My Costco visit; Do I listen to them or to audiologists?

Vitamins and medicines cost tens of dollars. Hearing aids cost thousands. Someone who’s been scared into spending that money by the threat of cognitive decline might need to cut back on things like healthy food, gym membership, and those vitamins and medicines. These things impact cognitive health.

On a related note. Shingles. The shingles vaccine is believed to reduce the risk of Alzheimer’s by about 20 per cent. Helps prevent Shingles as well.

Your point is valid. However, many medications cost more than hearing aids, especially amortized over the useful life of a hearing aid. If we assume 60 months most are paying less than $100 per month, less than $30 at Costco.

@srroat said:

Why are hearing aids judged more strictly by some people than vitamins, vaccines and medications?

In addition to what’s already been said, hearing aids require some amount of work every day, for maintenance of the devices and your ears. Some people have smooth sailing, others have wax problems or fit issues or pain/irritation issues or device problems, or any combination.

In your case, what if the aids, properly fitted by the audiologist, make no practical difference in your hearing experience at the present time? Will you still keep and use them?

So many things I love about your post. Thank you for warning people of the dangers of taking research/ scholarly literature at face value!

@srroat said:

Vaccines will not guarantee this, yet we still take them and receive a benefit. Cholesteral and blood pressure meds also won’t make these guarantees, yet we all know they are important and beneficial. How many here are taking vitamin supplements? Same thing. Why are hearing aids judged more strictly by some people than vitamins, vaccines and medications? Why are hearing aids required by some to meet a standard that is unattainable, but equally unattainible by the vitamins, vacccines, and medications that we gladly accept?

It’s not about whether it’s “guaranteed” or not. It’s about whether causation is clearly established. For those things, it is. For hearing aids, the only controlled study I’ve seen (the ACHIEVE study) was inconclusive at best. That doesn’t mean you shouldn’t get them, or even that you shouldn’t get them for that reason. But you should do it understanding that the evidence for a causal rather than correlative relationship is pretty scant.

@CombatWombat said:

But you should do it understanding that the evidence for a causal rather than correlative relationship is pretty scant

That’s inconsistent with the meta analysis published in the last few years. I’ve stayed out of this discussion as people seem to have lots of opinions based on their personal experiences and preferred evidence. Again: the plural of anecdote is not data.

Here’s the meta data: Association of Hearing Aids and Cochlear Implants With Cognitive Decline and Dementia: A Systematic Review and Meta-analysis - PubMed2.

Does that add as much clarity as you suggest? “In this meta-analysis, the usage of hearing restorative devices by participants with hearing loss was associated with a 19% decrease in hazards of long-term cognitive decline.” People who use and can adjust to hearing aids may have a similar resistance to decline even if they make the conscious choice not to use them.

The article seems to group more than hearing aids into hearing restoration devices. This analysis may be different if including cochlear implants and similar.

Is there research dividing this question between age related loss and those who likely have genetic loss that shows up earlier in life?

I am not advocating not to use hearing aids. There is likely no evidence of harm of decline from use so the risk is more in not using them.

@Um_bongo said:

That’s inconsistent with the meta analysis published in the last few years. I’ve stayed out of this discussion as people seem to have lots of opinions based on their personal experiences and preferred evidence. Again: the plural of anecdote is not data.

And “correlated with” is not a synonym for “caused by.” There’s strong evidence of correlation. There’s very little for causation. Here’s the methodololgy for the metadata analysis:

A total of 3243 studies were screened; 31 studies (25 observational studies, 6 trials) with 137 484 participants were included, of which 19 (15 observational studies, 4 trials) were included in quantitative analyses.

Observational studies cannot be used to establish causation, at least not here, because they compare self-selected groups. The comparison is between people who chose to get hearing aids and people who didn’t, which means there’s no way to determine whether the hearing aids themselves caused the difference. That’s one possible explanation, but there are quite a few other differences between people who choose to get hearing aids and people who don’t. They include financial differences between those who can afford hearing aids and those who can’t, geographic disparities between those who can conveniently access clinics and those who can’t, mindset differences between those willing to seek medical care and those reluctant to do so, lifestyle and activity differences between those who perceive moderate hearing loss as a problem and those who do not, and existing cognitive changes impacting all of the above. All of those other possibilities are known to either cause, be caused by, or be correlated with negative health outcomes in other contexts, so it would be no surprise if they were behind some or all of the correlative relationship here.

I’m not saying hearing aids don’t or can’t forestall cognitivie decline. I wouldn’t be surprised to learn they did. I’m saying that the evidence for definitively stating that they do just isn’t there, because most of the studies to that end have been observational studies rather than controlled randomized trials. The results for proper trials seem to have been quite a bit less dramatic, to put it mildly.