For most people, age-related hearing loss, also known as presbycusis, happens so slowly that they don't notice it at first. In fact, hearing loss actually begins in our late 20s and early 30s, when we lose the ability to hear high pitches, such as that of a buzzing mosquito. And by the time we reach our 70s, about half of us have diagnosable hearing loss.

What you may not know: Despite the high incidence of hearing loss, only about two in every five adults over age 65 with hearing loss use hearing aids. Plenty of people resist getting a hearing aid because they fear that it will make them look old, be too complicated to use and/or cost too much money.

Now: Based on recent research, people with untreated hearing loss have more reason than ever before to consider getting a hearing aid.

Health Hazards

While most people consider hearing loss a mere annoyance, researchers are now discovering that it may increase one's risk for...

  • Dementia. In a study of 639 men and women (ages 36 to 90) published in the Archives of Neurology, the risk of developing dementia was two, three and five times higher in those with mild, moderate and severe hearing loss, respectively, than in those with normal hearing.

Researchers do not have an explanation for the association between hearing loss and dementia-and they point out that the link does not prove cause and effect.

However, it's possible that damage to the cells involved in hearing may be a sign that damage has also occurred to nerve cells that are responsible for cognitive functions, including memory. Hearing loss also can cause social isolation, which contributes to the risk for dementia.

  • Depression. Significantly more older adults with hearing loss who did not wear hearing aids reported feelings of sadness and depression for two or more weeks during a one-year period than their peers who wore hearing aids, according to a study from the National Council on Aging.

Possible reason: Depression may be caused or worsen in people with hearing loss who withdraw from social interactions.

  • Injury. Hearing loss is a safety hazard, especially for pedestrians who may have trouble hearing oncoming traffic and for drivers who rely on their ability to hear to prevent collisions. It also affects a person's ability to hear a phone, doorbell and smoke detector alarm.

Do You Need A Hearing Aid?

If you have hearing loss, a loved one may be the first to notice it. In addition, if any of the statements below applies to you, it may mean that you have bearing loss…

  • You frequently ask, "What?" in conversations.
  • You have trouble following conversations. . Everyone around you seems to mumble.
  • You're always turning up the volume on the TV.
  • You can hear someone talking, but not what the person is saying.
  • It's especially difficult for you to hear women and children, both of whom have higher-pitched voices and generally speak with a lower volume than men. Higher-pitched voices are the most difficult to hear.

Best Hearing Aid Options

Many of today's hearing aids are highly sophisticated. For example…

Cutting-edge product: One of the newest hearing aids available is the SoundBite Hearing System, which allows sound to travel via the teeth to the inner ear. A small microphone in the ear canal transmits sounds to a wireless unit behind the ear, which sends a signal to a device that fits over the back teeth. The device converts the signals into vibrations, rerouting sound to the inner ear. SoundBite is especially helpful for people with hearing loss in one ear or who have conductive hearing loss-a problem in the middle or outer ear.

Main types of hearing aids…

  • Behind-the-ear (BTE) hearing aids, which are generally larger than other types of hearing aids, are the traditional kind that hooks over the top of your ear and sits behind it. The hearing aid picks up sound, amplifies it and carries the amplified sound to an ear mold that fits inside your ear canal. The large size allows for directional microphones and easier adjustment of volume and battery changing.

The BTE hearing aid is appropriate for almost all types of hearing loss and does the best job of amplifying sound for people with severe hearing loss. Siemens offers a couple of rechargeable BTE hearing aids for mild-to-moderately severe hearing loss.

Typical cost: $500 to $2,000 per ear.

  • Open-fit models are among the newer aids available today. They are smaller than BTE aids and suitable for mild-to-moderate hearing loss. Generally placed behind the ear, these aids leave the ear canal mostly open and are less visible than BTE models. Sound travels from the open-fit hearing aid through a small tube or wire to a tiny dome or speaker in the ear canal.

Typical cost: $1,000 to $2,500 per ear.

  • In-the-ear (ITE) hearing aids are custom-made to fit in the outer ear. ITE devices may pick up background sounds such as wind, since the microphone sits at the outermost portion of the ear. But the batteries tend to last longer than other types of hearing aids and are easier to change, especially if you have arthritis in your fingers.

Typical cost: $1,200 to $2,500 per ear.

  • In-the-canal (ITC) hearing aids fit farther into the ear canal than ITE aids. This style is best for mild-to-moderate hearing loss. It is hardly visible and is easy to use with the telephone. The small size makes adjustments, including battery changes and volume control, difficult for some people. The device may not fit well in smaller ears.

Typical cost: $1,300 to $2,500 per ear.

  • Completely-in-the-canal hearing aids are custom-molded and best for mild-to-moderate hearing loss. This is the least noticeable type of hearing aid and the least likely to pick up background noises such as wind. It also works well with telephones. But the small batteries require frequent replacement.

Typical cost: $1,300 to $3,000 per ear.

Main bearing aid manufacturers: Oticon, Phonak, Starkey, ReSound, Widex and Siemens.

Important: There are many over-the-counter devices that simply amplify sound. However, hearing aids are usually preferable because they are customized for an individual's specific degree and type of hearing loss, allowing them to be programmed for optimal hearing improvement.

If you are having difficulty hearing: See an audiologist. You can find one at the American Academy of Audiology consumer Web site at An audiologist can help you select the best hearing aid for you and explain how to properly use and maintain it. If the audiologist suspects that you may have an undetected medical condition that is causing your hearing loss, you will be referred to a physician.

What About Cost?

Some individuals put off purchasing hearing aids because of their high cost—about $500 to $3,000 per ear.

Recent research finding: People who have insurance plans that cover the entire cost of hearing aids purchased them seven years earlier, on average, than those who had partial or no insurance, according to a study conducted at Henry Ford Hospital in Detroit.

But only about one-third of health insurance policies cover the cost of hearing aids. Medicare does not. Health insurance from the Veterans Administration does cover the cost, and the Lions Club has a program that provides hearing aids to people who can't afford them.

You can use a health savings account or flexible spending account to pay for hearing aids with pretax funds, or you can deduct the cost on your tax return (check with your tax preparer for details).

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