Staff Standpoint | July 2018 Hearing Review

There are so many new technologies and research areas being developed that have the potential to radically change the future of hearing healthcare. The list includes nanotechnology; new power sources; sensor-driven functionality that will provide and transmit vital health and environmental data in real time; cloud-based apps that will augment our reality and whisper in your ear the name of that person you can’t remember or translate a foreign language; artificial/learning intelligence that will forever change the world as we know it (a technology that has been evolving in hearing aids for over a decade, learning user preferences and changing parameters, mic directionality, and programs accordingly), and more. My guess is that these areas—each with their own respective R&D and product delivery timelines—will move hearing aids and hearables forward in leaps on par with innovations like WDRC and digital signal processing.

Karl Strom_photoHowever, with the possible exception of sensor-driven functionality, the area with the largest and most immediate effect on our market may be audiology and neuroscience, the focus of this month’s edition of The Hearing Review which is guest-edited by Douglas Beck, AuD. Dr Beck has assembled an amazing package of articles from some incredible researchers. By reading this issue, you will gain greater insight into how we listen, how our brains adapt in response to the auditory information (or lack thereof) received, what tests we might use to gain a better picture of hearing, listening, and understanding, as well as future avenues to assess, diagnose, treat, and monitor the hearing and communication status of patients. 

Not to be missed here is the relationship of good listening and communication for general health, mental well-being, and quality of life. We think with words, and we listen and obtain much of what we know through audition. It’s increasingly apparent that the effort put into hearing and listening well—or, conversely, not doing so—has real neurological indicators and consequences. This is an important theme in each paper. Just to use the first three articles in this issue as examples: 

  • James Jerger, PhD, explains why speech audiometry falls short of Ira Hirsh’s philosophy for helping a person gain the “ability to communicate with his fellows,” and how decision-related auditory tasks and/or auditory event-related potentials (AERPs) might lead us to more useful hearing assessments (he reminds us that a parrot can chirp back and repeat words!); 
  • Anu Sharma, PhD, and Hannah Glick, AuD, show that brain regions responsible for processing auditory information can change, even in the presence of a mild hearing loss (does anyone else find the prospect frightening that hearing loss literally messes with your mind?), and,
  • Sridhar Krishnamurti, PhD, and Larry Wise, AuD, demonstrate how we can use cortical auditory evoked potentials (CAEPs) to “verify, demonstrate, and confirm physiological changes” due to hearing aid use (it’s impressive that we can provide a physician—or regulatory agencies—with proof that our hearing aid services improve brain processing).

So why might this area hurtle to the forefront and change everything? Money. There are staggering social and very real economic costs associated with degraded communication, social isolation, loneliness, depression, cognitive decline and dementia, and loss of independent living. As our population continues to get older and hearing loss continues to be strongly associated with these and other chronic conditions, research into improved communication—with audiology and neuroscience at the helm—should emerge as one of the most obvious and relatively easy/economical fixes. 

Consider two fairly recent studies about dementia only. In the April 4, 2013 New England Journal of Medicine, Hurd et al concluded the “total monetary cost of dementia [in the US] in 2010 was between $157 billion and $215 billion. Medicare paid approximately $11 billion of this cost.” The more recent (July 19, 2017) Lancet study by Livingston et al cited nine factors accounting for 35% of the risk for dementia, with hearing loss being the highest risk factor and close to the top in terms of prevalence (see the article in this issue by Beck, Weinstein and Harvey for more details on the study). The number of dementia patients is expected to triple by 2050.  Follow the money.

Citation for this article: Strom KE. Beyond the ears. Hearing Review. 2018;25(7):6.