Over-the-counter hearing aids appear to be alerting buyers' ears a bit earlier in their auditory journeys.
On average, people wait nearly nine years between an identified need for hearing aids and actually getting them, according to a 2019 study published in the National Library of Medicine.
“A lot of times, the patients themselves are in denial,” said Nancy Gilman, an audiologist with ENT Physicians Inc. in Toledo.
With FDA approval of over-the-counter hearing aids two years ago, research shows that the average age for that purchase was 62, rather than the average 64-year-old who seeks out a specialist. The move by the FDA was to make hearing aids more accessible and less costly in the same manner that one can buy reading glasses.
“Hearing loss is a critical public health issue that affects the ability of millions of Americans to effectively communicate in their daily social interactions,” said FDA Commissioner Dr. Robert Califf. “Establishing this new regulatory category will allow people with perceived mild to moderate hearing loss to have convenient access to an array of safe, effective, and affordable hearing aids from their neighborhood store or online.”
Easier access has not resulted in a stampede to buy hearing aids. Only 2 percent of American adults with perceived hearing loss age 40 and older reported buying over-the-counter hearing aids within the first year of availability, according to a survey conducted by the American Speech-Language-Hearing Association. The primary reason given was that people did not perceive their hearing loss as “bad enough” to warrant care.
“The big companies are still making them, but their sales have been far less than expected,” said Dr. Afser Shariff, an ear, nose and throat specialist with ENT Physicians Inc. "A few people have found that OTC has been helpful. OTC adoption rate has not been great."
The average cost for hearing aids is $2,000 to $4,000 and is not covered by most insurance companies. Over-the-counter models average about $1,500 and can be found for as low as $200.
This fall in an unprecedented move by Apple, the company entered the hearing aid market. In September, the FDA authorized the first over-the-counter hearing aid software intended to be used with compatible versions of the Apple AirPods. The Live Listen feature turns an iPhone or iPad into a directional microphone, which sends the sound directly to a set of compatible AirPods. The cost is about $250, with noise cancellation and an available hearing test.
There is no stigma associated with AirPods, but some people may steer clear and forego conversation if they think the user is listening to music.
“Marketing authorization of an over-the-counter hearing aid software on a widely used consumer audio product is another step that advances the availability, accessibility and acceptability of hearing support for adults with mild to moderate hearing loss,” said Dr. Michelle Tarver, acting director of the FDA's Center for Devices and Radiological Health.
About 28.8 million adults in the United States could benefit from using hearing aids, according to the National Institute on Deafness and Other Community Disorders. Among those 70 and older who could use that benefit, fewer than 1 in 3 has ever used them.
“They don't want to broadcast that they are getting older,” Dr. Shariff said of many people who reject the use of a hearing aid.
But get an earful of this: The pervasive isolation imposed by hearing loss can result in depression and an increased risk for dementia.
“Getting a hearing aid early on makes a huge difference. It changes the level of anxiety and depression because you are connecting back to the world,” Dr. Shariff said. “Quite often, we see patients at the early stages of dementia who do not have a hearing aid. That results in their brain shrinking over time.”
With a hearing aid, cognitive decline was slowed by 48 percent, according to results from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, which were reported in 2023 at the Alzheimer's Association International Conference in Amsterdam. Participants were aged 70 to 84.
“Hearing loss is very treatable in later life, which makes it an important public health target to reduce risk of cognitive decline and dementia,” said study investigator Dr. Frank Lin, of John Hopkins University School of Medicine.
Hearing loss also can be attributed to more falls.
“One in four people over the age of 65 have a fall once a year,” Dr. Gilman said. “Many are focusing so much on hearing you, they are not looking at what they are doing.”
One of the drawbacks to OTC hearing aids is the lack of long-term support from a specialist in handling problems or replacement if the hearing aids are lost, according to Dr. Shariff.
Contact Kimberly Wynn at kwynn@theblade.com
First Published October 20, 2024, 4:00 a.m.
