Hearing loss, isolation & your mind

Most age-related hearing loss comes from changes in the inner ear. Changes in the middle ear and in the nerve pathways to the brain can play a part too.

Years of loud noise, some health conditions such as high blood pressure and diabetes, and family genes can also add to it.

WHO says hearing loss often comes with stigma, which can make people slow to seek help. Fewer than 1 in 3 U.S. adults aged 70 and older who could benefit from hearing aids have ever used them.

It is common to think, “I can hear fine, people just mumble.” That thought is understandable. It can also keep you from help that makes life easier.

The National Institute on Deafness and Other Communication Disorders (NIDCD) offers a short list of questions about TV, phone calls, groups and social situations. Answering “yes” to two or more, or “sometimes” to three or more, suggests a hearing check is worth it.

Mishearing can feel awkward, especially in front of people you do not know well. Many people start nodding along so they do not have to ask again.

What can help

• Ask people to repeat or rephrase, rather than guessing
• Have a light phrase ready, like “My ears are on a go-slow today”
• Remind yourself that most people are glad to help when they know

Losing some hearing can mean losing things you loved: a favourite song, a grandchild’s soft voice, the ease of a phone call. It is okay to grieve these changes.

Concentrating hard to follow words, reading lips and filling gaps takes a lot of energy. After a family meal you may feel worn out, even if you enjoyed it.

NIA notes that older people who do not hear well are sometimes wrongly thought to be confused, unresponsive or uncooperative. This can be hurtful and frustrating.

• Choose smaller groups or one-to-one meetups
• Get your hearing checked and try the tools that fit you
• Pick quieter places and times, like a café mid-morning
• Tell one trusted person what helps you, and ask them to back you up in groups

Assistive devices such as phone amplifiers, smartphone and tablet apps, and hearing loops can make calls and everyday sounds easier to catch.

WHO says hearing loss that is not addressed is linked to a higher risk of dementia and faster decline in thinking skills.

A 2024 Lancet Commission report found that hearing loss is one of the largest of 14 changeable risk factors for dementia, linked to about 7% of cases. It recommends making hearing aids available to everyone who needs them.

The ACHIEVE trial followed nearly 1,000 adults aged 70–84 with hearing loss for three years. Hearing support (counselling plus hearing aids) did not slow thinking decline in the group as a whole.

But in older adults who were already at higher risk of decline, the results suggested hearing support might slow changes in thinking. Researchers are still studying this.

If you feel low, hopeless, or no longer enjoy things for more than a couple of weeks, it is worth talking to your primary care provider. Getting your hearing checked and getting support for your mood can go hand in hand.

Hearing aids are fitted by a hearing professional to match your hearing. They come in different styles and sizes.

Adults 18 and older with perceived mild to moderate hearing loss can buy over-the-counter (OTC) hearing aids in stores or online, without a medical exam or prescription.

They are not meant for severe hearing loss. If they do not help, or you cannot hear speech even in a quiet room, see a hearing professional.

A cochlear implant is a small device placed by surgery that can help some people with severe or profound hearing loss. An ENT and audiologist can explain whether it might suit you.

Assistive listening devices include phone amplifiers, smartphone and tablet apps, and hearing loop systems found in some theaters, places of worship and meeting rooms.

Everyday ideas

• Ask if a venue has a hearing loop or listening device
• Try captioning apps for conversations and calls
• Turn on captions on your TV and video calls

Phrases you could try

• “Could you face me when you talk? It really helps.”
• “Can you say that another way?”
• “I hear better on this side. Can I sit here?”

Walking groups, gardening, art classes, card games and volunteering can all be social without long, noisy conversations.

It is okay to leave a party early, step outside for a quiet break, or plan a calm evening after a busy day. Rest helps you enjoy the next gathering too.

• Choose a calm, private moment
• Share what you have noticed with kindness: “I miss our long phone chats”
• Offer to go with them to a hearing check
• Accept that it may take more than one conversation

• Seat them where they can see most faces
• Fill them in when they miss part of a story
• Take turns talking rather than talking over each other

Older people who do not hear well are sometimes wrongly thought to be confused or uncooperative. Make sure they heard you before worrying about their memory.

The Hearing Loss Association of America (HLAA) is a nonprofit that offers education, support and local chapters for people with hearing loss and their families. Visit hearingloss.org.

The Eldercare Locator, a free U.S. government service, connects older adults and families with local services. Call 1-800-677-1116, or visit eldercare.acl.gov.

Some people with significant hearing loss choose to learn sign language and connect with Deaf community. There is no single right way to live with hearing loss.