Can You Say That Again, Please?

Untreated hearing loss can lead to many problems, including social isolation, depression, and the dangerous inability to hear smoke alarms at home or police sirens while driving. Conversely, the benefits of hearing aids can help you stay active and engaged in conversation and in life. Unfortunately, the majority of people who need hearing aids don’t get them. The main reason? Fear that they will appear old and incapable.

“In audiology we have a slogan: Your hearing loss is more obvious than your hearing aids,” says Alison M. Grimes, AuD, director of Audiology and Newborn Hearing Screening at UCLA Health. “Someone who asks ‘what?’ all the time or answers a question that wasn’t asked makes them appear somewhat incapable. But if someone with hearing aids says, ‘Can you look at me when you’re talking because it’s noisy in here, and I can’t hear you when you turn your face away from me,’ that person is in control and quite capable.”

A Part of Getting Older for Some

Hearing loss is a part of getting older for most people, but not everyone. The loss is typically very gradual and usually affects both ears. Men are much more likely to be affected by hearing loss compared to women. Caucasians are affected in greater numbers, while African-Americans are affected the least.


  • Age-related hearing loss is typically very gradual.
  • Men are affected twice as often as women.
  • Loud sounds can permanently damage hearing.
  • Customized hearing aids are best.
  • Over-the-counter hearings aids can be useful to those with mild hearing loss.

The good news is that researchers have recently reported that hearing loss among U.S. adults aged 20 to 69 has declined over the last decade, even as the number of older Americans continues to grow. With loss delayed to age 70 or later, those who do develop hearing loss will have had more years with better hearing than previous generations. These findings, published in JAMA Otolaryngology–Head & Neck Surgery, also confirm that hearing loss is strongly associated with age and other demographic factors, such as sex, race/ethnicity, and education. The research was supported in part by the National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health.

Not Your Grandfather’s Hearing Aids

Hearing aids have come a long way. They are smaller, more discreet, and can be adjusted to an individual’s hearing needs. Customized hearing aids are superior to over-the-counter hearing aids, which Dr. Grimes compares to a pair of reader glasses you can buy at the store.

“People who will hear the best are those for whom hearing aids are custom-fitted, not just physically but acoustically,” explains Dr. Grimes. “I make sure it fits comfortably and snugly in the ear, but I also measure and program the sound the hearing aid is producing in the ear canal to make sure that it’s not too much and not too little. I also ensure that the hearing aid is providing the right amount of amplification for that patient because everyone’s hearing loss is different.”

Unlike reading glasses, however, it’s best to wear hearing aids every day rather than intermittently because your brain interprets the sound, and needs time to adjust to a new way of hearing.

Age-related Hearing Loss: Cumulative and Additive

Hearing diminishes with age due to a lifetime of noise exposure. It isn’t just something that happens to those who work in loud environments.

“The reality is we’re all exposed to loud noise in daily life. The siren that goes by, the nail in a board, an unexpected alarm close to your ear: When you get an exposure to excessively loud noise, some of your auditory nerve cells die, Dr. Grimes explains. “It’s cumulative and additive over a lifetime.”

The cells that die do not regenerate, though some early research in re-growing these cells is showing promise. Getting your hearing assessed early, before it becomes too advanced, is helpful because it’s easier to adjust to using hearing aids when the loss is minimal. If you are having trouble hearing in restaurants, at the movies, or while talking on the phone, it’s time to get your hearing checked.

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