It May Be Later Than You Think

Two Good Reasons to Get Your Hearing Checked Now

The negative health effects of hearing loss may affect people at a younger age than was previously believed.

“Higher Health Care Costs in Middle-Aged US Adults With Hearing Loss,” published online April 7 in the journal JAMA Otolaryngology-Head & Neck Surgery, found significantly greater health costs in middle-aged adults 55 to 64 years old who had hearing loss than in their peers with healthy hearing.images-2

The research examined the records of 562,000 adults, drawn from the Truven Health MarketScan national health care billing database. They were matched in terms of age, employment, the presence of a variety of chronic health conditions, as well as other factors. All had private low-deductible health insurance with at least 18 months of coverage.

Over 18 months, those with diagnosed hearing loss had 33 percent higher health care costs than those without hearing loss. The dollar amount was $14,165 for those with hearing loss, $10,629 for those without. This should not be read as suggesting a cause and effect relationship between hearing loss and higher health costs. It is a statistical association.

Of the 280,882 study subjects with hearing loss, just 36,323, or 12 percent, had received hearing services. The study adjusted for the cost of hearing services in this group. A study subject was identified as having hearing loss using a set of billing-related diagnosis codes that indicate age-related hearing loss.

The study’s lead author, Annie N. Simpson PhD, an assistant professor in the departments of Otolaryngology-Head & Neck Surgery and Healthcare Leadership and Management at the Medical University of South Carolina, emphasized in a journal news release that the important finding was that the patient cohort was not elderly. The finding, she said, shows that the negative health-related effect of hearing loss “may manifest earlier than is generally recognized and may affect use of health care across the continuum of care.”

This and other studies may make you think hearing loss is bad for your health. Based on another study published last fall in the same journal, you might even think it’s fatal.

Hearing loss is associated with a higher risk of health problems and with an increased risk of death. But it’s not a cause and effect relationship. Hearing loss does not cause physical and cognitive decline, and it does not kill you.

But it does have a strong correlation with these negative outcomes, and one explanation may be the very low use of hearing aids among those who could benefit from them. Fewer than 20 percent of those who could benefit from hearing aids have them. The Simpson study found that only 12 percent in her age cohort had received any hearing services.

Simpson offered some possible explanations for the negative correlation: “Patients with hearing loss may avoid seeking timely medical care because of their hearing difficulties,” she wrote in an email, and “patients with HL may be less effective participants in their care because of communication barriers that affect adherence to medication regimens, and/or recognition of symptoms that signal the need to seek care.”

Hearing loss often results in isolation, she went on, and it may also “reduce necessary communications about health problems to health care providers and family members.” It can also affect understanding of the proper use of medications.

Even going to the doctor may be affected by hearing loss. “Patients may avoid or delay visits to doctors” because their hearing loss makes it a stressful experience. All of these can lead to health-related problems becoming exacerbated, resulting in a sicker patient who needs more care.

And what about that study on hearing loss and death?

Kevin J. Contrera, Frank Lin and colleagues at Johns Hopkins University School of Medicine, studied associations between death and hearing loss. “Association of Hearing Impairment and Mortality in the National Health and Nutrition Examination Survey” was published online in the same journal as the Simpson study a few months earlier. It found that moderate or severe hearing loss in adults 70 or older is associated with a 54 percent increased risk of death, using an age-adjusted model.

The NHANES database, used in this study, identifies those with hearing loss based on audiometric testing. In a news release, Contrera noted that the most important unknown in their study is whether treatment helps offset the negative effect. “The big question is, do hearing aids and other therapies have an impact?” he said.

Does hearing loss cause death? No. But untreated hearing loss negatively affects cognitive and physical health. It is associated with a greater risk of falls in the elderly, with reduced walking speed and physical functioning and with decreased driving ability. It is also associated with greater risk of hospitalization.

The evidence for the benefits of treating hearing loss continues to mount. Simpson’s study is yet another wake-up call.

People with hearing loss – as well as insurers, including Medicare, and the hearing industry – need to pay attention to the negative health consequences of untreated hearing loss. The cost of treatment is likely to be far less than the cost of the consequences of not treating.

One thought on “It May Be Later Than You Think

  1. Good morning, world traveler. Hope you are having a great time or that you had a great time if you are back!

    Just wanted you to know that I was not able to open the link on your blog post. (It looks like an especially good one.)

    See you in June!



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