Hearing loss: how to get tested and find treatment

It comes to most of us sooner or later. We keep turning the TV up until we’ve driven everyone else from the room. And too often we pretend we can hear people talking around us when actually it is just a blur of sounds.

Around 6.7 million people are living with undiagnosed hearing problems that could easily be addressed, says Royal National Institute for Deaf People. While most of us would be quick to book an eye test if our sight began to deteriorate, it takes an average 10 years for people to tackle their hearing issues. However, that simple 20-minute check can hold the key to boosting your health and wellbeing in so many ways.

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What are the signs of hearing loss?

Hearing loss usually creeps up gradually, and those close to the person may be the first to notice the onset. If someone finds it hard to hear what others are saying, frequently asking them to repeat what they’ve just said, thinks that they are mumbling, and is often accused by colleagues, friends and family of not listening, it’s likely they have an issue. Similarly, if the volume on their radio or TV is always turned up very loud 

What to do if you have hearing loss

If you're worried you may have suffered some hearing loss, you shouldn't wait till your next routine doctor's visit.

You can take a hearing check on the website of the national charity RNID. If the findings indicate that you may have hearing loss, they will send you a statement of the results. You can also ask your GP to refer you to an audiologist (the hearing-check statement may help).

What kinds of hearing loss are there?

Hearing loss can be conductive or sensorineural.

Sensorineural hearing loss, caused by changes in the inner ear, is a more common cause of hearing loss in older people. Many people find their hearing becomes less acute once they are past the age of 50, and the majority of over 70s has some degree of sensorineural hearing loss.

This loss happens as the cochlea in the inner ear becomes less effective at picking up sound, especially high-pitched ones, often causing difficulty following conversation in a noisy environment.

Sensorineural hearing loss is assessed by audiometry: you listen through earphones to sounds of different frequencies and volumes, and the equipment records how loud a sound must be at any given frequency for you to be able to hear it.

Conductive loss is likely to be in the outer or middle ear, and may well be treatable.

What else can hearing loss indicate?

Heart issues

If you’re concerned that your hearing is failing, the obvious course is to have it tested. You should be aware, however, that this could lead to a diagnosis of a serious health condition of which you were not aware.

For example, research has shown there is a link between your hearing – especially low-frequency hearing loss – and your heart. Because your inner ear is sensitive to blood flow, if this is lower than it should be, it could be a sign of cardiovascular disease. So if you are diagnosed with a hearing problem, it is worth seeing your GP about your heart health.

Depression and social isolation

It stands to reason that untreated hearing loss can lead to communication problems, low mood and anxiety – and there's plenty of research to back this up.

In fact, adults with hearing loss who don't wear aids are 50 per cent more likely to experience sadness or depression than those who do wear them, according to a study from the National Council on Aging in the US.

Poor hearing can lead to all sorts of communication issues. If someone struggles with background noise in an exercise class or group session thry used to enjoy they might start to avoid it, and that can have an impact on physical fitness as well as reducing the mental stimulation they get from mixing with other people.

Dementia

Evidence of a link between dementia and loss of hearing has been growing. Most people with dementia are over 70, and the majority of people over 70 have hearing problems, but cause and effect are not entirely evident.

A study led by Professor Gill Livingston, of University College London, listed nine potentially modifiable life factors that contribute to our risk of developing dementia. Top of the list was mid-life hearing loss, which, if treated in every case, would result in 9% fewer total cases of dementia.

What is not yet clear is whether dementia results from social isolation and depression arising from hearing loss, or if it’s down to brain degeneration.

Can medication be causing your hearing problems?

According to Action on Hearing Loss, more than 100 prescription and non-prescription drugs are ‘ototoxic’ and can cause hearing loss, tinnitus and balance problems, especially when taken in high doses. Strong cancer drugs are often the culprit. As always, potential harm must be measured against benefits. Consult your doctor if you have any concerns.

What treatment is there for hearing loss?

Hearing aids

Hearing aids work by amplifying sound, and the newest models are generally stylish, often fitting inside your ear discreetly and fine-tuned to reduce distracting background noise, reacting to your environment, hooking up to your mobile, and much more.

Bone-anchored hearing aids (BAHAs)

These are a good alternative to conventional hearing aids if you have mild-to-moderate hearing loss and ordinary aids aren’t effective, perhaps because chronic ear infections or operations have damaged the eardrum or outer-ear mechanisms.

A small ‘press-stud’ is implanted in the mastoid bone, behind the outer ear, to which a sound processor is anchored in a short operation done under local anaesthetic. Sound passes via bone vibration directly to the cochlea.

Cochlear implants

If hearing aids no longer work for you or you have profound or severe hearing loss in both ears, you could benefit from a cochlear implant (CI).

A receiver is placed in the inner ear, under general anaesthetic, while an external processor is worn on the head behind the ear. The processor sends sounds to the receiver, which transmits them directly to the brain, via the cochlea’s auditory nerve. Surgical techniques that help preserve residual hearing, and the advent of more discreet speech processors that offer better sound clarity, have made CIs much more popular in recent years.

Assistive listening devices (ALDs)

These days you can augment your hearing aid or implant with wireless gadgets and gizmos designed to boost hearing as and when needed – during phone calls, one-to-one conversations in crowded rooms or when trying to hear PA systems.

Hearing loss resources

For advice on hearing loss, hearing aids and other equipment and issues, visit the Royal National Institute for Deaf People: rnid.org.uk
To find a hearing-aid dispenser in your area, try the British Society of Hearing Aid Audiologists www.bshaa.com
Selected branches of Boots and Specsavers, and Hidden Hearing all offer free hearing tests.

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