Acoustic shock of hearing loss

Out of the traditional five senses, hearing is probably perceived to be the least likely to disable us. After all, if you are blind you’ll have a difficult time getting around by yourself and maintaining your independence. Losing the ability to hear doesn’t interfere with mobility or independence. In the worst case, you’ll need to learn to read lips or sign. But the truth is that hearing loss can have a devastating effect on your social interactions and cognitive abilities.  Damage to hearing is cumulative and as permanent as blindness.

There are three types of hearing loss:

  • Conductive which involves the middle or outer ear
  • Sensorineural which involves the inner ear
  • Mixed which is a combination of both conductive and sensorineural

Many of us will experience hearing loss as we age.  In fact it’s estimated that one in three people between the ages of 65 and 74 have some degree of hearing loss.  And nearly half the people over the age of 75 have hearing loss.[1] But most people don’t notice that their hearing has diminished because the loss is very gradual over time.

The number of seniors is increasing every year. The current projection is that 1 out of every 4 people will require a hearing aid by the year 2050.[2] But, even when they discover their problems, most people don’t use hearing devices.  They associate hearing aids with the stigma and discomfort of the cumbersome and unreliable devices of the past.  And, since many people past retirement age depend on Medicare insurance, cost is a factor — Medicare doesn’t cover hearing exams or hearing aids.  In fact, only 23 states require hearing aids to be covered under private medical insurance plans.

Hard of hearing

Hearing loss is measured in decibels (dB). There are five different degrees of hearing loss: mild, moderate, moderately severe, severe and profound.

  • Mild hearing loss is characterized by being unable to hear sounds that are quieter than 25 decibels in adults or 15 decibels in children.  These are soft sounds like leaves rustling or whispering.  People who experience a mild hearing loss will have difficulty keeping up with conversations especially in noisy environments. You’ll notice that they turn an ear to the person speaking in an attempt to better hear what’s being said.
  • Moderate hearing loss causes speech to sound muffled.  People who have moderate hearing loss will often ask for others to speak more slowly, clearly and loudly.  They usually have the television turned up to a volume that is uncomfortable for people with unaffected hearing. Over the long term, moderate hearing loss causes people to withdraw from conversations and social occasions because of the difficulty in discerning words.
  • Moderately severe hearing loss, while being progressively worse than moderate hearing loss, is determined mainly by how much sound can be heard.  It’s a midway step between the loss of hearing in the 41 to 55 decibel range of moderate hearing loss and the 71 to 90 decibel loss that determines severe hearing loss.
  • Severe hearing loss can be sudden or come on gradually over time.  Hearing loss that is severe requires the use of a hearing aid because speech at a conversational level is muffled and sounds gradually fade. In addition, depending on the cause of hearing loss, there may be pain or a feeling of fullness in one or both of the ears.  Tinnitus, or ringing in the ears, may set in.  There may also be bouts of dizziness or vertigo.
  • People who have profound hearing loss cannot hear speech and will often rely on lip reading and sign language.  Hearing aids may offer some assistance when the hearing loss is more conductive than sensorineural.  It is estimated that about 11% of all people with hearing loss have a severe to profound hearing loss.

Hearing well equals being well

Married seniors Vernon and Violet both have hearing loss but for different reasons.  Vernon, a ninety-seven year old former train conductor, started wearing hearing aids in his late 60s.  He probably began experiencing hearing loss before he retired because of the noise produced by the trains. The deficit was first noticed by his wife Violet.  At first she thought that Vernon was ignoring her.  Then she realized he hadn’t heard what she had said. That combined with the need to have the television turned up made her think maybe his hearing needed to be checked.

Violet’s hearing loss is associated with age, she was fitted with a hearing aid when she was ninety-two.

Without the hearing aids, seniors like Vernon and Violet can quickly begin to feel isolated.  According to one Dutch study, every decibel drop in perception in people under 70 increases the odds of becoming severely lonely by 7%.[3]

Without the ability to clearly hear others, conversations become difficult, and often people with hearing loss will avoid social situations. Loneliness intensifies and sets off a spiral of detrimental health effects.  With loneliness comes the potential for depression, for example.

People who have hearing loss also begin to suffer from a slow cognitive decline. Studies have shown that when hearing declines, the brain begins to shrink in areas that help us grasp complex sentences.[4] This affects the ability to understand speech and leads to an overall decline in comprehension. Which then causes further isolation, loneliness and dementia.

There is also a safety issue when hearing declines. Not all hazards in life are visible. If you can’t hear the soft sound of water boiling on the stove, the high pitch of the smoke detector or the emergency vehicle behind your car, you are risking an accident or injury.  Hearing loss also means you may not hear someone calling for help or broadcast weather alerts.

The Sounds of Approaching Silence

Although hearing can be temporarily affected by a buildup of earwax or an ear infection, there are several ways that long term hearing loss can occur:

  • Aging
  • Medications like drugs used to treat cancer, heart disease or even aspirin
  • Medical conditions like an injury to the head or ears, Alzheimer’s Disease, type II diabetes, or dementia
  • Exposure to loud noise

While hearing loss with age is normal, the most common cause of hearing loss is loud sounds.  Everything from the lawn mower to street traffic raises the decibel levels of ambient noise that your ears experience.  If you’ve attended concerts or sporting events you’ve also encountered some of the highest noise levels around.  It’s estimated that 22 million workers are exposed to damaging noise levels at work.[5] In fact, workplace hearing loss is one of the most commonly reported injuries.

Most people had their hearing checked as part of a school screening and haven’t given their hearing another thought since. Because most hearing loss happens gradually, you may not notice that your hearing has diminished.

Here are some signs that you may want to have your hearing checked:

  • Speech and sounds seem muffled.
  • You have difficulty understanding words when there is background noise.
  • You have trouble hearing consonants.
  • You frequently ask others to repeat themselves or speak more slowly, clearly and loudly.
  • People are telling you that the television or radio is uncomfortably loud.
  • You find yourself withdrawing from conversations because it’s difficult to follow along.
  • You avoid crowded social settings.

Even if you haven’t noticed any hearing problems, you should probably have your ears checked at least once every ten years after you turn 21, every three years after you turn 50.


[1] U.S. Department of Health and Human Services. (2018, July 17). Age-related hearing loss (presbycusis) – causes and treatment. National Institute of Deafness and Other Communication Disorders. Retrieved September 17, 2021, from https://www.nidcd.nih.gov/health/age-related-hearing-loss.

[2] World Health Organization. (2021, March 2). WHO: 1 in 4 people projected to have hearing problems by 2050. World Health Organization. Retrieved September 17, 2021, from https://www.who.int/news/item/02-03-2021-who-1-in-4-people-projected-to-have-hearing-problems-by-2050.

[3] Centers for Disease Control and Prevention. (2013, August 15). CDC – noise and hearing loss prevention – about noise and hearing loss – NIOSH workplace safety and health topic. Centers for Disease Control and Prevention. Retrieved September 17, 2021, from https://www.cdc.gov/niosh/topics/noise/about.html.

[4] U.S. Department of Health and Human Services. (2018, July 17). Age-related hearing loss (presbycusis) – causes and treatment. National Institute of Deafness and Other Communication Disorders. Retrieved September 17, 2021, from https://www.nidcd.nih.gov/health/age-related-hearing-loss.

[5] Centers for Disease Control and Prevention. (2013, August 15). CDC – noise and hearing loss prevention – about noise and hearing loss – NIOSH workplace safety and health topic. Centers for Disease Control and Prevention. Retrieved September 17, 2021, from https://www.cdc.gov/niosh/topics/noise/about.html.

2021-10-06