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Audiologists and always wear my hearing aids

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In reply to @Neville

Appropriately fit hearing aids improving cognition, sure. But without hearing aids “causing” “dementia” (not just affecting cognition–which includes a lot of mental processes) I still think is in question. There are some intriguing study findings, I’d agree. Her scare tactics alerted me to a line of research I knew nothing about (which doesn’t justify the tactics–just sayin’)

The overview study you attached is authored by at least two of the researchers in the study whose results I’m interested in seeing. That study is called Aging and Cognitive Health Evaluation in Elders (ACHIEVE) and is NIH funded.

In my own case, I went to this audiologist because I hadn’t seen one in a couple of years and I felt my hearing had worsened. Pandemic restrictions happened not long after that failed visit and it turned out to be about another two years before I got tested. That was of course by a different audi. Indeed, my high frequency hearing had declined (but mid and low unchanged over many years). That meant my hearing aids weren’t helping in that range. I couldn’t distinguish between words like wood and hood for example.

The dementia claim audiologist and the assertion that not wearing aids even in a quiet environment can cause irreparable cognitive damage made me think maybe I’d never be able to make those distinctions, hear speech clearly again, if they’re right. But with a pair of P70s after the first fitting, I no longer mistook or missed a word in conversation (aside from noisy environments). The effect was immediate. Which made me think–what brain adaptation? If the first audi had just tested and adjusted my hearing aids accordingly (as I’d asked), I’d have been hearing what I was missing again. Despite not wearing the aids all day every day.

Admittedly, the newer technology made a big difference in clarity. But I’d have heard with my old aids being properly adjusted. The whole experience, including two years of periodically wondering if my prized body part was going to turn into mush, made (and makes) me question this issue of HL-cognitive impairment. Especially the degree and types of stimulation needed, since the brain gets stimulation in many ways. Also, the extent of its resilience and under what circumstances.

I recall in another post you said you prefer a quiet environment too. There’s a part of me, I think, that just resists extroverts and the noisy, chaotic environment they’ve created and love, insisting that we all must hear that screaming too. If not, we might not even be able to remember or think at some point.

Ok, that’s all. :slight_smile:

In reply to @Neville

I understand some are as you say trained with however there are some that have AI features such as Widex with there sound sense tech or Opticon More. I mean it isn’t the full fledged AI but it does exist and is in hearing aids. The times are changing the one issue that we all have to separating speech from noise and AI would eventually be able to do this much better than it’s been done currently but as I said the self improvement of hearing aids are negligible but they do exist in more modern aids.

Edited

In reply to @cleimer101

@cleimer101 said:

Appropriately fit hearing aids improving cognition, sure. But HL without hearing aids “causing” “dementia” (not just affecting cognition–which includes a lot of mental processes) I still think is in question.

I think sometimes, understandably given the emotional component, we put more weight on the word “dementia” than it really deserves? It’s just a reduction in cognition beyond what we would expect as measured by some specific tests. It may well be that the hearing loss was resulting in increased listening difficulty which drew upon cognitive reserves and reduced cognitive bandwidth for other functions, and once the hearing improves and the cognitive load is reduced, thinking improves. So, on one hand you think, “well then that wasn’t really dementia”, but in so far as dementia is just reduced cognition measured on some particular tests, it was. Maybe with time and better understanding, we actually will cut this out of our understanding of what dementia “is”, and maybe there will be other factors that further improve it, finally narrowing down what we call “dementia” to a very specific disease process. So, there’s a bit of semantic witchcraft there.

In terms of permanent damage of untreated hearing loss: We know that in cats when you induce a reversible hearing loss the auditory cortex re-organizes and will also start to be taken over by other brain systems (vision). When you reverse the hearing loss, depending on the length of auditory deprivation, SOME of the original organization returns but not all of it. From an anecdotal clinical perspective, it also appears to be the case that long-term auditory deprivation can result in a loss of speech clarity (as judged by max word recognition scores) that does not fully return after consistent amplification. So there is some reason for concern, and really it is consistent with a lot of other parts of our body that will suffer when left to disuse and return to a variable degree depending on age, etc. (Edit addition: We can probably also draw insight from cochlear implant outcomes after auditory deprivation, which are clearly better the shorter the deprivation. Yet criteria for implantation are still looking at years-long time frames.)

But what we DO NOT KNOW at this point is what length of what type of deprivation we should be concerned about. At the base, you and I agree. It’s one thing to talk about this stuff and quite another to use it as a high-pressure sales tactic.

@cleimer101 said:

I recall in another post you said you prefer a quiet environment too.

-ish? I’m actually a music-all-the-time person. I just don’t like parties with too many people because I’m an introvert and find that level of socialization exhausting. But despite a very mild hearing loss, my auditory processing is good and background noise doesn’t bother me from a comprehension perspective the way it does some of my really normal-hearing friends.

In reply to @sparks-blend0p

@sparks-blend0p said:

there are some that have AI features such as Widex with there sound sense tech or Opticon More

No. There is no part of the Oticon More that is still learning. The widex app uses some clever data mining to support the A/B comparisons that it presents, but I wouldn’t call that either.

Wow, my thread has gone some strange places!
But my problem is understanding some voices. But I have no problem hearing most noises (high frequencies excepted). So if I am at home alone, there are no meaningful sounds to hear with or without hearing aids.
So my question remains: What will wearing hearing aids under these conditions accomplish?

@Speedskater said:

So my question remains: What will wearing hearing aids under these conditions accomplish?

Why not find out for yourself, you could then post your findings and this could then be a case study for anyone else.

In reply to @Speedskater

Getting used to meaningless noises while wearing aids at home would prepare you to deal with those noises in conditions where you anticipate benefits from the aids.

The cessation of otherwise meaningless noises can carry meaning.

You really don’t know what might happen in or around your house in the future that would be signaled by a noise audible only with aids.

The more you know, the better.

First I need to dispel the idea that I can’t hear noises. I was just walking in the park (between snow storms) I could hear others footsteps at 30 feet and two women talking at about the same distance (couldn’t understand them).
Sitting at my computer, I turned on my meter to the most sensitive range, the only time the needle moved was for key strokes that I can easily hear. Put in my (audiologist molded) hearing protectors and I can still hear the noises that I make and the TV at a normal volume.

In reply to @Neville

Sorry I misunderstood your quiet “ish” environment. :slight_smile:

Yes, some of the study findings you mention I’ve seen too. “Dementia” does get used in multiple imprecise ways. To me it connotes memory loss, executive function deterioration and perhaps personality or emotional changes, including Alzheimer’s. So yes, this kind of potential loss is enormously threatening. I don’t like to see claims about it over blown.

As always, I appreciate you taking the time to provide information and talk things through.

In reply to @Speedskater

I’ve only skimmed this. I don’t see your . If you’ve got a mild loss and seldom hear speech, hearing aids probably aren’t going to help you much. I’m confused though in that I thought you could listen to TV “at normal volume” and do ok. My understanding is that for hearing aids to help you understand speech, you have to be exposed to speech. Wearing them at other times lets you be accustomed to the louder noises that accompany the wearing of hearing aids.

Edited

In reply to @Speedskater

@Speedskater said:

First I need to dispel the idea that I can’t hear noises. I was just walking in the park (between snow storms) I could hear others footsteps at 30 feet and two women talking at about the same distance (couldn’t understand them).
Sitting at my computer, I turned on my SPL meter to the most sensitive range, the only time the needle moved was for key strokes that I can easily hear. Put in my (audiologist molded) hearing protectors and I can still hear the noises that I make and the TV at a normal volume.

Okay, this is probably sort of a useless quibble, and I cannot see your hearing loss so I grabbed a random one. But say your hearing loss looks like this:

audibility

In that case, you cannot hear any sounds that occur in the yellow highlighted range, which are sounds that normal hearing people can hear. There are lots of speech sounds in that area, as well as lots of other sounds.

At a particular frequency, a speech sound and a “noise” sound activate exactly the same nerve fibres. I think this is going to end up being a crappy analogy but. . . say you sometimes have to lift heavy things and all the rest of the time you keep your arm in a cast. Someone might say, “You know, if you take your arm out of that cast then when it comes time to lift heavy things it will be easier because your incidental arm use will help to keep it stronger and more mobile.” And you say, “But lifting heavy things is the only important thing I do with this arm, and I get along perfectly fine without it the rest of the time. Though, when I do lift heavy things I notice that it’s still hard. I never lift heavy things at home. What would having the arm out of the cast accomplish?”

In reply to @markoo355

I wear my hearing aids all the time.

For a while I found I was really really tired by end of the work day. I was straining to hear. I increased volume each day until I could get in to see my audiologist. After changing settings including volume I’m much better off.

I have said this before, comfort over efficiency as they are totally inefficient if you don’t wear them. If they are comfortable, and you put them on when you get up, you can have them in all day and not notice you have them in.
Where I get niggles is face masks etc where the aid gets dislodged.
Even so, the are not magic bullets and my wife will complain about household noises that I cannot here, the underfloor heating pump for instance.
There will be other noises that you will never hear without aids though, a dripping tap for instance.

You won’t see my , it doesn’t represent what I hear at realistic volumes.
The issue is:
Bilateral Dehiscence of the Superior Semicircular Canals
- hearing loss is only item #5 (of 7) on my ear problem list.

So a reciprocal of the Audiogram is painful.

Yes, SSCD is a real challenge, and in your situation I may not wear my hearing aids at home either. It’s surely still good for your auditory system to hear sounds, but. . . sometimes you’ve got to manage what you’ve got to manage. If there’s any room for balance (e.g. lower volume is tolerable) I might try for that, but if it’s really hard on your other symptoms to wear your hearing aids, then what can you do. One only has so many reserves.

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