Is there a Connection Between Hearing Loss and Cognitive Decline?

In a clinical study by Dr. Lin at Johns Hopkins and the National Institute on Aging, hearing loss causes social isolation which has been recognized as a risk factor for cognitive decline and dementia.  When your hearing lessons, your brain receives less regular stimulus from your ears to process and identify different sounds.  After time, this reduced interaction for your brain can lead to dementia and memory loss.  It helps to visualize your brain like your body.  When you exercise your body, you remain healthy.  When you do not engage your muscles, they become weaker.  When you do not treat your hearing loss, your brain becomes ‘weaker’.  Specifically, the part of your brain involved with processing speech becomes ‘weaker’ and this increases chances of memory loss.

What Is A Hearing Instrument Specialist?

Hearing instrument specialist (HIS): A hearing instrument specialist is licensed to perform audiometric testing to sell and fit hearing aids. They also are trained to diagnose, treat and monitor hearing losses.  Training also includes amplification devices, acoustics, as well as a supervised externship prior to state licensure.  Continuing education requirements must also be met in order for a hearing instrument specialist to maintain state licensure.  For individuals with hearing loss or auditory issues, a hearing instrument specialist is a highly qualified professional to assist with diagnosis and treatment.  In order to obtain a license, a HIS generally has to take extensive training in ear anatomy and physiology, otoscopic examinations, audiological examinations, hearing aid function, fitting and operation, hearing aid adjustments, and state laws concerning hearing aid dispensing.  In addition to a state licensure as a hearing instrument specialist, clinic owners also have state licensure as a dealer and carry several million dollars of General Liability insurance.  Hearing instrument specialists are trained to deliver safe, effective hearing solutions for patients.

What Is An Electrical Engineer?

Electrical Engineer (B.S.E.E.): The bachelor of science electrical engineering program focuses on fundamentals and practical applications, including circuits, electronics, power systems, machinery, signal analysis, computers, controls, and communications.  As an electrical engineering student, you work in the electric circuits laboratory and the microcontroller and instrumentation laboratory, among others.  You get a state-of-the-art experience in all things electrical including electronics, circuits, and control systems which help you to understand the inter-workings of computers and electronics hardware and software.

An electrical engineer with state licensure as a hearing instrument specialist has advantages over other specialists and Hearing Instrument Specialists.  Only an electrical engineer understands software and electronics hardware intimately as it relates to applying hearing solutions for clients.

What Types Of Tests And Treatments Do Hearing Instrument Specialists Perform?

Common services and treatments provided by anHearing Instrument Specialist include:

  • Diagnostic hearing tests
  • Otoscopic examinations
  • Audiologic evaluations
  • Hearing aid fittings and consultations
  • Hearing aid repairs and maintenance
  • Aural rehabilitation
  • Earmold and earplug fitting and consultation
  • Tinnitus treatment programs
  • Hearing rehabilitation and auditory training

Is Hearing loss Preventable?

Unfortunately, hearing loss is not preventable in most cases.  Hearing loss caused by genetics, trauma, disease or aging can not be prevented.  But hearing loss caused by “noise” (NIHL = noise-induced hearing loss) is preventable.  Noise-induced hearing loss is caused by intense sound and/or repeated exposure to unsafe sounds and volume levels such as louder than a vacuum cleaner.  Good examples of this are a siren, firecrackers, gunshots, musical concerts, and construction machinery.   

The three factors driving noise-induced hearing loss are:  duration of the loud noise, loudness (decibel level, db) of the sound and closeness to the loud noise.

Noises above 85 db (i.e. vacuum cleaner loudness) can cause noise-induced hearing losses.  Louder sounds and close proximity to sounds take less time to deliver hearing loss damage.

How do I Know that I need a Hearing Aid?

You need a hearing aid if you:

  • turn the TV volume too loud for others
  • can’t understanding conversations in restaurants and noisy places
  • don’t hear women and children’s voices
  • avoid social contact you used to enjoy
  • always say others are mumbling
  • have difficulty on the phone
  • have tinnitus (ringing in the ears)
  • always ask others to repeat themselves
  • have your family tell you that you can’t hear

What Causes Hearing Loss?

Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. It is estimated that nearly 20 percent of adults in the United States (48 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.

Genetics and presbycusis (aging) account for about 50% of the hearing loss in older adults.  Many other factors also contribute to hearting loss including loud noised, ear/head trauma, infections, medications, congenital (birth) issues, and several ailments of the eardrum and middle ear.  It is estimated that about 20% of adults in the United States have hearing loss at some degree.

Will a Hearing Aid Restore My Hearing to Normal?

Each person’s hearing loss is unique and the answer cannot be determined until after a diagnostic evaluation and full audiological testing is done.  That said, most individuals with hearing losses can be successfully treated with hearing aids.  If normal is described as understanding all of the syllables and vowels clearly, then most people will have the opportunity to hear normally with the proper hearing aids, fitting, adjustments, daily ear care, daily hearing aid maintenance, and counseling.  Hearing aids were developed to clearly help you detect and hear soft sounds and separate the background noise from speech that you want to understand.  Hearing is an involved process involving auditory sounds that move the ear drum which moves the auditory ossicles and touch delicate hair cells in your cochlea. These hairs emit chemicals which convert to electrical signals which pass to the brain so the process is complex.  Even with professionally fitted hearing aids, you may have some difficulties hearing in some situations as each person’s hearing loss is slightly different.  Your hearing instrument specialist will help you find ways to adapt to your new hearing aids as long as you give it time to acclimate to your mind and body.

How Is Hearing Loss Diagnosed?

The evaluation starts with a diagnostic audiologic evaluation which will include the otoscopic (viewing of the ear canal and ear drum) exam, pure-tone testing, bone conduction testing, and speech (or word recognition) testing.  All of the above tests will give the hearing professional an understanding of the condition and health of the ear canal and middle ear (behind the ear drum).  They will also determine the level and type of hearing loss.   The Hearing Instrument Specialist can then determine if the hearing loss is conductive or sensorineural depending on the location of the hearing loss (outer ear, middle ear, inner ear or central processing difficulty in the brain).

All these tests will typically take about 30 to 45 minutes.  This is followed by a review of the test results shown on an audiogram with the Hearing Instrument Specialist and answering of any questions that you might have.  The audiogram shows the hearing test results across a range of frequencies necessary for understanding speech.  These results help the hearing instrument specialist to create a prescription to program your hearing aids.

What Are The Different Degrees Of Hearing Loss?

The degrees vary from normal hearing to profound hearing with three other categories.  Basically, the different degrees have to do with the hearing test results for each patient at speech range frequencies.  For reference, the following shows the categories of speech loss by level:


  • Normal (0-25 db HL)
  • Mild (26-40 db HL)
  • Moderate (41-70 db HL)
  • Severe (71-90 db HL)
  • Profound (> 91 db HL)

How Long Will My Hearing Aid Last?

(3-5) years is typically the life of hearing aids that are properly maintained and serviced.  Good practices for the longest hearing aid life include:

  • Daily ear cleaning which helps keep aids clean
  • Regular cleaning of hearing aids with wipes
  • Put rechargeable aids in the charger daily
  • Open battery doors of aids with disposable batteries when not using them to extend the battery life
  • Schedule 6 month visits to your Hearing Instrument Specialist to clean and replace parts on your hearing aids
  • Keep your aids from water, hair dyes, hair sprays or the hair dryer

Some hearing aids go in the ear while other aids go behind the ear and this affects the life of the hearing aid.  Environmental conditions like wax, rain, snow, seat and dirt can also affect the life of the aids.  Most of these factors can cause damage to the aids which should be addressed under the warranty.  Go regularly to see your Hearing Instrument Specialist and this will extend the life of your hearing aids.

What Are The Different Types Of Hearing Loss?

There are three types of hearing loss and the type of loss determines the type of hearing aids which would best work.

  • Conductive hearing loss happens when sounds cannot get through the outer and middle ear. It usually involves some type of obstruction in the ear.  It may be hard to hear soft sounds and louder sounds may be muffled.
    • Ear wax buildup
    • Middle ear infections (or the ear canal)
    • Unwanted object in the ear canal
    • Perforation or scarring of the eardrum
    • Abnormal tumors or growths
    • Hearing loss risk factors
  • Sensorineural hearing loss is the most common type of hearing loss and it occurs when there is a problem with the inner ear or the hearing (auditory) nerve.  It occurs from damage to the hair cells in the auditory system.  Sensorineural loss accounts for more than 90% of hearing loss.  Causes of sensorineural hearing loss include:
    • Getting older
    • Exposure to loud noises
    • Ototoxic (cancer) medications
    • Viral infections (i.e. measles or mumps)
    • Acoustic tumors


  • Mixed hearing loss is a combination of the Conductive and the Sensorineural hearing loss. This is usually age related. Many times the conductive portion of the loss can be addressed with proper cleaning of the ear.

Do Hearing Aids use Special Batteries?

There are disposable and rechargeable batteries.  Disposable batteries need to be replaced every 4 to 12 days depending on the size.  The amount of time depends on the size of the disposable battery, how often the aid is used, and how much Bluetooth streaming the aid experiences.  Rechargeable batteries are often a good option for those wanting to do less maintenance or those with dexterity issue changing batteries.  Rechargeable batteries can deliver 15-24 hours of power in a single charge.

What Style of Hearing Aid Should I Wear?

There are many factors to consider when determining the style of hearing aid with your Hearing Instrument Specialist.  The factors include your level of hearing loss, the functionality you desire, and your manual dexterity and ability to place the aids in your ears.  Your Hearing Instrument Specialist will work with you to determine the style of aids that help you to hear best while working with your lifestyle.

Hearing aids come in multiple shapes and styles, depending on many factors.  When selecting your hearing aids, these are some considerations:

  • Hearing loss level
  • Lifestyle and activities
  • Financial budget
  • Rechargeable or disposable batteries
  • Manual dexterity
  • Type of hearing loss
  • Physical limitations
  • Visual abilities

There are many factors to consider when determining the style of aid.  There are Invisible in the canal aids, In-the-ear aids, receivers-in-the canals, and Behind-the-ear aids.  Hearing aids can come with chargers or disposable batteries and can connect via Bluetooth to your phone or your TV.

What Is Tinnitus?

Tinnitus is overactive nerves in the brain and a common disorder affecting almost 50 million people in the United States. Tinnitus has many sounds including “ringing in the ears,” hissing, roaring, whistling, buzzing or clicking. Tinnitus is a symptom of an underlying condition of the auditory nerve, ear or other factor.  Tinnitus comes in a variety of tones, volumes and frequencies. The volume experienced can range from very soft to extremely loud and can be intermittent or constant.

What Causes Tinnitus?

Generally, stress causes tinnitus.  A wide variety of factors can worsen tinnitus including:

  • Hearing loss
  • Mental stress
  • Physical stresses
  • Medications
  • Noise-induced hearing loss
  • Jaw misalignment
  • Heart disease
  • Some tumors
  • Thyroid disorders
  • Ear or sinus infections
  • Wax build-up in the ear canal

How Is Tinnitus Treated?

Underlying conditions and level of severity help determine how tinnitus will be treated.  The unwanted, internally generated noises (a.k.a. tinnitus) are commonly treated many ways including:

  • Programming hearing aids
  • Tinnitus masking programs on hearing aids
  • Physical therapy for neck and head muscles
  • Behavioral and sound therapy
  • Retraining therapy
  • Avoiding stressful situations

How Long Does it Take to Adjust a Hearing Aid?

The amount of time is different for each person.  Also, it matters how long you have waited to address your hearing loss and the level of your hearing loss.  A mild hearing loss might take shorter than a profound hearing loss to adjust.  The ears capture sound waves and convert them to electrical signals for the brain which translates this into understandable sounds, syllables and words.  The longer one waits to address their hearing loss, the longer the brain can atrophy which makes for a longer adjustment period.