New Research: Hearing Aids Help Ward Off Dementia — Study Author Reveals Who Benefits The Most

Hearing aids can be life-changing for people with hearing loss — after all, not being able to hear can significantly affect your quality of life. So when the sense of hearing is restored, life can get a lot easier and more enjoyable. What’s more, new research finds that hearing aids can be a critical tool in the fight against cognitive decline in older adults. And now that hearing aids are available over-the-counter at stores like Walmart, it’s easier — and more affordable! — than ever to secure the devices.

That said, we tapped experts, including the author of this groundbreaking study, to get you the details you need to know if you’re considering hearing aids for yourself or a loved one.

Can hearing aids help ward off dementia?

Exciting new research out of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, a multicenter randomized trial involving 977 older adults ages 70 to 84 years with untreated hearing loss, addresses that very. The goal of the study was to learn if treating hearing loss in older adults reduces the loss of thinking and memory abilities (cognitive decline) that can occur with aging. 

The new study, published in The Lancet, found that older adults with hearing loss who were also at risk of developing dementia slashed cognitive decline in half by wearing hearing aids for three years.  

According to Frank Lin, MD, PhD, lead author of the ACHIEVE study and professor at Johns Hopkins University School of Medicine and the Bloomberg School of Public Health, hearing aids, audiological counseling and other hearing interventions slowed the loss of thinking and memory abilities by 48% over three years in older adults at an increased risk for cognitive decline and dementia.  

3 ways hearing loss can lead to cognitive decline

“We’ve known for over a decade that hearing loss is strongly linked with risk of dementia and cognitive decline,” says Dr. Lin. “However, we didn’t know if treating hearing loss could, in fact, reduce cognitive decline and potentially even lower the risk of dementia.” He says there are three main mechanisms that explain why hearing loss may be associated with dementia.

First, with hearing loss, Dr. Lin says speech and sound are garbled by the time they reach the brain, and that requires the brain to use extra effort for processing the signals that come from the ear. “The brain then has fewer resources for supporting thinking and memory abilities,” says Dr. Lin. 

Second, with hearing loss, Dr. Lin says the parts of the brain that are stimulated by speech and sound are now under-stimulated, and that can lead to atrophy (decrease in size) and changes in brain structure and function. And finally, hearing loss can make communicating with others more difficult, leading to social isolation, another risk factor for dementia.

The good news? Dr. Lin says treatment of hearing loss with hearing aids does not carry any health risks. “That’s why we recommend clinicians encourage patients to get their hearing tested and to consider addressing any hearing loss that may be present,” he adds. 

The difference between prescription and OTC hearing aids

Choosing the right hearing aid can be a daunting task, especially when deciding whether to opt for an over-the-counter (OTC) hearing aid or a prescription hearing aid. Although both types of hearing aids can enhance your hearing ability, it’s important to understand the significant differences before making your purchase.

What is a prescription hearing aid?

Prescription hearing aids are specialized hearing devices appropriate for mild to profound hearing loss. These devices are custom-fitted to your specific hearing needs and require a comprehensive hearing evaluation and recommendation, plus a prescription from a qualified audiologist or hearing care professional. 

Prescription hearing aids come in various technology levels and offer features such as noise reduction, directional microphones, Bluetooth connectivity, smartphone apps for control and compatibility with other assistive listening devices. You also get ongoing professional support, which is a top priority for many older adults. 

If you have moderate or greater hearing loss, asymmetric hearing loss (i.e., one ear hears worse than the other), very narrow ear canals, poor dexterity or more complex needs, Amy Sarow, AuD, lead audiologist at Soundly, says you will be best served with prescription hearing care.

What is an OTC hearing aid?

In an effort to increase access and affordability to the public, the U.S. Food and Drug Administration (FDA) established a new category of hearing aids called over-the-counter (OTC) hearing aids. These new devices do not require a hearing exam or prescription and are available in a variety of settings, including retail stores like Walmart and Best Buy, your local pharmacy or drugstores such as Walgreens and CVS or through various online providers. 

While easier access and lower prices are definite perks of OTC hearing aids, they are only approved for adults 18 and older with perceived mild to moderate hearing loss. You’re also responsible for setting the device up, fitting it to your ears and tuning the sound, which may not be ideal for some people. And if you compare them to prescription hearing aids, OTC devices have limited features and loudness output, which is why they are not recommended for people with moderate to profound hearing loss. 

There is some good news about OTC hearing aids: In a study published in JAMA Otolaryngology-Head & Neck Surgery, when study subjects were given OTC hearing aids and instructions on how to self-fit the devices with a smartphone app, the devices corrected their hearing as effectively as subjects who were fitted for the same hearing aids by an audiologist. The researchers note that the settings on OTC aids can often be adjusted via apps, making it easier to get the device to fit.

“The need for OTC is definitely there, especially since only one-third of people who could benefit from a hearing aid actually get one,” says Rebecca Lewis, AuD, audiologist and Audiology Director of the Adult & Pediatric Cochlear Implant Program at Pacific Neuroscience Institute in Santa Monica, CA. “Hopefully, OTC hearing aids will improve access and encourage people to treat their communication difficulties,” says Lewis. However, Lewis says there are still valid reasons to see a hearing healthcare professional. “Consumers need to be savvy when considering OTC products to ensure they are safely benefiting from this new, exciting technology,” she adds. 

How much do hearing aids cost at Walmart?

Hearing aids are a pricey investment, but affordable options that don’t compromise quality are available. In general, costs range from $199 to over $8,000, depending on the brand, model, type and where you purchase the hearing aid. Prescription hearing aids cost between $2,000 and $8,000 per pair. But budget-priced options like the OTC hearing aids available at Walmart average between $200 to $1,000 per pair, resulting in a significant savings for you. 

Does insurance cover the cost of hearing aids?

Some private insurance plans cover a portion of prescription hearing aid costs, while others offer no benefits for hearing aid expenses. Medicare Part A and Part B do not offer hearing aid benefits. If you have one of these plans, you will be required to pay the full cost of hearing aids and exams. 

But if you have a Medicare Advantage Plan or Part C, you may be eligible for extra benefits that Original Medicare does not cover. To determine if you have benefits to apply towards hearing aid prices with Medicare Part C, contact your plan provider for more information.

One way to make paying for hearing aids easier is to use a health savings account (HSA) or flexible savings account (FSA) if you have one. 

Tips for choosing a hearing aid at Walmart and elsewhere

Finding a hearing aid that fits properly, accommodates your hearing loss and works with your budget may take some trial and error, but there are a few tips to ensure the process goes smoothly. 

Get a hearing evaluation

For anyone new to hearing aids, Sarow recommends having a hearing evaluation first. “Hearing evaluations provide good information, including whether OTC devices or prescription hearing aids are appropriate,” she says. Plus, because OTC hearing aids do not require a comprehensive audiologic or medical evaluation, Lewis says you may miss treatable hearing conditions, such as impacted ear wax, and those that need medical attention, such as asymmetric hearing loss. Walmart offers hearing evaluations at their Walmart Health Centers for a seamless evaluation and shopping experience. 

Consider the type of hearing aid and hearing loss 

Behind-the-ear models are larger and therefore, easier to handle. Completely-in-the-canal and other in-the-ear hearing aids are smaller and might be difficult to manage if dexterity is an issue. Also, the type of hearing loss is vital. 

Most hearing aids styles and brands work with mild to moderate loss, but if you have moderately severe to profound hearing loss, you will likely require a specific type of device. If you hear reasonably well in quiet situations but struggle in background noise, Lewis says you may be a good candidate for an OTC hearing aid.

Decide if you want ongoing support

Customer support is a critical factor when deciding on a hearing aid. Access to a hearing care professional for help and support is a nice feature when using a hearing aid. But it is typically only available with a prescription hearing aid. You will not get ongoing support with an OTC hearing aid. 

Find the right brand to match your budget

When shopping for an OTC hearing aid, Sarow recommends the Lexie B2 Powered by Bose (buy from LexieHearing, $999). “It’s a great product for the price point,” she says. But if you’re looking for a discrete OTC option with a little more budget to spend, Sarow says Eargo (buy from Eargo, $1,490) is a good choice. As for prescription products, which come with a much higher price tag, Sarow says any of the top six manufacturers are a good choice: GN ReSound, Phonak, Starkey, Signia, Widex, and Oticon.; all are available at Walmart and other retailers.

Finally, check out this inclusive article from our sister site for advice on To save money on hearing aids.

For more advice on protecting your hearing, check out these stories:

Expert Advice: ‘Do OTC Hearing Aids Really Work?’

3 Surprising Things You Can Do Right Now to Prevent Hearing Loss

Say What? New Study Finds Link Between Hearing Loss and Healthy Diet

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.