The annual dog costume contest was beginning at my block party. I popped out of my house without my hearing aids and cheered on the winners, a husky dressed as a bumble bee and a labradoodle in a wizard’s robe.   

Afterward, I chatted with a few friends until one admitted she could barely hear me. I live in a quiet world, and without my hearing aids in, I tend to be even more soft-spoken. It was a good reminder that I needed to wear my hearing aids.

I’m not the only one who needs a reminder. The vast majority of people who could benefit from hearing aids do not use them. It’s a behavior that public health officials want to reverse. 

Studies have found that hearing aids help slow cognitive decline. These findings come at a time when public health officials are calling hearing loss in older people a global health issue that needs addressing. 

Understanding Who Experiences Hearing Loss

Typically, a person is considered to have hearing loss if they have a loss of 35 dB or more. In the U.S., about 13 percent of people age 12 and older have hearing loss in both ears.

Hearing loss is less common in young people. Five percent of Americans ages 45-54 have “disabling hearing loss.” But as people age, disabled hearing becomes more common. Fifty-five percent of people ages 75 and older have “disabling hearing loss.”

Many people who could benefit from hearing aids don’t use or even own them. Although more than half of people ages 70 and older need hearing aids, less than 30 percent of people who need hearing aids have ever used one.

Younger people with hearing loss are even less likely to use hearing aids. Only 16 percent of people age 69 or younger who need hearing aids actually use them.

Why Don’t People Wear Hearing Aids?

There are multiple reasons why people who need hearing aids just don’t wear them. In a 2024 study in the International Journal of Audiology, researchers interviewed 332 people from Australia, the U.K., and the U.S. with hearing loss.

All of the participants were at least 50 years old and had self-reported hearing loss. Despite knowing they had hearing loss, 65 percent did not wear hearing aids. Of these non-users, about 31 percent said they couldn’t afford hearing aids. One-third of non-users claimed they didn’t think they needed them because no one had ever said they had a problem. Non-users also said they didn’t think they would like wearing a hearing aid. Some expressed it would make them feel old.

Read More: Is it Bad to Listen to Music All the Time? Here’s How Tunes Can Help or Harm

Challenges of Living With Untreated Hearing Loss

Like the non-users in the study, people with gradual hearing loss may not be aware their abilities have changed. However, other studies have found that many people who actually own hearing aids keep them in the drawer rather than wearing them when needed. 

In a 2013 study in the International Journal of Audiology, researchers conducted a literature review and analyzed the reasons why hearing aid users opted to leave their devices at home. They found there wasn’t just one reason as to why these non-users never adapted to the technology.

Some reported they found the devices too uncomfortable to wear or too difficult to maintain. Others said they didn’t find them to be helpful or claimed they didn’t feel they needed them.

The Connection Between Hearing Loss, Dementia, and Listening Fatigue

In recent years, studies have found that people with hearing loss are more likely to socially isolate,  which raises their risk for dementia.

In 2023, the National Institutes of Health funded a clinical trial at Johns Hopkins University that followed 1,000 people ages 70 to 84 for three years.

The study found that among older adults who were at high risk for dementia, hearing aid use reduced the rate of cognitive decline by almost 50 percent. 

Participants in the study who wore their hearing aids reported having an improved ability to communicate. Without that ability, people tend to self-isolate. And when they do engage with others, they find the experience exhausting. Audiology researchers call it “listening-related fatigue.” 

“You actually get cognitive fatigue and it can translate into physical fatigue if you are listening hard,” says Stephen Camarata, a professor of speech and hearing sciences at Vanderbilt University.

Problematically, studies have found that listening-related fatigue can prompt people with hearing loss to avoid social situations or specific environments they think might be tiresome.

Read More: Navigating Hearing Loss And New Over-the-Counter Solutions

Struggling to Hear

In a 2020 study in the International Journal of Audiology, Camarata and his colleagues conducted focus groups with 43 adults who have some form of hearing loss. The participants described environmental situations that made listening fatigue likely. A noisy restaurant, for example, made it difficult for a person to hear. Similarly, listening as a member of a large audience or having to listen for a long time was also tiring. The participants also said that certain speakers were just hard to understand.

In difficult listening situations,  participants described feeling physically and mentally tired. Listening-related fatigue made it hard for them to concentrate and get the most from the experience. Participants also said they felt frustrated.

In response, participants admitted they avoided social situations or withdrew when listening became a challenge. But others developed coping strategies to help them in hard-to-hear settings.

Coping Strategies for Listening Fatigue

Listening-related fatigue is subjective, and what tires one person might not tire another. That means that coping strategies must be subjective as well, Camarata says.

“It’s subjective fatigue, so whatever strategy you think you have that works is a good strategy,” he says.

For example, in his team’s studies with children, Camarata has seen how they often take breaks from hearing during the school day by discretely turning off their listening devices for a short while. Others rest in advance if they know they have plans that may drain their cognitive energy. 

Although treatment studies are still in progress, rest is on researchers’ radar as a possible solution.

“Listening breaks and microbreaks seem to be a promising treatment area,” Camarata says.

Read More: How the Brain Processes Music for Those With Hearing Loss

Article Sources

Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:

Emilie Lucchesi has written for some of the country’s largest newspapers, including The New York Times, Chicago Tribune and Los Angeles Times. She holds a bachelor’s degree in journalism from the University of Missouri and an MA from DePaul University. She also holds a Ph.D. in communication from the University of Illinois-Chicago with an emphasis on media framing, message construction and stigma communication. Emilie has authored three nonfiction books. Her third, A Light in the Dark: Surviving More Than Ted Bundy, releases October 3, 2023, from Chicago Review Press and is co-authored with survivor Kathy Kleiner Rubin.