Key Takeaways

• Only one in three older adults who could benefit from hearing aids actually use them.
• Hearing loss can lead to atrophy of the brain, which can lead to more serious health problems.
• Hearing aids can improve quality of life, help ease depression, and decrease the risk of dementia and falls.

Hearing loss can significantly take a toll on your overall health and quality of life, including increasing social isolation and feelings of frustration when it becomes challenging to keep up with normal conversations. But you’re not alone.

According to the National Institute on Deafness and Other Communication Disorders, about 15% of Americans 18 and over report difficulty hearing, and 28.8 million U.S. adults could benefit from hearing aids. ^[1]Quick Statistics About Hearing. National Institute on Deafness and Other Communication Disorders. Updated March 25, 2021. Found on the internet at https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing. Among those who could benefit, less than 30% of those 70 and older and approximately 16% of those 20–69 have used hearing aids.

While hearing aids require an adjustment period, treating your hearing loss can allow you to hear sounds you might not have heard in a while and communicate more easily. ^[2]Hearing Aid Benefits and Limitations. U.S. Food and Drug Administration. Update Nov. 18, 2022. Found on the internet at https://www.fda.gov/medical-devices/hearing-aids/hearing-aid-benefits-and-limitations. Our Reviews Team created this guide so you can understand the benefits of hearing aids and decide if they are right for you.

Benefits of hearing aids

Hearing loss can lead to a number of health problems, like atrophy (wasting away) of the brain. ^[3]The Hidden Risks of Hearing Loss Johns Hopkins Medicine. Found on the internet at https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss. Atrophy can lead to more serious health complications and challenges, including dementia, seizures, disorientation, loss of coordination, and difficulty communicating. ^[4]What Is Cerebral Atrophy? National Institute of Neurological Disorders and Stroke. Reviewed Feb. 7. 2023. Found on the internet at https://www.ninds.nih.gov/health-information/disorders/cerebral-atrophy.

Social isolation is another common occurrence with hearing loss that can lead to depression. Unfortunately, people with difficulty hearing may be less likely to initiate or continue conversations with others.

Hearing aids can help with these challenges. When you improve your hearing, you exercise your brain more, and decrease your risk of atrophy. You’re also more likely to have more social interactions with improved hearing. ^[3]The Hidden Risks of Hearing Loss Johns Hopkins Medicine. Found on the internet at https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss. Other benefits of hearing aids include:

• Decreases the strain of hearing through the amplification of sound ^[5]Benefits of Hearing Aids. Oregon Health and Science University. July 29, 2023. Found on the internet at https://www.ohsu.edu/ent/benefits-hearing-aids.
• Filters out background noise to improve listening to the television or having a conversation
• Minimizes ringing or buzzing sounds experienced by those with tinnitus ^[6]Hearing Aids/Masking Devices. American Tinnitus Association. Found on the internet at https://www.ata.org/about-tinnitus/therapy-and-treatment-options/hearing-aids-masking-devices.
• Improves communication skills and understanding conversations ^[7]Hearing Aids. National Institute on Deafness and Other Communication Disorders. Updated Oct. 11, 2022. Found on the internet at https://www.nidcd.nih.gov/health/hearing-aids.
• Increases independence
• Decreases risk of falling

Benefits of using two hearing aids

If you only have hearing loss in one ear, one hearing aid will suffice. But, if like most people with hearing loss you have hearing loss in both ears, research shows wearing one doesn’t allow your brain to work as efficiently picking out sounds you need to hear, which means understanding speech can be more difficult. ^[8]One Hearing Aid or Two? Harvard Health Publishing. Dec. 5, 2019. Found on the internet at https://www.health.harvard.edu/diseases-and-conditions/one-hearing-aid-or-two. When you wear two hearing aids, you enhance your ability to locate where a sound is coming from. The brain processes the time, loudness, and pitch of sounds to localize them. If these sounds occur on the side without a hearing aid, there is a delay, making localization difficult.

This is why if you have hearing loss in both ears, wearing two hearing aids can benefit you in a number of ways: ^[5]Benefits of Hearing Aids. Oregon Health and Science University. July 29, 2023. Found on the internet at https://www.ohsu.edu/ent/benefits-hearing-aids.

• Each ear communicates with the brain individually through localized cells on the left or right side. When the cells on the side with hearing loss and no hearing aid are not used regularly, they may atrophy due to decreased use. This atrophy may result in permanent hearing loss that can’t be helped with hearing aids.
• Many hearing aids have dual microphones. Wearing these hearing aids in each ear increases sound localization and decreases background noise. During activities such as walking, the ability to hear in each ear allows you to know the appropriate location of cars or other potential hazards.
• Hearing aids can be programmed for each ear, which improves sound processing. Since some people have different levels of hearing loss in each ear, it’s important to adjust the hearing aids to provide the best results on each side.

Limitations of hearing aids

After understanding the potential benefits of hearing aids, consider their limitations to make an informed decision.

• Hearing aids do not restore normal hearing. ^[2]Hearing Aid Benefits and Limitations. Food and Drug Administration. Update Nov. 18, 2022. Found on the internet at https://www.fda.gov/medical-devices/hearing-aids/hearing-aid-benefits-and-limitations. Ricky Emerson, a hearing instrument specialist licensed in North Carolina and Virginia, shared that people “may see improvements with hearing aids but not back to 100%.”Adding to this, Rachel Magann Faivre, AuD, owner of Oklahoma City-based Ash Audiology, said: “I tell patients that no matter how good the sound quality is coming from the hearing aid, there’s still damage in their hearing pathway. So, they won’t hear like they did when they were younger, but their hearing will improve significantly.” Hearing aids with dual microphones can filter out excess sound in the room and amplify those closest to you.
• Background noise may increase, which can be distracting. Emerson said, “The amplification of ambient sounds can be perceived as an echo chamber in the ear and make conversation difficult.”
• Hearing aids may increase the loudness of your voice and other sounds. The increased volume may be irritating to some. Fortunately, adjusting the settings of the hearing aids can help.
• It may require several months to get used to your hearing aids as your brain adjusts to the newly amplified sounds.
• Hearing aids can be expensive, and the cost may not be covered by Medicare or other insurance. To avoid surprises, check with your insurance carrier before purchasing.
• While hearing aids serve as hearing loss treatment, they can’t slow the progression of nerve- or age-related hearing loss. ^[5]Benefits of Hearing Aids. Oregon Health and Science University. July 29, 2023. Found on the internet at https://www.ohsu.edu/ent/benefits-hearing-aids. “Hearing aids are not cures. If total hearing loss is present, those people will not benefit from their use,” Emerson said.For hearing loss so profound a hearing aid is no longer helpful, Magann Faivre noted, the next step may be a cochlear implant, which can treat people with one-sided hearing loss, one-sided deafness, and other conditions hearing aids may not be able to treat. ^[9]Cochlear Implants. National Institute on Deafness and Other Communication Disorders. March 24, 2021. Found on the internet at https://www.nidcd.nih.gov/health/cochlear-implants.

Who benefits from hearing aids?

Older adults experiencing age-related hearing loss

Structures in the inner ear change as you age, resulting in age-related hearing loss. ^[10]Age-Related Hearing Loss (Presbycusis). National Institute on Deafness and Other Communication Disorders. March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss. Age-related changes also occur in the middle ear and the pathways from the ear to the brain, which impacts hearing.

People with jobs that damage their hearing

Occupational hearing loss occurs when you are consistently exposed to noise levels above 85 decibels (equivalent to the sound of a garbage disposal). One in eight workers in the United States has hearing loss, with 22 million people exposed to hazardous noise at work each year. Additionally, among those with hearing loss, occupational exposures are the cause for one in four people. ^[11]About Occupational Hearing Loss. Centers for Disease Control and Prevention. Jan. 25, 2023. Found on the internet at https://www.cdc.gov/niosh/topics/noise/about.html. These people may work in one or more of the following jobs:

• Construction workers
• Professional musicians
• Veterans and military personnel
• Landscapers
• Truck drivers
• Firefighters
• Law enforcement officers
• Shipbuilders

People with hobbies that damage their hearing

As with occupational exposure, extended exposure to loud noise levels while participating in various hobbies can lead to hearing loss. Proper hearing protection is crucial when participating in these activities:

• Shooting: Recreational firearm decibel levels are typically above 140 decibels and can reach 175 for large-bore rifles and pistols. Exposure to these levels can permanently damage hearing. ^[12]Recreational Firearm Noise Exposure. American Speech-Language-Hearing Association. Found on the internet at https://www.asha.org/public/hearing/recreational-firearm-noise-exposure.
• Motorcycles and dirt bikes: These vehicles can reach decibel levels of 80–110. ^[13]Noise-Induced Hearing Loss. National Institute on Deafness and Other Communication Disorders. March 16, 2022. Found on the internet at https://www.nidcd.nih.gov/health/noise-induced-hearing-loss. Noises the rider is exposed to include sound created by the exhaust, engine, and wind.
• Performing loud music, concerts, or sporting events: While these activities are fun, decibel levels can reach 94–110. ^[12]Noise-Induced Hearing Loss. National Institute on Deafness and Other Communication Disorders. March 16, 2022. Found on the internet at https://www.nidcd.nih.gov/health/noise-induced-hearing-loss. Musical performers, concertgoers, and those attending sporting events will likely experience some ringing in the ears after these events. This indicates the hearing pathway has incurred some damage, noted Magann Faivre.

Protecting your hearing

“The loudness of life can take a permanent toll on your ears. Regular or repetitive exposure to loud sounds is known to directly lead to hearing loss and ringing in your ears. Hearing protection can prevent this damage. There are a wide range of products to suit each individual’s needs, but there are three main types of hearing protection: earmuffs, custom and non-custom earplugs, and electronic hearing protection.rnrnEarmuffs are easy to put on and off and are widely available online and in stores. Custom earplugs are the most comfortable since they are made from a mold of your ear and are most appropriate for regular use. They also come with replaceable filters to adjust your protection level depending on what type of noise you are around. Non-custom earplugs are inexpensive and widely available online and in stores; however, their comfort usually isn’t great for more than a half hour’s use, and they’re difficult to insert properly in most people’s ears. Earmuffs with electronic components amplify speech and other environmental sounds while protecting your ears from sounds that are too loud. These are ideal for people who need to be able to hear their surroundings while also protect their ears.”rnrn—Rachel Magann Faivre, AuD

When and why do people get hearing aids?

Nearly one in three people age 65–74 have hearing loss and require hearing aids to treat their hearing loss. ^[10]Age-Related Hearing Loss (Presbycusis). National Institute on Deafness and Other Communication Disorders. March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss. Others may require hearing aids earlier due to excessive noise exposure from their job or hobbies. It’s important to remember choosing to get hearing aids can be a difficult decision, particularly if you feel self-conscious about others seeing the devices. “For new users, I always discuss their motivation to hear better,” said Magann Faivre. “Because hearing aids don’t restore hearing but rather act as an ‘aid,’ and they require a commitment to wearing them daily, the patient needs to be motivated to want to wear them and hear better. A spouse or loved one pushing the patient to get hearing aids never works, and the hearing aids often end up in a drawer after a few months.”

People seek out hearing aids for various reasons. Some may have recently undergone a hearing assessment and were informed they have some degree of hearing loss. Others may have noticed they’re turning on the television or radio louder than they used to. Difficulty understanding conversations, particularly in crowded settings, can also encourage a person to research their hearing aid options. Often, a spouse is the driving force, noted Emerson.

“We hear with our brains and not with our ears,” Emerson said. “Going without hearing aids when you need them can impact balance.” In fact, a Johns Hopkins study recently linked untreated hearing loss with a higher risk of developing Alzheimer’s. ^[14]New Study Links Hearing Loss With Dementia in Older Adults. Johns Hopkins Bloomberg School of Publich Health. Jan. 10, 2023. Found on the internet at https://publichealth.jhu.edu/2023/new-study-links-hearing-loss-with-dementia-in-older-adults.

Bottom line

Hearing loss becomes more prevalent in older adults, but only one in three older adults who would benefit from hearing aids use them. ^[1]Quick Statistics About Hearing. National Institute on Deafness and Other Communication Disorders. Updated March 25, 2021. Found on the internet at https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing. Hearing loss can also be caused by exposure to excessive noise in occupations and hobbies.

Those with hearing loss may experience a decreased quality of life, depression, higher risks of falls, and an increased risk of developing dementia. Consistent use of hearing aids has been shown to reduce these risks. ^[3]The Hidden Risks of Hearing Loss Johns Hopkins Medicine. Found on the internet at https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss.

Understanding the benefits and limitations of hearing aid use can help you make an informed decision, so you can treat your hearing loss and improve your overall quality of life.

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

1. National Institutes of Health. Quick Statistics About Hearing. March 25, 2021. Found on the internet at https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
2. U.S. Food and Drug Administration. Hearing Aid Benefits and Limitations. Nov. 18, 2022. Found on the internet at https://www.fda.gov/medical-devices/hearing-aids/hearing-aid-benefits-and-limitations
3. Johns Hopkins Medicine. The Hidden Risks of Hearing Loss. Found on the internet at https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss
4. National Institute of Neurological Disorders and Stroke.What Is Cerebral Atrophy? Reviewed Feb. 7, 2023 Found on the internet at https://www.ninds.nih.gov/health-information/disorders/cerebral-atrophy
5. Oregon Health and Science University. Benefits of Hearing Aids. Found on the internet at https://www.ohsu.edu/ent/benefits-hearing-aids
6. American Tinnitus Association. Hearing Aids/Masking Devices. Found on the internet at https://www.ata.org/about-tinnitus/therapy-and-treatment-options/hearing-aids-masking-devices
7. National Institute on Deafness and Other Communication Disorders.Hearing Aids. Updated Oct. 11, 2022. Found on the internet at https://www.nidcd.nih.gov/health/hearing-aids
8. Harvard Health Publishing. One Hearing Aid or Two? Dec. 5, 2019. Found on the internet at https://www.health.harvard.edu/diseases-and-conditions/one-hearing-aid-or-two
9. National Institute on Deafness and Other Communication Disorders.Cochlear Implants. March 24, 2021. Found on the internet at https://www.nidcd.nih.gov/health/cochlear-implants
10. National Institute on Deafness and Other Communication Disorders. Age-Related Hearing Loss (Presbycusis). March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss
11. Centers for Disease Control and Prevention. About Occupational Hearing Loss. Jan. 25, 2023. Found on the internet at https://www.cdc.gov/niosh/topics/noise/about.html
12. American Speech-Language-Hearing Association.Recreational Firearm Noise Exposure. Found on the internet at https://www.asha.org/public/hearing/recreational-firearm-noise-exposure
13. National Institute on Deafness and Other Communication Disorders. Noise-Induced Hearing Loss. March 16, 2022. Found on the internet at https://www.nidcd.nih.gov/health/noise-induced-hearing-loss
14. Johns Hopkins Bloomberg School of Public Health.New Study Links Hearing Loss With Dementia in Older Adults. Jan. 10, 2023. Found on the internet at https://publichealth.jhu.edu/2023/new-study-links-hearing-loss-with-dementia-in-older-adults