Advice on Hearing Aids

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#2065594 31-Jul-2018 12:51

There are all kinds of BTE and ITE aids for sale on Aliexpress, from about US$5 and up.

I'm pretty sure that the expensive aids from an audiologist will have programmable frequency equalisation but also the aids are very high tech with DSP to suppress background noise and make speech more clear, some have different switchable programmed modes, one for say listening to music, another for hearing speech in crowds etc etc.

This is all very jolly, but for example some aids that my FIL had - at a cost of about $8,000 / pair - a non tech-savvy retired farmer in his late 70s then - had not the faintest practical clue how to use the modes the audiologist had set up, he had difficulty changing the batteries (and the tiny batteries needed to be changed very frequently) with his fat fingers, the aids had a tiny orifice that would block up with an invisible to him blob of earwax, and if he dropped them they were hard to see and not resistant to being stomped on when he was dancing around in hobnail boots waving his arms in the air saying that he'd dropped a $4,000 hearing aid on the floor. Couldn't hear the crunch.

To cap it off - the DSP modes that had been set up used frequency shift - presumably to adjust voice frequency in to the range where his hearing was best. This produced truly remarkable effects when he was playing his ukulele and trying to sing in tune, he'd hear himself singing through conductive hearing, the ukulele sound frequency shifted through the aids, it possibly sounded spot on to him - but to anybody else within range it was a horrific discordant cacophony. The audiologist may have set up a "music" mode which turns DSP off - but he had no idea how to switch modes.

Those aids are gone - he's got normal and relatively inexpensive BTE aids - which are much better for his needs.

nakedmolerat

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#2065653 31-Jul-2018 13:23

@eracode:....

Would welcome informed comment and advice. Thanks.

1. hearing loss is a risk factor for dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527366/

2. audiologist are medical provider - therefore this notion of 'selling' stuff for no reason is absurd.

3. the cost of hearing aid - you pay what you get. the newest one does not require you to change battery - some has wireless/touch charging

4. the reason why they cost so much it is because it is a medical device, personalized to each patient. you can get from aliexpress, but they are almost as useless or even worse than not having anything.

5. government does fund up to certain amount (i think $2k - every few years). if it has to do with work related, ACC will fund it rather than govt. https://www.health.govt.nz/publication/guide-getting-hearing-aids-hearing-aid-funding-scheme

good luck

vexxxboy

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#2065661 31-Jul-2018 13:43

im not sure what the complaints over batteries are, i pay $5 for a months supply of 6 batteries as each battery lasts 6 days and you do get a warning when they are about to run out which gives you 10 or so minutes to replace the battery. You cant go cheap on the batteries as you do get what you pay for . I have tried the Aliexpress type ones but they only last a day or so so you dont save money.

Common sense is not as common as you think.

Fred99

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#2065668 31-Jul-2018 13:53

nakedmolerat:

1. hearing loss is a risk factor for dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527366/

You've misquoted the title of that paper - that is not what the study claims.

It is: Hearing loss as a risk factor for dementia: A systematic review

From the conclusion:

Although cross‐sectional studies provide valuable insight into the correlation of hearing loss and dementia, they cannot provide causality, making it difficult to observe the etiology behind the connection. More prospective studies should be done on this subject in order to identify causation rather than just correlation.

There's only one (of the 17 studies cited) that suggests hearing aids may attenuate cognitive decline. I can think of one obvious confounding factor to that - bias in self-selection of hearing aids by the study group. People with early stage dementia tend to get stubborn - in fact those personality changes usually appear long before any formal diagnosis of dementia. (typically reported retrospectively by family etc - along the lines of "we knew something wasn't quite right for years - never thought it was dementia")

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#2065691 31-Jul-2018 14:38

@nakedmolerat

Thanks for your reply. Sorry to say I find it a bit hard to accept your view that audiologists are not there to promote sales of hearing aids. Some audiologists are employed in the public health system but others are businesses that exist to make a profit - which is probably why some of the big chains advertise quite heavily. I don't see them as being any different to Specsavers.

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jonathan18

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#2065703 31-Jul-2018 15:02

Well, this thread has been the impetuous for me to push my mother to go for a proper test and hopefully determine what aids are suitable (not if she needs them!). In my mother’s case we are also talking early-mid stages of dementia, so there’s that other complexity to deal with (that includes denial of anything that may be seen as related to aging!).

Valuable points made earlier, re the latest and greatest and tiniest hearing aid may not be suitable for some people, and given my mother’s state this could be a key consideration in this case. One likely option, though, is she’ll concede to buying the aids and then just refuse to wear them - just like her personal alarm!

I’ve also elected to book her in with a local, independently owned audiology company and pay for the tests, as I too remain sceptical of the methods employed by some of the firms out there. Also helped to sell it to her that the audiologist is the son of a close friend of my mother’s!

Thanks for the useful information.

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nakedmolerat

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#2065796 31-Jul-2018 17:14

@Fred99:

nakedmolerat:

1. hearing loss is a risk factor for dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527366/

You've misquoted the title of that paper - that is not what the study claims.

It is: Hearing loss as a risk factor for dementia: A systematic review

From the conclusion:

Although cross‐sectional studies provide valuable insight into the correlation of hearing loss and dementia, they cannot provide causality, making it difficult to observe the etiology behind the connection. More prospective studies should be done on this subject in order to identify causation rather than just correlation.

There's only one (of the 17 studies cited) that suggests hearing aids may attenuate cognitive decline. I can think of one obvious confounding factor to that - bias in self-selection of hearing aids by the study group. People with early stage dementia tend to get stubborn - in fact those personality changes usually appear long before any formal diagnosis of dementia. (typically reported retrospectively by family etc - along the lines of "we knew something wasn't quite right for years - never thought it was dementia")

that is disingenous. you quote discussion not conclusion part. systematic review means they are looking at MULTIPLE studies related to the subject.

boy - the conclusion is this:-

While each of the studies included in this study utilized slightly different methods for evaluating participants, each of them demonstrated that hearing loss is associated with higher incidence of dementia in older adults.

Fred99

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#2065809 31-Jul-2018 18:09

nakedmolerat:

@Fred99:

nakedmolerat:

1. hearing loss is a risk factor for dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527366/

You've misquoted the title of that paper - that is not what the study claims.

It is: Hearing loss as a risk factor for dementia: A systematic review

From the conclusion:

Although cross‐sectional studies provide valuable insight into the correlation of hearing loss and dementia, they cannot provide causality, making it difficult to observe the etiology behind the connection. More prospective studies should be done on this subject in order to identify causation rather than just correlation.

There's only one (of the 17 studies cited) that suggests hearing aids may attenuate cognitive decline. I can think of one obvious confounding factor to that - bias in self-selection of hearing aids by the study group. People with early stage dementia tend to get stubborn - in fact those personality changes usually appear long before any formal diagnosis of dementia. (typically reported retrospectively by family etc - along the lines of "we knew something wasn't quite right for years - never thought it was dementia")

that is disingenous. you quote discussion not conclusion part. systematic review means they are looking at MULTIPLE studies related to the subject.

boy - the conclusion is this:-

While each of the studies included in this study utilized slightly different methods for evaluating participants, each of them demonstrated that hearing loss is associated with higher incidence of dementia in older adults.

It's not disingenuous - it was a mistake in a copy paste - that was from discussion - it was close to the final conclusion (below) and I grabbed the wrong text.

My points were that the mistake you made in the title is suggestive that there is a known causative link.

The conclusion you quote above shows a correlation.

The final conclusion states:

Multiple epidemiological studies have shown that hearing loss is an independent risk factor for the development of dementia. Future studies controlling for potentially confounding variables and mechanistic studies will be necessary to further elucidate this association.

And it's still a stretch from there to "prove" that hearing aids reduce (progression of) dementia.

SepticSceptic

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#2065810 31-Jul-2018 18:09

I recall no too long ago that you can approach the aged concern orgaisation for impartial hearing tests.

It was an article in a recent Consumer mag about hearing aids, and did mention about the so called free hearing tests are not really free, and that the hearing aid market in NZ is controlled by 2 multinational companies.

I'll have to check my email when I get home, as I emailed myself the info ...

nakedmolerat

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#2065856 31-Jul-2018 20:12

@eracode:
@nakedmolerat

Thanks for your reply. Sorry to say I find it a bit hard to accept your view that audiologists are not there to promote sales of hearing aids. Some audiologists are employed in the public health system but others are businesses that exist to make a profit - which is probably why some of the big chains advertise quite heavily. I don't see them as being any different to Specsavers.

audiologists are bounded by Health & Disability Act, work closely with ORL & GP - if you truly think they are trying to sell something that is not needed, file a complaint at HDC.

the truth is, most people don't like spending money for their health because they just don't see or understand the long term benefits.

nakedmolerat

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#2065857 31-Jul-2018 20:14

Fred99:
nakedmolerat:

@Fred99:

nakedmolerat:

1. hearing loss is a risk factor for dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527366/

You've misquoted the title of that paper - that is not what the study claims.

It is: Hearing loss as a risk factor for dementia: A systematic review

From the conclusion:

Although cross‐sectional studies provide valuable insight into the correlation of hearing loss and dementia, they cannot provide causality, making it difficult to observe the etiology behind the connection. More prospective studies should be done on this subject in order to identify causation rather than just correlation.

There's only one (of the 17 studies cited) that suggests hearing aids may attenuate cognitive decline. I can think of one obvious confounding factor to that - bias in self-selection of hearing aids by the study group. People with early stage dementia tend to get stubborn - in fact those personality changes usually appear long before any formal diagnosis of dementia. (typically reported retrospectively by family etc - along the lines of "we knew something wasn't quite right for years - never thought it was dementia")

that is disingenous. you quote discussion not conclusion part. systematic review means they are looking at MULTIPLE studies related to the subject.

boy - the conclusion is this:-

While each of the studies included in this study utilized slightly different methods for evaluating participants, each of them demonstrated that hearing loss is associated with higher incidence of dementia in older adults.

It's not disingenuous - it was a mistake in a copy paste - that was from discussion - it was close to the final conclusion (below) and I grabbed the wrong text.

My points were that the mistake you made in the title is suggestive that there is a known causative link.

The conclusion you quote above shows a correlation.

The final conclusion states:

Multiple epidemiological studies have shown that hearing loss is an independent risk factor for the development of dementia. Future studies controlling for potentially confounding variables and mechanistic studies will be necessary to further elucidate this association.

And it's still a stretch from there to "prove" that hearing aids reduce (progression of) dementia.

I guess you miss this sentence?

"Multiple epidemiological studies have shown that hearing loss is an independent risk factor for the development of dementia."

What you highlighted is merely a recommendation of the author(s) reviewing the papers....

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Fred99

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#2065929 31-Jul-2018 21:54

nakedmolerat:

I guess you miss this sentence?

"Multiple epidemiological studies have shown that hearing loss is an independent risk factor for the development of dementia."

What you highlighted is merely a recommendation of the author(s) reviewing the papers....

No I didn't miss that - nor the comment that more research is needed to validate the suggestion that more research is needed (allowing for potentially compounding variables) - and then there would be further studies needed to find out if hearing aids could be useful to ward off dementia.

Lots of things might be useful to ward off dementia. It kind of doesn't matter with hearing aids - as if you need them you need them to ward off all kinds of other issues anyway.

I really do think that something needs to be done about the price of hearing aids - they are way way too expensive for many people, that's a huge barrier if you don't qualify for ACC.

SepticSceptic

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#2066180 1-Aug-2018 11:08

SepticSceptic:

I recall no too long ago that you can approach the aged concern orgaisation for impartial hearing tests.

It was an article in a recent Consumer mag about hearing aids, and did mention about the so called free hearing tests are not really free, and that the hearing aid market in NZ is controlled by 2 multinational companies.

I'll have to check my email when I get home, as I emailed myself the info ...

Found it - Try here:

https://www.lifeunlimited.net.nz/hearing/

eracode

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#2067507 3-Aug-2018 15:21

Just to round-off my OP: The family member concerned has determined that she doesn’t need aids at this stage and has returned them to the probably profit-seeking audiology chain half-way through the two-week ‘free trial’.

If/when necessary later, she will take the excellent approach suggested above by @SepticSceptic.

Appreciate the replies.

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grenow

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#2078389 24-Aug-2018 11:32

Coming to this discussion late - sorry - but thought it might be worth adding a note about some earbuds I bought recently.

I have significant hearing loss in my left ear, and some loss in my right. Menieres disease caused the big loss, loud music and a misspent youth the rest. I have tinnitus in both ears that varies with the weather and alcohol intake. I can function fine without hearing aids in most circumstances (not noisy restaurants/pubs), but it is clear that at some point relatively soon I will need hearing augmentation. I've also steered my aged mother (95 next week) through two sets of hearing aids, so know something about the real things.

Like the OP, and being a cheapskate, I am not keen to drop several (or many) thousands of dollars on "proper" aids. So I have been watching developments in "augmented hearing" apps and earbuds - combinations of phone-based audio processing apps and earbuds that offer a much cheaper approach to addressing some types of loss. There's a lot going on in this space - iOS 12, for instance, will allow Apple's hearing aid link to work with AirPods (https://www.engadget.com/2018/06/05/live-listen-ios-12-apple-airpods/). It's logical enough: current phones pack huge amounts of processing power - much more than even high end hearing aids - so you can do interesting things with them. Overview here: https://9to5mac.com/2017/12/18/airpods-hearing-aid-accessibility/

Anyway: my interest in this field saw my web browsing being chased by ads for hearing products, so called "hearables" - including a fairly aggressive campaign by an Aussie outfit called NuHeara https://www.nuheara.com/ for a product that would make it easier to hear speech in noisy surroundings. I ended up pre-ordering their new IQbuds Boost for $629. My rationale was that even if they didn't solve all my hearing issues, at least I'd have a decent pair of Bluetooth earbuds to listen to music with. They arrived in May, and I've been using them for music playback more than speech processing - but the fact they are compensating for my hearing loss (through a self-test via their phone app) makes music much more listenable. I'm hearing a lot more than just the right channel now... They're also great for listening to the TV, either via Bluetooth or using the built-in speech processing. A review that seems on the money here: https://www.hearingaidknow.com/review-of-the-iqbuds-boost/

I've yet to wear them in a noisy restaurant - vanity at play, ribbing by friends a certainty - but I will do.

For anyone who thinks hearing aids might be in their future, "hearables" technology is advancing rapidly and already offers a (relatively) cheap way to put a toe in the water.

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