We often hear from our patients with untreated hearing loss that they can’t be bothered to attend social gatherings anymore, that they feel somewhat withdrawn and are starting to feel depressed. The difficulty of trying to hear what people are saying in cafes, restaurants, pubs, family events, in fact, anything with background noise, can be more than a little tricky.

In social situations, the person with hearing loss may not be understanding what you are saying yet is too embarrassed to say anything and so may sit there quietly in the corner nodding in where they think the right places are or just nursing a drink quietly. Just because they are there in in the social situation doesn’t mean they can engage in conversation.

It can be confusing for everyone as what we often find is that in a 1:1 situation where there is very little background noise, the person can hear no problem and so therefore, they don’t feel they have a hearing problem. However, as soon as any background noise is thrown into the mix, they can drown a little as the clarity of speech has gone for them.

Even a mild hearing loss can affect our clarity of speech in social situations. The reason for this is that the key speech sounds for differentiation between words such as “toast” and “coast”, “squeak” and “reak”, “fish” and “dish”, “key” and “tree” are sounds that are essentially unvoiced and are high frequency. Sounds such as “f” “s” “th” are tiny weeny sounds that we make with our lips and teeth and have very little energy to them. Rather than sound such as “m”, “b”, “d”… these are all quite high volume and powerful low frequency sounds.

Usually, when our hearing starts to deteriorate, the high frequency sounds drop off first. Background noise is typically low in frequency. Remember how speech clarity sounds are tiny weeny and in the high pitches? Well if you have reduced hearing in the high pitches but reasonable low frequency hearing, that background noise is going to swallow up those crucial high frequency sounds like “f”, “s”,”th”, “t”… and so on, like a PacMan and so you may be confused as to what is being said.

If we’re lacking the clarity of speech, this can affect our confidence, our ability to engage in conversations, and even how we remember what has been said; after all, how are we able to remember a conversation easily if the signal reaching our brain is blurred?

We don’t have unlimited cognitive resources.

If someone has “normal” hearing, they are able to apply equal levels of attention to what is being said in background noise (unless they have a processing disorder) whilst being able to carry out additional tasks. This isn’t true for those with hearing loss. People with hearing loss have to use up a lot more energy on trying to process what is being said, which can leave them both physically and mentally tired, leaving them with less energy to perform other cognitive tasks.

Did you know that people with untreated mild hearing loss are 2 x more likely to develop dementia?

Did you know that people with untreated moderate hearing loss are 3 x more likely to develop dementia?

Did you know that people with untreated severe hearing loss are 4 x more likely to develop dementia?

The Lancet published (2020) that hearing loss is a modifiable risk factor for developing dementia, particularly in those in mid life or aged 45-65 years of age.

ENT News Today report that Dr Livingston advises that “There is neuroradiological evidence of brain atrophy associated with hearing loss.” The brain quite literally shrinks due to untreated hearing loss.

However, the good news is that the 2020 report in The Lancet outlines that hearing aids can be an enormous help in assisting with assisting in cognitive function as consequence of hearing loss.

In the illustrated example above you can see that consonant sounds such as “t” and “st” give the clarity of speech which is why someone even with a mild hearing loss may report that everyone mumbles. It’s hard for them to understand that they may have hearing loss as hearing loss is more often than not, gradual, and it’s invisible, unlike eyesight.

Often people can start to fill in the blanks through body language and context and so for it may take a long time for someone to approach an audiologist for hearing testing.

However, the sooner you see a hearing professional, the better for your overall wellbeing and cognitive function.