As an individual with severe hearing loss, the arrival of Deaf Awareness Week 2022 is an important time to take stock.

These days, the technology supporting hearing loss is so much better than when I was diagnosed with catastrophic bilateral hearing loss in 1992 (long story).  Most TV programmes are captioned now, you can order taxis and pizzas with smartphone apps, hearing aids are vastly superior and have Bluetooth technology.  It’s so much better than it was. And yet…

There remains tremendous stigma attached to the use of hearing aids.  In a recent paper, Lash and Helme (2020) evidenced that hearing loss is not seen in the same way as other disabilities. Stereotypes of the typical hearing aid user prevail with hearing aids symbolic of physical and cognitive decline.  However, this could not be further from the truth.

I have a final year elective class (Biopsychology of Stress and Health) here at Leeds Trinity and in my last lecture Successful Ageing, I push the idea that physical and cognitive decline are not an inevitable consequence of ageing.  As we will see, the acceptance and use of hearing aids can halt and perhaps even reverse cognitive decline.

Hearing loss is a slow and progressive condition, but people adapt. The TV volume goes up, you ask people not to mumble, you start to prefer people standing on a particular side, etc. You begin to avoid the most challenging conditions for understanding speech – hard wooden floors and ‘hubbub’.  As such, concerned with the stigma of hearing aid use, it takes the average person 7-10 years to seek help for hearing loss, by which time quality of life has irretrievably reduced.

As a biological psychologist, I subscribe to ‘use it or lose it’ theories of cortical plasticity, with a recent paper by Glick & Sharma (2020) of real interest.  In this study adults with normal hearing in their 60s were compared with adults with hearing loss (also in their 60s) yet without hearing aids.  As is common in the literature, the latter were significantly worse at perceiving speech in noise and performed less well across a range of cognitive tasks. But why is this?

Current definitions of hearing loss from the British Society of Audiology are as follows: 

• Mild (21–40 dB)
• Moderate (41–70 dB)
• Severe (71–95 dB)
• Profound (95 dB)

It is now known that a hearing loss of only 10dB will increase risk of dementia by 14%.  The danger is not due to hearing loss, it is due to untreated hearing loss.  Currently, only one in five people with hearing loss pursue amplification (Jilia et al., 2020), but self-reported and daily use of hearing aids increase patient satisfaction and quality of life.  

Untreated hearing loss results in increasing detachment from the world around you – increasing social isolation and reduced wellbeing.  In addition, the areas of the brain which would have processed the incoming sounds and speech go unused. They end up being stolen away by other cortical processes and their primary functions are lost.

In a US study it was found that only 29% of adults will ever have their hearing tested, and only 15% of adults who could benefit from hearing aids actually have some (Chien & Lin, 2012).  Hearing loss should never be dismissed as a normal aspect of ageing.  However mild your hearing loss may be, well-fitted hearing aids will help support and protect cognitive ability.  If hearing aids are prescribed early enough, recent research suggests that cognitive and speech performance can even be restored to previous levels.

As we move into a post-COVID world, there have been many reports of COVID-19 symptoms including hearing loss, tinnitus and vertigo. As we know little of the long-term effects of COVID-19, employers should consider that hearing loss and tinnitus will be more frequently encountered than before. 

As co-chair of the Staff Disability+ Network at Leeds Trinity University, I recognise that employees do not always come forward and report conditions such as hearing loss, fearing that they will no longer be perceived as being able to undertake their job effectively.  It is the duty of an employer to be open, to encourage or perhaps even provide hearing tests (and hearing protection when relevant).  In such ways, they can protect highly experienced staff from slow and utterly avoidable cognitive decline.

Please be aware: if hearing loss is sudden, it can be considered a medical emergency. In such cases, please contact your GP immediately.

Dr James Jackson is a Reader in Psychology and co-chair of Leeds Trinity University’s Staff Disability+ Network.