How Fit is Your Hearing?

Recently, a prominent researcher in the field of hearing loss suggested a simple change in the way we talk about hearing loss. Rather than frame it as a disability, said Dr. Justin Golub of Columbia University Irving Medical Center, “I like the idea of hearing fitness.”

images“Hearing loss” is a negative term. For people who don’t want to admit they have hearing trouble, it invites the dismissive response: “I’m fine.”  But who wouldn’t want to be as fit as possible, especially if it takes little to no work on their part?

Dr. Golub is the lead author on a November 2019 paper in JAMA Otolaryngology-Head Neck Surgery, which found an association between cognitive impairment and what is generally considered “normal” hearing. In 2011, Johns Hopkins’ researchers led by Frank Lin, published the result of a longitudinal study on a large cohort of older adults showing that those with moderate or more severe hearing loss were at a greater risk of dementia. The greater the hearing deficit, that study found, the greater the risk of developing dementia. What Golub and his colleagues have now found is that even minor loss, within the so-called normal range  of 25 dB or less, is associated with lower cognition.

Using two major national databases as their source, the Golub team studied data on hearing and cognitive performance in 6451 people age 50 and over. This study, unlike previous studies of hearing loss and cognition, focused on people with hearing loss in the range usually considered normal. They considered all levels of hearing in that category, down to what would be considered “perfect” hearing, the ability to hear at zero decibels. (Dogs can hear at -5 to -15 decibels.)

After adjusting for demographics and cardiovascular disease, the study found that decreased hearing was independently associated with decreased cognition. The study did not look at whether hearing loss causes cognitive decline. Nor did it look at whether correcting hearing loss with hearing aids offsets the correlation.

“Can Hearing Aids Help Prevent Dementia?” That question was the title of the article in The New York Times Magazine where Golub’s hearing fitness quote appeared. We don’t have an answer yet but Frank Lin and colleagues will conclude what is expected to be the definitive study on hearing aids and their deterrent effect on cognitive decline in 2022. (For those who are interested in learning more about the study, Aging and Cognitive Health Evaluation in Elders (ACHIEVE), funded by the National Institute on Aging, here’s a link to an interview in AudiologyOnline on the study and other hearing-related public-health issues.)

Speaking to the Times Magazine, Golub mused, “We always frame [hearing loss] as a disability.” Telling college students that blasting their ears with loud noise is going to make them more susceptible to dementia 50 years later, he said, isn’t going to be much of a deterrent. “But if you say, ‘Hey, hearing is good for your brain, the more hearing you have the better,” that has immediate implications.”

“Hearing Fitness” is good for people at any age. Whatever it is about hearing loss that aligns it with an increased risk of dementia is of course of paramount interest. But poor hearing has a host of other physical and psychological ramifications, some of which themselves are a risk factor for cognitive decline.

Hearing fitness means taking care of the hearing that you have, whatever your age. And if it begins to decline, as it often does with age, correcting it. Cost has been a prohibitive factor for many up till now, but this year the FDA will announce guidelines for an over-the-counter hearing aid that will cost a fraction of existing FDA-approved hearing aids. Hearing aid companies and the consumer electronics industry are already offering products that are as good as some hearing aids at even cheaper prices. Costco is reportedly the nation’s largest hearing aid dealer (except for the VA), with volume permitting lower prices. Having hearing professionals on staff insures responsible service. Insurance companies are increasingly covering hearing aids, finally understanding their role in healthy aging. In some states, Medicaid covers hearing aids. Even that dinosaur Medicare may soon revise its hearing aid policies.

Tuesday March 3 is World Hearing Day. Although hearing fitness may be a distant goal for the half a billion people worldwide with disabling hearing loss, those of us in prosperous countries can make a start by taking care of our hearing, and by treating it promptly when problems develop. Hearing help comes in all price ranges. Keep your hearing fit!


For more about living with hearing loss, read my books, available at and maybe at your favorite bookstore or library. If it’s not there, ask for it!




17 thoughts on “How Fit is Your Hearing?

  1. I heard this at the convention last year whereas someOne protested my use of the words hearing impaired. Among normal hearing folk; they will understand where I am coming from with that terminology. . I have hard enough time being able to exists among the hearing folks without having to worry about disparities in terms. Folks still will not associate with someone with a hearing loss because it is harder on ( I got kicked out of Friends in the city because of it- sound of my voice/ hard hearing ) Younger folks- go ahead. Me- keep on with my terms.


    • Thanks for your comment. I didn’t mean to suggest we actually use this term. It would indeed be confusing to hearing people. It’s really a philosophy that I’m endorsing.
      I think all of us with hearing loss eventually find the most effective (and most comfortable) way of expressing our situation. Sometimes I say I’m very hard of hearing. Other times I say I’m deaf and please speak more clearly, etc.


  2. Why don’t you mention the name of the prominent person?

    I think the “fitness” terminology is absurd, but thank you for asking for comments. It’s a disability, and we all know that. “Fitness, etc”., is, again, just soft-soaping the situation.

    There’s a big push everywhere to neutralize language, which amounts to not being truthful about anything. Sounds very governmental.


    • I did mention his name and referred to him later in the piece as well. Justin Golub of Columbia. I don’t think anyone thinks this is a usable term – it’s just a different way to think about hearing: keeping it healthy. Th he disability question is different. For some of us it is a disability but there are many with hearing aids who function fine and don’t need accommodations. I wouldn’t consider them to have a disability. I do though.


  3. Dr. Golub is doing important research on hearing loss and dementia, but he oversteps when he says we shouldn’t use the term disability or hearing loss because they are too negative and don’t encourage young people to protect their hearing. For me, “hearing loss” exactly describes what I have been experiencing for the past 20 years, beginning in my mid forties. My hearing loss is a disability that I must deal with daily, especially because I chose to lead an active, social life with a profound hearing loss.
    So, Dr. Golub, keep using your term “hearing fitness” if it helps you get the message out to younger generations, but don’t tell me what words to use to describe my loss of hearing.


    • I would never argue that serious hearing loss is not a disability. I’ve written this many times. If those of us with severe hearing loss refuse to use the term disability, then no one needs to provide accommodations under the Americans with Disabilities Act.
      I have disabling hearing loss. I need accommodations like CART captioning, LED signs, captions on TV and movies, and hearing loops.
      But many many more people have mild to moderate loss, and Dr. Golub is saying they should pay attention to it. They should treat that loss and keep their hearing fit — and their brain fit as well.


  4. Thank you for sharing your thoughts on this, Katherine. As someone who has been living with a progressive, now profound, hearing loss for 40 plus years, I find Dr. Golub’s approach refreshing. I agree ” hearing is good for your brain, the more hearing you have the better.” That’s why I had a left ear CI six months ago. My brain is responding to the sounds it is hearing positively. I’m not exhausted at the end of every day because my brain isn’t struggling to hear all the time. I also agree, “Hearing Fitness is good for people at any age”. I can’t think of a better way to persuade people to wear their hearing aids or use assistive listening devices to help them hear better.


  5. Consistent with Dr. Golub is this text from an article by Karl Strom, the Editor of the Hearing Review in its January 2020 issue, captioned Situational Hearing Loss.

    “So, as our field moves into the era of OTC, we may need to stop gauging a successful fitting by the amount of time a wearer uses his/her amplification. Rather, it will depend on the particu- lar device and the stated objectives of the wearer. As greater numbers of people with borderline/ mild hearing losses seek help from your practice, maybe it’s time to see situational hearing— and the OTC and/or “basic” hearing aids it calls for—as an entry-point or threshold for people to learn about hearing loss and experience


  6. I’lll try not to fall into an old cliché but hearing fitness and hearing disability seem to be on opposite sides of the same coin. I don’t hear anyone denying that any level of deafness is a disability. When deafness is detected, treatment is usually called for. This is usually in the form of hearing aids. More profound loss can be treated by a cochlear implant or some combination of devices.

    Hearing fitness to me is just an extension of physical fitness. The aural “training effect” could be realized early in life as part of a school curriculum where students apply exercises to enhance understanding and accurate listening in much the same way as hearing aid and implant users practice rehabilitation exercises. Such a program would, as a matter of course, reveal real disabilities earlier in life. – – – While we’re at it we can throw in a few courses in elocution. Fast talkers and mumblers beware!


  7. Where can I workout 🏋️‍♀️ to improve me hearing fitness? Maybe the speaker could improve their communication fitness.


    • Of course it’s a two-sided street.
      But you can practice hearing fitness by getting and wearing hearing aids, by doing auditory rehab exercises if you’re having trouble adjusting the new hearing aid, by requesting accommodations.
      And we have to teach others how to speak so that we can understand them. We have to tell them to look at us when they speak, not to put their hands or anything else in front of their mouths (including, in my opinion, a mustache or a beard), to speak in an ordinary tone of voice with careful enunciation, to repeat when we ask them to and not brush us off with a “never mind, it wasn’t important.”


  8. Hello Katherine – it’s been some time since I got a “newsletter” from you, and I hope the reason is neither of these: you are ill, or – you’ve stopped sending specifically to me.

    Either way, I hope to hear from you. Thank you


Please leave a reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s