1. Holly Hosford-Dunn PhD Academy Village, January 23 2013

2.  Myths ◦ #1: Hearing Losses are All Alike ◦ #2: Don’t Need Hearing Aids for Mild Hearing Losses ◦ #3 & #4: Hearing Aids Don’t Work & They’re all the Same  Misconceptions ◦ #1: Hearing Declines with Age ◦ #2: Don’t Get Hearing Aids Til You Really Need Them ◦ #3: Hearing Aids Keep Going Up in Price HearingHealthMatters.org tucsonaudiology.wordpress.com

3. Hearing Declines with Age

4. What Makes Us Think This?  Observational Data ◦ ~30 million hearing impaired individuals in US ◦ 70% ≥ 55 years  Professional Terminology ◦ Presbycusis: Hearing Loss ≥ 65 years ◦ #1 most prevalent chronic condition in males ◦ #4 most prevalent condition in females

5.  Cardiovascular Disease (CVD) ◦ nature and extent difficult to estimate Rosenhall et al 2006 Rosenhall et al 2006  Noise ◦ totally intertwined ◦ Occupational ◦ Recreational ◦ Military Misconception #1: Hearing declines with age

6. Hearing thresholds increase with age, especially at high frequencies Hearing loss increases with age, especially at high frequencies Misconception #1: hearing declines iwth age

7.  Threshold goes up 1 dB/year at >60 (Lee et al)  Quick Math ◦ 20 dB high frequency loss at age 80 d.t. age ◦ But data show HL in 80-90 dB range ◦ 60 to 70 dB of “age-related” hearing loss d.t. environmental factors Misconception #1: Hearing declines with age

8.  Hearing Declines Mainly from Environmental Exposures, NOT Age Itself  TAKE HOME: Lose the Ageist Language ◦ “I hear well for my age” is not defensible ◦ Protect your hearing Misconception #1: hearing declines with age

9. 1. All Hearing Losses Are Alike. 2. People with Mild Hearing Losses Don’t Need Hearing Aids.

10.  What Makes Us Think That? ◦ The audiogram  a bunch of averages  A bunch of frequencies  Measures audibility  Categorized

11. 0 = normal, equalized, averaged Mild or moderate loss? Myths 1 & 2: all hearing losses are alike; you don't need hearing aids for mild losses.

12.  Speech depends on perceptual processing  Perception is a brain process  The Ear is Hooked Up To The Brain  QED: Everybody is different, even if they have the same audiogram Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.

13.  Audibility is a prerequisite ◦ Necessary, but not Sufficient  Speech recognition in noise ◦ decreases with age, even if audiogram is normal ◦ Is worse for Olds than Youngs with mild hearing loss (Dubno et al, 1984) ◦ Is worse in the evenings for Olds (Veneman et al, 2012) Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.

14.  Just because you hear doesn’t mean ◦ You hear what you need to ◦ You understand what you hear  TAKE HOME: Lose the Ageist Language ◦ “I hear well for my age” is not defensible ◦ Exercise your auditory processing as much and often as you can Myths 1 & 2: All hearing losses are alike; you don't need hearing aids for mild losses.

15. Don’t Get Hearing Aids Until You REALLY Need Them!

16. What Makes Us Think This? ◦ Fear of Dependency  It’s actually the other way around – use it or lose it ◦ “Prescription” Device … Take it Like a Pill ◦ Stigma  Makes you look old…so don’t get them till you are!  Disappearing fast thanks to iPhones & Bluetooth

17. Misconception #2: Don't get hearing aids until you really need them.

18. ◦ Get fitted earlier rather than later  When your spouse complains  Make it easy on your brain and your memory ◦ Don’t lose it and then try to get it back  Fix it before it becomes a problem ◦ Make them part of your routine while it’s easy  When memory slips, it’s hard to learn new routines Misconception #2: Don't get hearing aids until you really need them.

19. ◦ Hearing Aids are For the Young at Heart – those who are not only in the game but winning the game Hearing Aids are For the Young at Heart  TAKE HOME: Lose the Ageist Language ◦ Hearing Aids don’t make you look old ◦ Not hearing makes you old Misconception #2: Don't get hearing aids until you really need them.

20.  Myth #3: Hearing Aids Don’t Work  Myth #4: Hearing Aids Are All the Same Why do we think this? We don’t. This is deliberate ignorance used for purposes of denial and avoidance. Who thinks this? People who waited too long. People who don’t want help and don’t want to take responsibility. They’re not here today.

21.  Hearing Aids Keep Going Up in Price “Every time a new feature comes out, the price goes up.”

22.  What Makes Us Think That? ◦ Anchor price is $6000 ◦ Nominal value of currency ◦ Heuristics – we believe what others say ◦ Technological advances Technological advances  Moore’s Law  Koomey’s Law ◦ Equated with pills instead of learning & exercise

23.  Relative Price ($6K * CPI increase) ◦ Increased 34%  Nominal Price (actual Dollars) ◦ Decreased 25%  45% more purchasing power now than you did in 1997 Misconception 3: Hearing aids keep going up in price

24. ◦ Hearing Aids Are Getting Better and Cheaper  Easier to operate  Functional in more diverse environments  Work better for complex signals  Speech  Speech in noise ◦ Good Hearing Aids  Are expensive  ½ as expensive and twice as effective as 15 years ago  Require training, effort, and regular maintenance Misconception 3: Hearing aids keep going up in price

25.  Audiogram isn’t it!  Age isn’t it!  Hearing Aids aren’t it!  Price isn’t it! Brain + Ear + Age + Exercise = It

26.  Stimulate your Ears ◦ to Stimulate your Brain  to Maintain Functionality  to Age Healthily and Happily Thanks for inviting me today