Hearing aids are still not cool

One in six people in the UK are deaf or hard of hearing and the majority are older people who develop hearing loss as a normal part of the ageing process. According to the charity, Action on Hearing Loss, about two million people in the UK have hearing aids, but only 1.4 million use them regularly.

At least four million people who don’t have hearing aids would benefit from using them.

‘We recently described speech recognition in noise performance in the very large UK Biobank data set [1], which included speech recognition data (based on the digit triplet test [2]) for 164,770 UK adults aged between 40 and 69 years [3]. Impaired hearing was identified if speech recognition in noise performance was well outside the normal range (poorer than two standard deviations), compared to a normative sample. This level of performance would correspond to significant hearing difficulties in both home and work life.

Overall, 10.7 per cent of adults had impaired hearing .The proportion of adults with impaired hearing begins to rise steeply after around age 50 years. The proportion of people who reported tinnitus was 16.9 per cent overall. The proportion of people with tinnitus also increased with age, although there was a more gradual increase with age than for poor hearing.

Only two per cent of adults reported using a hearing aid. The last time hearing aid use in the general UK population was in the early 1980s; hearing aid ownership was 2.8 per cent among 41-70 year-olds (compared to an estimated 9.4 per cent of the population in that age range who had hearing loss severe enough to benefit from a hearing aid [4]). Despite advances in hearing aid technology and improvements in service provision, it seems that hearing aid uptake and use has not improved substantially in the last 30 years. Recent reviews surveyed reasons for low hearing aid uptake and use, which include motivation, expectation, attitude to hearing aids, hearing sensitivity and the effect of counselling, uncomfortable fit and lack of perceived benefit [5, 6].

Low uptake/use may be addressed by:

i) making hearing care a ‘lifestyle choice’ by removing the need to obtain a referral from a GP to go to a hospital-based audiology clinic (which may contribute to the stigmatisation of hearing loss by association with infirmity) and making quality audiology services more accessible.

ii) undertaking good-quality trials of adult hearing screening and intervention based on models of hearing aid uptake and use.

iii) improving hearing aid technology to a point where it will significantly improve speech understanding in noise, so doing away with a major reason for non-use.

References:

1. Collins, R., What makes UK Biobank special? The Lancet, 2012. 379(9822): p. 1173-1174.

2. Smits, C., T.S. Kapteyn, and T. Houtgast, Development and validation of an automatic speech-in-noise screening test by telephone. International Journal of Audiology, 2004. 43: p. 15-28.

3. Dawes, P., et al., Hearing in middle age: a population snapshot of 40-69 year olds in the UK. Ear and hearing, 2014. 35(3).

4. Davis, A.C., Hearing in adults. 1995, London: Whurr Publishers Ltd.

5. McCormack, A. and H. Fortnum, Why do people fitted with hearing aids not wear them? International Journal of Audiology, 2013. 52(5): p. 360-368.

6. Vestergaard Knudsen, L., et al., Factors influences help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: A review of the literature. Trends in Amplification, 2010. 14(3): p. 127-154.