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The Importance of Cradle to Grave Hearing Health

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Hearing is one of the most important human senses.  It allows us to connect to our physical and social worlds, fundamentally dictating how we live our lives.

Neurologically, the auditory system is a distributed but integrated circuit, which continuously changes throughout our lifetime.  The sounds we hear can shape our auditory system, and consequently shape our futures in many ways. Although negative shaping can be caused by concussions, noise, hearing loss and aging, positive shaping can be accomplished through music, bilingualism and amplification.  Therefore, audiological care can be beneficial at any stage of life, since hearing plays many key roles throughout these stages.  Notably, early interventions that support hearing health will pay great dividends over time.  

During the early years, hearing is crucial for the development of numerous functions. Properly maintaining hearing health in this stage allows for successful language and literary acquisition, as well as social development.  In addition, studies of children who are bilingual have been associated with better cognitive functioning later in life when compared to monolingual children (1).  This cognitive difference later in life may lead to improved communication abilities. By providing their expertise to children with and without hearing impairments, audiologists can make a lasting impact. 

When examining the prevalence data on concussions, the highest rate by far is seen during the adolescent years (2).  Often, university athletes with concussions experience difficulty hearing in noise, which stems from auditory processing deficits (3) that may impact the academic and social skills developed at that age.  Since concussions have been linked to the onset of cognitive degenerative diseases in later life, such as dementia (4), effective post-concussion care is important for maintaining current and long-term health. Research from Nina Kraus’s lab at Northwestern University has found evidence that electrophysiological testing may be used to monitor recovery from concussions through the brain’s response to speech in noise (5). Further exploration in this area could substantially promote concussion recovery and hearing health. 

For most adults, hearing is vital for vocational purposes and maintaining healthy social interactions.  Studies investigating the effect of hearing loss on employment found significant differences in job performance, salary and occupational stress between those with and without hearing loss (6-7).  This indicates that audiological interventions could improve one’s job satisfaction, financial situation, and mental health, and thereby drastically improve their quality of life. Beyond employment, hearing loss has been strongly connected to social isolation in adults, acting as a participation barrier in recreational activities (8). By creating a dialogue with these adults as early as possible, audiologists have the potential to minimize hearing loss stigma, advocate for their patients, and ideally lessen the chances of social isolation and the other negative side effects of hearing loss.

One thing that is equally—if not more—important than early audiological intervention is hearing protection.  It is well documented that high level industrial or recreational noise exposure can permanently damage the auditory system (9), but newer research is drawing attention to the effects of moderate noise levels (10). Though not as damaging as high levels, moderate noise can cause physiological stress effects on the body, such as hypertension and the disruption of sleep and endocrine regulation (10). If left untreated, these effects can lead to decreases in productivity, learning and development (10), and generally decrease one’s quality of life. Therefore, audiologists who provide education about hearing conservation will ultimately improve hearing and overall health for years to come. 

Beginning in our early 20s, our sound processing and auditory memory starts to decline, resulting in increased difficulty hearing in noise, among other hearing challenges (11). However, there is a large amount of variability regarding the degree of decline, especially later in life (11). Evidently, in addition to bilingualism, making music and auditory training can reduce the auditory decline of aging (11-13). This was discovered by experimental and correlational studies of auditory training and music production, which showed positive effects on auditory memory, sound processing and hearing in noise (11-13). Electrophysiology studies of musicians have also shown better neural synchrony in response to sound (11-12), which indicates the potential of music in regards to better hearing health.  This research proves hearing declines in aging are not inevitable and offers audiologists educational information to use in the promotion of hearing health, especially with older adults. 

It is estimated that about 45% of people over age 65 and over 80% of those over 70 have hearing loss (14). Unfortunately, hearing loss is known to accelerate cognitive aging, especially in the elderly (15).  However, electrophysiological studies have found that with the restoration of audibility through amplification and assistive listening devices, aided adults with hearing loss experience a boost in neural synchrony (16).  This boost should strengthen auditory processing and the perception of speech, therefore improving capabilities for social connections, and a higher quality of life as a result. 

The goal of gerontology is not necessarily to help people live longer, but rather achieve the compression of morbidities.  At this stage of life, good hearing health benefits one’s overall health and quality of life, while hearing loss is correlated to numerous mental and physical diseases. These can include cardiovascular and chronic kidney disease, dementia, mental health issues, diabetes, falls and hospitalizations (17). Since most healthcare professionals administer aural assessments, hearing loss can compromise diagnostic accuracy, which may explain the correlation to other health conditions. Therefore, with good hearing health, allied health services can be more effective and holistically beneficial.  

Like gerontology, palliative healthcare strives to improve patients’ quality of life during their final stages. Hearing and communicating with loved ones and religious leaders can allow people to attain closure and accept their mortality, making good hearing health extremely valuable at the end of one’s life.

During our life experiences, the dynamic human auditory system can be damaged or strengthened by the sounds we hear. Audiologists, fortunately, can provide services that minimize the negative effects of hearing loss at any age, and ultimately change lives for the better.  
 

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