Opening the Market for Lower Cost Hearing Aids: Regulatory Change Can Improve the Health of Older Americans

Hearing loss impairs communication, an essential human function. 1 The most common cause is age-related hearing loss (ARHL), characterized by progressive hearing loss and degraded speech comprehension in both ears. In the United States, one quarter of adults aged 60 to 69 years have a bilateral disabling hearing loss; this climbs to nearly 80% among those aged 80 years and older.(2) ARHL reduces quality of life(3) and is associated with social isolation(4) and depression(5) - problems that are important in their own right and are risks for medical conditions such as cardiovascular disease. Hearing loss is also associated with falls, fractures, and faster cognitive decline. Hearing loss disrupts health care. Compared with adults with normal hearing, those with hearing loss report worse communication with their physicians.(6) They also report overall poorer health care quality.(6) Because many older people have complex medical problems, these disruptions pose a serious challenge. In this commentary, we contrast the high population burden of disability with the low prevalence of hearing aid ownership among older Americans. We describe cost as a barrier toownership and discuss a recent high-profile call for regulatory change that could substantially lower costs. We note factors beyond cost that need to be addressed to improve hearing health and functioning.cited cost as a major deterrent to buying a hearing aid.(9)