behavior. Symptoms develop slowly and gradually worsen. Alzheimer’s is by far the most common type of dementia (accounting for 60-80% of all cases), and it affects more than five million Americans.
Hearing loss and Alzheimer’s share many overlapping symptoms. Those suffering from hearing loss or Alzheimer’s may also feel depression, anxiety, and an increased paranoia. They may respond inappropriately to social cues or feel isolated. They typically experience problems talking or understanding what is being said, and they score lower on mental function tests. They are often in denial, acting defensive and showing negative feelings.
Much of this correlation can be traced back to how brain activity and hearing operate. The temporal cortex, occipital cortex, posterior parietal cortex, and brain stem all contribute to our ability to hear a sound and judge its location, and they’re also very close to the area of the brain that Alzheimer’s first damages. When we hear, the sound travels into the ear and stimulates small sensory hair cells in the cochlea (the inner ear), whose vibrations trigger electrical impulses to move along nerves to the brain stem. Once in the brain stem, the electrical impulses travel to the temporal lobe, which is located just above the ear.
Researchers have also found that mild hearing loss doubles dementia risk, and the risk of dementia rises as hearing loss also rises. The specific connection between hearing loss and brain activity can be traced back to the hair cells in the cochlea. Cochlear hair cells can be damaged as a results of age or exposure to loud noises for a long period of time (as in the case of war veterans), and the less hair cells there are, the harder it is to capture a sound.
An active, healthy brain is a great defense against the symptoms of both hearing loss and Alzheimer’s Disease.
Whether you or a loved one are concerned about either symptoms of hearing loss or dementia, a good first step is to talk to your doctor about getting tested for hearing loss. By getting treatment for hearing loss early, you can address many of the symptoms of both hearing loss and Alzheimer’s while maintaining high cognitive function. Many studies have shown that getting fitted with hearing aids greatly improve Alzheimer’s patients’ ability to understand and communicate, prolonging a higher quality of life.
A recently published study has some good news for hard of hearing consumers on a budget. The Better Hearing Institute reports that direct-to-consumer (mail order) hearing aids are just as beneficial as traditional, expensive hearing aids, yet the consumer enjoys an 80% cost savings with mail order hearing aids.
The study also found that mail order hearing aid consumers are empowered to adjust the fit and settings of their hearing aids. Overall, these users achieve higher overall satisfaction rates and are more likely to recommend their hearing aid brand to others than those who purchase traditionally dispensed aids.
The Better Hearing Institute’s report came as no surprise to Dr. Sreek Cherukuri, founder of MDHearingAid, Inc., one of the largest direct-to-consumer hearing aid companies. “When we started out in 2009, there was some uncertainty in the marketplace, but I was determined to help my patients who couldn’t afford the thousands of dollars that traditional hearing aids cost.”
“It is gratifying to see a scientific study confirm what we and over 100,000 of our satisfied customers have known for some time – it is possible to enjoy better hearing without spending thousands of dollars.”
*Data in table sourced from: Kochkin, S. A comparison of consumer satisfaction, subjective benefit, and quality of life changes associated with traditional and direct-mail hearing aid use. Hearing Review. 2014;21(1):16-26.
A person with sensorineural hearing loss can have an audiogram curve that looks like a cookie that has a bite taken out of it. This loss pattern is called “cookie bite hearing loss”.
Other names for cookie bite hearing loss are pool hearing loss, soup plate hearing loss or U-shaped hearing loss. A person with this pattern is unable to hear mid-frequency sounds while still being able to hear high and low frequency sounds. Fortunately, this hearing loss pattern is relatively rare
With this condition, a person might be able to hear something like a door slamming, but have a hard time following a conversation.
For the majority of people with cookie bite hearing loss, the reason is genetic rather than from aging, being exposed to loud noises, or illnesses/injuries. Although a person is born with this predisposition, he may not notice a problem for many years.
The symptoms are often slow to appear, with the more serious problems occurring after a person reaches 30 years of age. Many times people are not even aware of the problem until they are between 30 and 40.
Because this is a type of sensorineaural hearing loss, it can’t be cured or avoided. Anyone with this type of problem would require a hearing aid. For this type of condition a specific type of hearing aid is needed. Users need a hearing aid that focuses on amplifying mid-frequency range sounds.
Hearing aids will not be able to restore normal hearing but they will help manage the condition. Cookie bite hearing loss can get worse over time, so the sooner one begins using a hearing aid, the better. It will take a little while to get used to, but proper use of hearing aids will lead someone with cookie bite hearing loss to a better quality of life in the long run.
We’ve all wondered if music played too loudly from headphones can damage your hearing. Well, the answer is a definite yes. In the past, these noise concerns were mainly associated with industrial workers who experienced prolonged exposure to high noise levels without adequate protective equipment. Now these concerns are spilling over onto people who listen to music too loudly with headphones.
Don’t assume this is only affecting teenagers and children though. According to the World Health Organization, hearing loss is one of the leading causes of disability in adults, with noise induced hearing loss being the second largest cause. No matter your age, you need to take precautions when listening to music with your headphones.
The problem comes from the maximum volume level that smartphones and media players can play audio. Some of these devices can reach up to 115 decibels, roughly the same as a chainsaw. At this level it takes less than a minute to do permanent damage to your ears. There are tiny, very sensitive, hairs inside your ears that are responsible for hearing. When these are subjected to prolonged exposure to loud noise they can become damaged. This process is gradual, but unfortunately once these hairs are damaged, they don’t grow back.
Recent US studies have shown a worrying trend stating that noise induced hearing loss is increasing among teenagers. As smartphones and media players become more and more common, the ability to damage one’s hearing increases. Even a slight hearing loss can negatively affect a child’s language development and academic progress.
So how loud is just too loud? Generally, anything over 85 decibels is too loud. Any prolonged exposure at or above this level is likely to cause damage to your hearing. The louder the volume, the less time it takes for permanent damage to occur.
Some smartphones allow you to monitor how loud your audio is being played. There are apps you can download that will make sure your audio isn’t at a level that can cause hearing loss. You should also be wary of apps that increase audio automatically to adjust for background noise. Also take breaks when listening with headphones to allow your ears to “relax”. Losing your hearing at any age will cause significant problems for you. Use caution when listening to audio with headphones to avoid future hearing loss problems.
For people with hearing loss, talking on the telephone can be a bit of a challenge. Luckily with today’s great advancements in technology, there are several ways those with hearing loss can talk on the phone. Below are some suggestions.
Amplified telephones can increase the decibel level of sound. They come in plenty of different styles, like corded or cordless, and are usually pretty easy to buy. Many of these phones are also hearing aid compatible, and have features such as loud ringers and flashing lights to alert you of a call.
For those with severe hearing loss these phones can caption entire conversations. They have audio input/output, but also display what the other person is saying in text on a screen. These are more expensive as there is more advanced technology inside them.
There are also state funded specialized telecommunications equipment programs that you can look into. Currently 47 states are offering these programs, so check to see if yours does. You can check with a local telephone company to see what your state currently offers.
How to Buy:
There are plenty of places that one can get an amplified telephone. A quick internet search will lead you to plenty of websites that can assist you. Prices usually fall in the range from anywhere between $30 up to $300. The price usually depends on the features you need.
Many people, when confronted with the fact that they may be suffering from hearing loss, tend to brush it aside. They think to themselves “It’s not too bad yet, I can live with it” or “I’ll just get a hearing aid for the weaker ear.”
Even being recommended a hearing aid often leads to resistance. For whatever reason, people tend to push away the idea of getting help for their hearing loss. If you are one of these individuals who has been putting off seeking treatments, or know someone who is, it’s time to seek aid.
Recent estimates suggest that only twenty percent of the 36 million people who suffer from hearing loss seek treatment. According to ASHA.org, on average people will wait ten years or more before getting a hearing aid.
While during this time they may have felt they were coping with the problem and that it wasn’t causing any harm, recent studies would suggest otherwise. Not only does hearing loss contribute to emotional, physical, social, and psychological problems, but these studies have shown a connection between hearing loss and reduced cognitive function.
Individuals who suffer from hearing loss are more susceptible to cognitive disorders such as Alzheimer’s and dementia, according to the National Institute on Aging. At John Hopkins, a recent study examined individuals with different levels of hearing loss and found a link between hearing loss and dementia.
After 20 years, almost 10 percent of participants were identified as having dementia. The study showed that overall, for every 10 decibels of hearing loss, the risk of dementia went up 20 percent.
Participants with mild loss were three times as likely to develop dementia, while those classified with severe loss were five times as likely. This cognitive disorder is suggested as being caused by auditory deprivation.
When the hearing nerve is under-stimulated, auditory deprivation occurs. This can stem from untreated hearing loss over a period of time. When you get auditory deprivation, this can lead to a weakening of the entire auditory system.
Adults tend to experience hearing loss gradually, and as such auditory deprivation can often go on for a long period of time. When your brain goes without getting adequate sound, it causes atrophy in the areas responsible for speech and sound.
The ears act as a gateway for sound to get to our brain. If a sound doesn’t get to the ear, it doesn’t get to the brain. Sound means nothing to us until it is processed by our brains. Prolonged absence of sound can lead to the brain having trouble understanding sounds. It’s like a muscle in that if you don’t use it enough, it becomes weaker over time.
One of the most common causes of auditory deprivation is failure to treat hearing loss with a hearing aid. You can also suffer from the atrophy mentioned above if you only take care of one ear and not the other. When one ear does all of the work, the other one becomes unused and eventually weaker. Even if the other ear is later supported by a hearing aid, it can be difficult to help because of the existing auditory deprivation damage.
How much auditory deprivation is experienced depends on the individual. Each person has a different circumstance when it comes to the amount of hearing loss and how long the auditory system has gone under-stimulated. The main thing to remember about preventing auditory deprivation is to keep your auditory system stimulated!
If you suspect you have hearing loss, schedule a hearing test to see if hearing aids are right for you. Studies have shown that identifying and treating hearing loss sooner, rather than later, results in greater success.
Should I get hearing aids? Many people have asked themselves this question over the years. As people get older, their hearing tends to slowly decline and can reach a point where they need some additional help. When deciding if you or a loved one would benefit from hearing aids, there are several things to consider.
The first thing to consider is the severity of your hearing loss. For most people, that requires a trip to the doctor or audiologist. A hearing professional will be able to test your hearing and let you know if you would benefit from hearing aids. Frequently when being tested, patients are surprised at just how much their hearing has degraded. This is because hearing loss is usually a gradual process, and therefore less noticeable.
Safety is another consideration. Hearing plays an important role in your daily life, so hearing impairment can negatively impact you in many ways. Driving becomes a hazard to not only you, but to those around you when you can’t hear well. Daily tasks become increasingly risky if you can’t hear as well as you used to and work can be more difficult and dangerous if you can’t hear what is going on around you. Consider your lifestyle and the implications of not having optimal hearing. If you think you or someone else could be hurt because of it, you should definitely consult a doctor.
There are also health risks associated with untreated hearing loss. It can put additional stress on your hearing pathways, which can cause them to deteriorate and lead to more rapid hearing loss over time. Patients with hearing loss are at a higher risk for depression and other health complications. By taking care of your ears early, you can prevent future health risks from occurring.
Start living life more fully by getting your hearing tested as soon as you can.
Do you know someone who is losing their hearing but refuses to get a hearing aid? This can be a very difficult situation to be in. On one hand, you are concerned for the other person and want him to get help, but on the other, you don’t want to offend him or make him feel bad about himself.
Many people find themselves in this situation. While it won’t be easy, having a talk with this person can be of great benefit for the both of you.
When starting this conversation, be sure to keep your tone calm and caring. Trying to force someone into doing something he doesn’t want to do may only make things worse. Try to explain to him how his hearing loss is affecting you.
You could try explaining that the problems is a safety issue. Or that you are frustrated having to repeat yourself all the time when talking with him. It may not be easy for him to hear that he is causing you problems, so try to do it in a non-accusatory way.
If that isn’t enough, try explaining some of the more serious consequences of hearing loss. For example, people with hearing loss are at higher risk for depression and other serious health complications. Let this person know that he is doing himself more harm than good by not getting his hearing problems resolved.
Finally, you can explain that hearing aid technology has come a long way. Hearing aids today are lightweight and barely noticeable. Hearing aids are not something to be embarrassed about, and the changes he will see in his hearing will be remarkable.
Tell him at the very least he should have his hearing tested.
Hopefully, with this advice you are able to convince your loved one with hearing loss to consider getting a hearing aid. Remember not to force him into anything and for this decision to be the most effective it has to be made by the person with hearing loss. If you make your arguments clear and from the heart, the outcome will be more positive for both of you.