The number one reason why people purchase their first hearing aids is they recognize their hearing has worsened. The second reason is pressure from family members who are negatively impacted by the individuals hearing loss. As you know by now, hearing loss occurs gradually. By the time you recognize a need for hearing aids, your quality of life may have deteriorated unnecessarily.
The average age of first-time hearing aid wearers is close to 70 years of age, despite the fact that the majority (65 percent) of people with hearing loss are below the age of 65; and nearly half of all people with hearing loss are below the age of 55. For the vast majority of individuals who have decided to wait to purchase hearing aids (78 percent of all people who admit to hearing loss), although they may be aware their hearing loss has deteriorated, they delay hearing aid purchases under the excuses: “My hearing loss is not bad enough yet; I can get by without them; my hearing loss is mild.”
A large number of people wait 15 years or more from the point when they first recognize they have a hearing loss to when they purchase their first hearing aids. This is a tragedy since they might not be aware of the impact this delayed decision has had on their life, and the lives of their family and associates.
The literature presents a compelling story for the social, psychological, cognitive and health effects of hearing loss. Impaired hearing results in distorted or incomplete communication leading to greater isolation and withdrawal and therefore lower sensory input.
In turn the individual’s life space and social life becomes restricted. One could logically think that a constricted lifestyle would negatively impact the psychosocial well-being of people with hearing loss.
Research indicates that hearing loss is associated with embarrassment, fatigue, irritability, tension and stress, anger, avoidance of social activities, withdrawal from social situations, depression, negativism, danger to personal safety, rejection by others, reduced general health, loneliness, social isolation, less alertness to the environment, impaired memory, less adaptability to learning new tasks, paranoia, reduced coping skills, and reduced overall psychological health.
For those who are still in the workforce, uncorrected hearing loss has a negative impact on overall job effectiveness, opportunity for promotion and perhaps lifelong earning power. Few would disagree that uncorrected hearing loss is a serious issue.
Prior Experimental Evidence that Hearing aids Improve Quality of Life
An effective human being is an effective communicator; optimized hearing is critical to effective communication. Modern hearing aids improve speech intelligibility and therefore communication. The benefits of hearing aids (audiologically defined as improved speech intelligibility) have been demonstrated in rigorous scientific research.
It would seem that if one could improve speech intelligibility by correcting for impaired hearing, that one should observe improvements in the social, emotional, psychological and physical functioning of the person with the hearing loss. There have only been a few studies to date comparing hearing aid owners and non-owners with known hearing loss.
The majority of studies had small sample sizes and in general tended to confine themselves to U.S. male veterans. The results of these studies, as well as the exciting findings of a very large U.S. study conducted in collaboration with the National Council on the Aging in 1999 (with publication in January 2000), are described below. Harless and McConnell demonstrated that 68 hearing aid wearers had significantly higher self-concepts compared to a matched group of individuals who did not wear hearing aids.
Dye and Peak studied 58 male veterans pre- and post-hearing aid fitting and found significant improvement on memory tests. In the most rigorous controlled study to date, Mulrow, Aguilar and Endicott studied 122 male veterans and 72 patients from primary care clinics.
Half were randomly chosen and fit with hearing aids while the other half were not. After four months compared to the control group, the researchers found significant improvements in the hearing aid wearers on emotional and social effects of hearing handicap, perceived communication difficulties, cognitive functioning, and depression.
In addition, the same researchers in a follow-up study published in 1992 demonstrated that the quality of life changes were sustainable over at least a year. Bridges and Bentler determined in a study of 251 subjects comprised of normal hearing elderly individuals with hearing aids, and individuals with unaided hearing loss that hearing aid wearers had less depression and higher quality of life scores compared to their unaided counterparts.
Finally, in a pre-post study (that is the person was studied before and after a hearing aid fitting) with 20 subjects, Crandall demonstrated after three months of hearing aid use that functional
health status improved significantly for hearing aid wearers.
Research on the Positive Impact of Hearing aids on Quality of Life
Following are the results of the largest study in the world conducted on the impact of hearing aids on quality of life. After reading this, we hope you agree that hearing aids when successfully fit to your unique audiological needs, have the potential to literally transform your life.
Utilizing the famous National Family Opinion Panel (NFO) in 1997, a short screening survey was mailed to 80,000 panel members to find a representative sample of people with hearing loss in the United States. This short survey helped identify nearly 15,000 people with self-admitted
hearing loss. The response rate to the screening survey was 65 percent. Since 1989, research has been conducted in this manner on more than 25,000 people with hearing loss and the findings have been under the generic name “MarkeTrak.” Working with the National Council on the
Aging, a sample of 3,000 individuals with hearing loss ages 50 and over were randomly drawn from the MarkeTrak hearing loss panel. Equal samples of 1,500 hearing aid owners and non- owners were drawn from the panel.
What is unique about this study is that people with hearing loss, as well as their significant other (usually the spouse), were studied. Extensive questionnaires were sent to both the person with the hearing loss and the spouse or family member. The number of questions was 300 and 150 respectively. The comprehensive survey covered a myriad of topics including: self and family assessment of hearing loss,
psychological well-being, social impact of hearing loss, quality of relationships, life satisfaction, general health, self and family perceptions of benefit of hearing aids (wearers only) , reasons for purchasing hearing aids (wearers only), reasons for not purchasing hearing aids (non-wearers
only) , and attitudes toward hearing health and hearing aids. In addition, a number of personality scales, which were deemed relevant to this study, were included in the survey.
After analyzing the returned surveys for usability (e.g. minimal missing information, hearing aid owners who wear their hearing aids) the final sample sizes for respondents with hearing loss and family members were reduced to 2,069 and 1,710 respectively. Thus, this study involved nearly
4,000 people.
The goal of the study was to determine if hearing aids had an impact on hearing loss independent of hearing loss. In other words, do people with mild hearing loss derive as much benefit as individuals with more serious hearing losses? As part of the research design, in addition to quality of life items, a paper and pencil assessment of hearing loss was administered with the anticipation that the results of this assessment would be used to control for hearing loss when comparing the quality of life of hearing aid wearers and non-wearers.
The key hearing assessment tool used was the Five Minute Hearing Test (FMHT) by the American Academy of Otolaryngology-Head and Neck Surgery. The FMHT is a fifteen-question test measuring self-perceived hearing difficulty in a number of listening situations (e.g. telephone, multiple speakers, television, noisy situations, reverberant rooms), as well as self- assessments of some signs of hearing loss (e.g. people mumble, inappropriate responses, strain to hear, avoid social situations). Previous research has determined that the FMHT is significantly correlated with objective audiological hearing loss measures.
Based on hearing difficulty scores, all subjects in this study were grouped into five equal size groups (20 percent each-called quintiles). These ranged from quintile 1 (the 20 percent of respondents with the mildest hearing loss as measured by the FMHT) to quintile 5 (the 20 percent with the greatest hearing loss). The quintile system was utilized for all analysis as a means of controlling for differences in hearing loss between the hearing aid wearer and non- wearer samples. The use of these quintiles allowed the researchers to achieve more valid comparisons between samples of hearing aid wearer and non-wearers.
If the responses of all hearing aid wearers with those of all non-wearers were compared without regard to the degree of hearing loss, the findings would have been misleading, and even erroneous.
For example, it is widely known that incidence and degree of depression have been found to increase with the severity of hearing loss. Thus, even if people with severe hearing loss experience reduced depression after getting hearing aids, they might still report more depression than non-wearers overall, since hearing aid wearers tend to have more severe hearing loss. However, when hearing aid wearers are matched with non-wearers in the same quintile (non-wearers having a fairly similar degree of hearing loss), the differences between them better reflect the potential impact of the hearing aids rather than the effect of their degree of hearing loss.
While there is no audiological basis for labeling hearing loss associated with each quintile group, the researchers did find an excellent correlation between self-perceived loss (e.g. mild to profound hearing loss) and the FMHT test. As we discuss the findings of this study with respect
to the five hearing loss groups, it’s appropriate to consider people in quintile hearing loss groups 1, 3 and 5 as having respectively a “mild,” “moderate,” and “severe /profound” hearing loss; group 2 is between mild and moderate hearing loss while group 4 should be viewed as between
moderate and severe hearing loss.
Research Findings
Following is a systematic evaluation of the impact that hearing aids have on the quality of life. This will be done by comparing the responses of hearing aid wearers and non-wearers while controlling for hearing loss. As you evaluate the impressive findings below keep in mind the following:
• the devastating impact of hearing loss on quality of life is well-documented;
• quality of life is primarily impacted by the fact that uncorrected hearing loss results in
reduced speech intelligibility;
• hearing aids when fitted correctly improve speech intelligibility and therefore can restore
your ability to function more effectively in life.