Joyful Musings

By Joy Birnbach Dunstan, MA, LPC, MAC

Speak Up – I Can’t Hear You!


Joy-4-11About 12% of the U.S. population or 38 million Americans have a significant hearing loss. That number soars to about 30-40% for those over 65. Because the onset of hearing loss is usually insidious, gradually worsening over the years, it is easily ignored. Most of those affected can still hear sounds and think the real problem is that other people are mumbling or speaking too softly. They often ask others to speak up, repeat what was said or speak more slowly. A lot of marital discord happens when one spouse doesn’t hear what the other is saying.

Unable to hear well in social settings, a person may gradually stop going to the theater, movies, or out to restaurants with friends or family. Over time, they are likely to become increasingly frustrated and socially isolated.

For years, social isolation has been a known risk factor for depression and other major health problems.  Dr. Frank Lin of  Johns Hopkins and the National Institute on Aging reported that “A decline in social engagement and the resulting loneliness is one of the most important determinants of health outcomes in older adults.”

And now there is another major risk associated with hearing problems. A study published last year by Dr. Lin and his team of researchers showed that seniors with hearing loss are significantly more likely to develop dementia over time than those who retain their hearing. The greater the loss, the greater the risk.

Although the reason for the link between the two conditions is uncertain, the researchers suggest that the strain of decoding sounds over the years may overwhelm the brains of people with hearing loss, leaving them more vulnerable to dementia.

“The brain dedicates a lot of resources to hearing,” Dr. Lin said. “When the clarity of words is garbled, the brain gets a garbled message. It has to reallocate resources to hear at the expense of other brain functions.”

Thus, the overworked brain may lose “cognitive reserve,” the ability of healthy parts of the brain to take over functions lost by other parts.

Regular hearing tests should be part of your basic health regimen. Optimally, the test should be performed by a trained audiologist, not just a hearing aid salesperson.  If a significant hearing loss is discovered, properly  fitted hearing aids may be an important next step.

One woman whose life was transformed by hearing aids commented that she understands how hearing loss could lead to dementia because she was “forgetful” when she did not hear what she should have heard. It’s not that she forgot things; rather, she hadn’t heard them to begin with, and the strain of constantly trying to piece things together was taking its toll. “When you can’t hear anybody, you don’t pay attention,” she said. “You shut yourself off from the world, you don’t think very well, your memory gets bad and you get kind of dull.”

Sadly, hearing loss goes untreated for about 85% of those who have it. Compounding the problem is that most insurance, including Medicare, does not pay for hearing aids, and many people cannot afford the thousands of dollars that quality aids and auditory training can cost.

Perhaps with continuing research and recognition that hearing loss is more than just a minor inconvenience, insurance companies may begin to pick up the bill because it is less costly than the many potential physical and emotional problems that might result. But don’t wait for them to wise up. Wise up yourself, and have your hearing checked. Do what you can to make sure you stay in touch with the world around you. Your family and friends may all appreciate it too.

Editor’s Note: Joy is a practicing psychotherapist in Riberas. She can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. or 765-4988. Check out her new website:




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