Hearing loss

The growing hearing loss epidemic
By Jeannie Ralston
Published May 30, 2014

This is how things sometimes go at my house: Me at the kitchen table, making a to-do list: "I need to wash my car. My husband, sitting nearby, working on his Sudoku: "You need flash cards? Me, shaking my head: "You need your hearing checked. My husband, after a beat: "Huh? Sometimes it's him, sometimes it's the other way around, and we usually laugh off the mix-ups as the natural decline in listenership after 22 years of hearing each other say the same thing a million times. But during the past couple of years, as the misunderstandings have become more frequent, we've gotten snippier. I'll say, "I'll wash this," and he hears only "Wash this," as if I've decided he's the downstairs to my upstairs at Downton Abbey. When I read recently that people with hearing issues are more likely to divorce, I got a little scared. And I called an audiologist.

We're not old. I'm 53 and my husband, Robb, is 51. We're active and health-conscious, trying to beat back the effects of aging any way we can. But having trouble hearing feels like incontrovertible proof that we are old. Which is likely why we've put off hearing tests for years, distracting ourselves instead with Robb's complaints about the funky acoustics of our high-ceilinged house. Early hearing loss (and a reluctance to deal with it) is shaping up to be a grim feature of our generation. Current estimates say that only 18 percent of Americans in their 40s and 50s have auditory issues, but that's based on self-reports, which are notoriously inaccurate. A recent study from Johns Hopkins put the numbers closer to 30 percent for that age-group, and some experts think that if you throw in the whole baby boomer generation, the real count could actually be closer to what it is in the U.K.: 40 percent of people over age 50, which translates to 40 million people here.

  How do everyday sounds stack up? Count the decibels: Something at zero is barely audible. Noises 10 times more intense clock in at 10 dB, and so on. Get hit with 85 or 90 dB for 30 minutes or more and you risk hearing loss. Single-exposure risks 130 dB: Jet plane during takeoff from 100 feet 120 dB: Chain saw, thunderclap 30 minutes or more can cause damage 110 dB: Car horn (from 3 feet), concert, sports event 100 dB: Snowmobile, MP3 player at full volume, motorcycle, train, subway 90 dB: Lawn mower, power tool, blender, hair dryer Unlikely to cause loss 80 dB: Alarm clock, garbage disposal, car wash from 20 feet, diesel truck going 40 MPH from 50 feet, MP3 player at three-quarters volume 70 dB: Traffic, vacuum cleaner All signs point to an oncoming epidemic of hearing loss for those approaching middle age , says Seth S. Horowitz, an auditory neuroscientist and the author of "The Universal Sense: How Hearing Shapes the Mind.

 Gradual age-related hearing loss is normal. What's speeding up the process, Horowitz says, is our ever more urban, iPod-wearing, Weed Eater-wielding world. Not since the industrial age, when almost everyone with a job reported for duty at a factory and every factory was an all-day Metallica concert, have people been so exposed to ongoing noise. "We've grown up in noisy cities, with more access to noisy toys," he says. This aural assault can initially cause the loss of high-frequency hearing that's registered by the sensory cells nearest our eardrums, where they take the worst beatings. We don't regenerate these cells, so once they're gone, they don't come back. Complicating matters (and not just conversations) is that only one in five people who need help actually gets it. That seems an astonishingly low figure when you compare it to our acceptance of glasses and contacts for vision problems.

 "You wear glasses," I pointed out to Robb when he first hesitated about getting his hearing checked, grumbling that the audiologist would likely just try to sell him old-man hearing aids. "Isn't it just as important to hear what's being said as it is to see clearly? "Plenty of clients are brought in like this," said Bill Rudolph, an audiologist at Austin Hearing Aid Center, tugging on his own ear. As Robb and I sat in the doctor's office, Rudolph explained the signs of hearing trouble. Common ones include consistently losing the thread of conversation at a restaurant, thinking that everyone else is mumbling, and denying having a hearing problem. Bickering about the dishes, he said, is plain cute compared to what often happens. In a survey of people with hearing issues in the UK, one-third said their inability to hear properly had caused major family arguments. Relationships and careers both take hits as people bumble interactions, hide their handicap, and bumble some more. "You ask the wrong questions or give the wrong answers; you seem vacant, like you're not paying attention, maybe drunk, maybe senile," says Katherine Bouton, a writer who lost much of her hearing by 60. "People fear being open about it and seeming old or stupid.

 Data confirms that people who don't address their hearing problems have lower salaries and higher rates of unemployment. Before she got hearing aids in her early 40s, Debra Summerlin, 57, of Wetumpka, Ala., retreated at work. "I hated meetings," she says. "I'd be in a room full of bosses, and I didn't want to seem lame, so I'd pretend to understand, then send an e-mail later to clarify what went on. Bouton, who last year published a hearing-loss memoir called Shouting Won't Help, remembers missing announcements and office banter, which led the boss at her newspaper job to tell her flat out, "You aren't a team player. The hearing challenged are also at higher risk of falls (hearing may impact balance), depression (a study published in March found twice the rate in groups with hearing loss), and cognitive problems, possibly including Alzheimer's disease. Researchers don't know if hearing loss is a cause or marker for such cognition issues, but the isolation that comes with missing out on social exchanges may well play a role, say experts from Johns Hopkins. If we'd walked into the doctor's office a little tense, that list of risks didn't ease the mood. Following Robb's hearing exam, Rudolph showed us a graph of his notes. The verdict for us was at hand. "Your hearing is really good through here," Rudolph said, pointing to frequencies of 250 hertz up to 3,000. But then, from 3,000 to 6,000 hertz, Robb's hearing in both ears fell off fast. That's the high end of frequency for normal speech. The diagnosis explains why Robb often confuses rhyming and near-rhyming words. Wash the car becomes flash cards because he can't easily distinguish the sounds of different consonants, which come in at a high frequency. Robb was neither a jet mechanic nor a metalhead, but eventually we came up with a possible cause. In his 30s, he'd spent a few years clearing cedar with a chain saw on a large property, and he only sometimes wore ear protection. Call it the Texas Chain Saw Ear Massacre. Robb was less upset by the news than I'd expected. He found it reassuring that his hearing was still good in most of the conversational frequencies. "This isn't as hard to accept," he said to Rudolph, "as the creaks and pains when you get out of bed. That's the part of getting older I really hate.

When it came time for my evaluation, I was genuinely surprised (and maybe a little too gleeful) that I did well in all frequencies. I learned later that women often have better hearing than men, at least until after menopause, when we lose the protective effect that estrogen seems to have on the inner ear. Could my problems hearing Robb be chalked up to those bad acoustics after all? Before we left, I asked Rudolph to show us some modern aids. He left the room and came back empty-handed. When I asked where the sample was, he said, "I'm wearing it," and pointed to a thin, flesh-colored, barely noticeable wire dropping into his ear. Robb declined Rudolph's offer of loaners, but he's not opposed to hearing aids down the line. Rudolph advised him to visit again in a couple of years, or sooner if he notices a decline in his hearing. Meanwhile, we're making adjustments. We've promised to clarify that we're understanding each other correctly. I vowed not to tune out just because I know exactly what Robb will say. And Robb has received this advice from Horowitz: "Pay attention to other sensory cues to fill in the loss. Watch people when they talk; you can get a ton of information from watching faces and mouths. "I thought it was going to be both of us," I said to Robb as we walked out to the car. "Yeah, well, now I have an excuse for missing things," he said, smiling. "You don't. Is hearing loss in your future?