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Does using hearing aids make you dependent on them?

A question I answered on Quora today…

Does using hearing aids make you dependent on them? Specifically, let's say that you are x% deaf (but can still hear things), then you start with hearing aids for years. If you stop using them permanently, does your ear without aids remain x% deaf?

If you wear aids for a significant number of years, then discontinue using them, you will still be just as hard of hearing as you were before. It is likely that you will lose more hearing as time goes by, depending on the cause. Most age-related hearing losses advance by a few decibels a year in some frequencies.

So, say you wore them for 10 years, your hearing loss would have declined further and you would have had the aids turned up to meet your changing hearing needs. You would be more deaf than when you started, and more ‘dependent’ on them because your hearing without aids would be poorer. This would not be because of the aids, just natural progression.

You would also perhaps feel dependent on them because you have got used to hearing clearly, and not having to struggle or concentrate as hard on speech. Taking that away will bring into contrast how difficult life was before using the aids. Again, this is not a problem caused by using aids, it’s just contrast and knowledge you would not have if you’d never taken them up.

The interesting thing is though, that you would be 9% less likely to have acquired dementia and less likely to suffer cognitive decline in general. Unaided hearing loss causes these conditions, whereas aids allow you to stay sharp.

The most important factor for me is the ‘use it or lose it’ one that someone else has mentioned. If you are destined to lose more hearing over the years (as almost all of us are), the time you start using aids is connected to how well you will ultimately hear with them. Starting sooner (as soon as there are noticeable problems and you get a noticeable benefit from the aids) will enable you to get the best out of your hearing. Your brain needs time to adjust to hearing artificially, it has to adjust to things like frequency compression which literally changes the shape of the words when they hit your brain, so it doesn’t fit the existing templates that allow us to recognise speech quickly enough to process conversation. If you start sooner, you will be able to adjust more easily, because the aids are just ‘topping you up’ a little at first and it’s not too difficult/strange to wear them. The contrast is harder to adjust to if you wait until you need a lot of amplification.

Your brain is more adaptable when it’s younger, so starting younger means you have the facility to adapt. Leaving it for many years means your brain is less ‘plastic’ and it will not be able to accept the artificial sounds as the new normal. How this plays out in the real world means you will basically struggle less to understand speech when you’re 75 if you started using the aids at 65, than if you had put it off til age 74.

It is sometimes disheartening for me to see older people simply unable to adjust to hearing aids, having left it until they have a severe high frequency loss, and a moderate mid frequency loss. At this stage speech is difficult to understand in anything other than perfect conditions (quiet room, face to face, clear speaker). It is impossible to understand in noise. They are forced to try hearing aids to keep up socially, but it is such a huge adjustment that they give up, and they have no choice than to withdraw further into that dull, distorted world. Alternatively they might persevere with hearing aids but not be able to adapt to frequency compression, meaning they will never be able to hear sounds above a certain pitch, even with hearing aids. This makes life more difficult than it needs to be, all because of initial refusal to accept a problem/solution exists.

In the interests of transparency, research suggests that a very small percentage (less than one percent) of people will acquire more hearing loss with aids than would have occurred naturally. This is very rare, whereas the problems I have listed above are incredibly common. On balance then, the advice is absolutely to start wearing aids as soon as you need them, and they will provide huge benefits that you can clearly see, along with underlying benefits that are important to your quality of life.

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