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    • Don’t let it get hear
    • Hearing and your health
    • Causes of hearing loss
    • Know your Hearing Number
    • Improve your hearing
    • Protect your hearing
    • Talk to an audiologist
  • HCPs
    • Donʼt let it get hear
    • Hearing and your health
    • Grades of hearing loss
    • Diagnosing hearing loss
    • Treatments
    • Refer your patients
    • Resources
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Know your Hearing Number

A Hearing Number can help you understand the impact of hearing on you or your loved one. If your Hearing Number is over 26, getting a hearing test from an audiologist is recommended. Download the Mimi App to know your Hearing Number.

download on the app store

Download a doctor discussion guide

A proper assessment from an audiologist, or hearing health professional, can help direct you to the right treatment. Fill out this discussion guide and bring it with you when you see an audiologist.

Get the Guide
soc-ear.svg

Hearing loss can disrupt your patients’ health

Changes in hearing can impact your patients’ levels of social engagement, mental well-being, and physical safety¹

Allow

Don’t Allow

Don’t let it get hear for your patients

Hearing loss is the third most reported chronic health condition in the United States.

48%

A study found that for older adults at higher risk of cognitive decline, hearing intervention for 3 years can reduce the rate of cognitive decline by 48%2

77%

According to a study, itʼs estimated that 77% of adults over 40 donʼt realize they have hearing loss3

Hearing is essential for good health

Left unchecked, hearing loss can have multiple effects on overall health, well-being, and quality of life for adult patients, including:

soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17

Hearing is essential for good health

Left unchecked, hearing loss can have multiple effects on overall health, well-being, and quality of life for adult patients, including:

soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17
soc-hcps-cognitive-new.png

Cognitive decline and dementia

  • Treating hearing loss in older adults who are at high risk of dementia can reduce cognitive decline by almost 50%2
  • Dementia is more common in those with hearing loss. Compared to those with normal hearing, the risk of dementia:
    • Doubles with mild hearing loss3
    • Triples with moderate hearing loss3
soc-hcps-comorbidities-new.png

Elevated risks for other conditions

  • Hearing loss has a proven impact on mental health and social interaction18-21
  • People who suffer from cardiovascular disease, diabetes, anxiety, depression and schizophrenia have a higher risk of hearing loss 22-26
soc-hcps-coordination-new.png

Coordination and physical decline

  • Hearing loss has been shown to impact movement, mobility, and balance, including:
    • Walking speed, gait, and endurance13-15
    • Lower extremity function15
    • Vertigo (dizziness)16,17

Know the grades of hearing loss

Your adult patients can experience different levels of hearing loss. The World Health Organization (WHO) has assigned a grade to each level of hearing loss to help patients better understand their current hearing health. Johns Hopkins has matched each grade with a Hearing Number to indicate how loud speech must be for patients to hear it.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

soc-ear-dark@2x.png
Normal Hearing
Hearing Number <25

No hearing loss.

soc-ear-dark@2x.png
Grade 1 Hearing Loss
Hearing Number 26-34

Difficulty hearing soft conversations. Patient may feel like background noise drowns out conversations.

soc-ear-dark@2x.png
Grade 2 Hearing Loss
Hearing Number 35-49

Difficulty with normal conversations. Patient may feel like they need to keep turning up the volume on the TV or radio.

soc-ear-dark@2x.png
Grade 3 Hearing Loss
Hearing Number 50-64

People need to consistently raise their voice for patient to hear them. Patient has difficulty participating in group conversations.

soc-ear-dark@2x.png
Grade 4 Hearing Loss
Hearing Number 65-79

Even with hearing aids, it’s difficult for the patient to understand what people say.

soc-ear-dark@2x.png
Grade 5 Hearing Loss
Hearing Number 80-94

In noisy environments, the patient cannot hear conversations at all, even if people raise their voice.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

soc-ear-dark@2x.png
Normal Hearing
Hearing Number <25

No hearing loss.

soc-ear-dark@2x.png
Grade 1 Hearing Loss
Hearing Number 26-34

Difficulty hearing soft conversations. Patient may feel like background noise drowns out conversations.

soc-ear-dark@2x.png
Grade 2 Hearing Loss
Hearing Number 35-49

Difficulty with normal conversations. Patient may feel like they need to keep turning up the volume on the TV or radio.

soc-ear-dark@2x.png
Grade 3 Hearing Loss
Hearing Number 50-64

People need to consistently raise their voice for patient to hear them. Patient has difficulty participating in group conversations.

soc-ear-dark@2x.png
Grade 4 Hearing Loss
Hearing Number 65-79

Even with hearing aids, it’s difficult for the patient to understand what people say.

soc-ear-dark@2x.png
Grade 5 Hearing Loss
Hearing Number 80-94

In noisy environments, the patient cannot hear conversations at all, even if people raise their voice.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

Now is the time to act, even if you don't currently have concerns about your hearing. New global guidelines recommend adults regularly test their hearing every 1-3 years.18 Download the Mimi App to help you or your loved one know your Hearing Number and track it over time.19

download on the app store

Know the grades of hearing loss

Your adult patients can experience different levels of hearing loss. The World Health Organization (WHO) has assigned a grade to each level of hearing loss to help patients better understand their current hearing health. Johns Hopkins has matched each grade with a Hearing Number to indicate how loud speech must be for patients to hear it.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

soc-ear-dark@2x.png
Normal Hearing
Hearing Number <25

No hearing loss.

soc-ear-dark@2x.png
Grade 1 Hearing Loss
Hearing Number 26-34

Difficulty hearing soft conversations. Patient may feel like background noise drowns out conversations.

soc-ear-dark@2x.png
Grade 2 Hearing Loss
Hearing Number 35-49

Difficulty with normal conversations. Patient may feel like they need to keep turning up the volume on the TV or radio.

soc-ear-dark@2x.png
Grade 3 Hearing Loss
Hearing Number 50-64

People need to consistently raise their voice for patient to hear them. Patient has difficulty participating in group conversations.

soc-ear-dark@2x.png
Grade 4 Hearing Loss
Hearing Number 65-79

Even with hearing aids, it’s difficult for the patient to understand what people say.

soc-ear-dark@2x.png
Grade 5 Hearing Loss
Hearing Number 80-94

In noisy environments, the patient cannot hear conversations at all, even if people raise their voice.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

soc-ear-dark@2x.png
Normal Hearing
Hearing Number <25

No hearing loss.

soc-ear-dark@2x.png
Grade 1 Hearing Loss
Hearing Number 26-34

Difficulty hearing soft conversations. Patient may feel like background noise drowns out conversations.

soc-ear-dark@2x.png
Grade 2 Hearing Loss
Hearing Number 35-49

Difficulty with normal conversations. Patient may feel like they need to keep turning up the volume on the TV or radio.

soc-ear-dark@2x.png
Grade 3 Hearing Loss
Hearing Number 50-64

People need to consistently raise their voice for patient to hear them. Patient has difficulty participating in group conversations.

soc-ear-dark@2x.png
Grade 4 Hearing Loss
Hearing Number 65-79

Even with hearing aids, it’s difficult for the patient to understand what people say.

soc-ear-dark@2x.png
Grade 5 Hearing Loss
Hearing Number 80-94

In noisy environments, the patient cannot hear conversations at all, even if people raise their voice.

soc-ear-dark@2x.png
Grade 6 Hearing loss
Hearing Number 95+

You cannot hear speech and most environmental sounds.

Now is the time to act, even if you don't currently have concerns about your hearing. New global guidelines recommend adults regularly test their hearing every 1-3 years.18 Download the Mimi App to help you or your loved one know your Hearing Number and track it over time.19

download on the app store

Diagnosing hearing loss

To spot the signs of worsening hearing loss, ask patients these 5 questions:

soc-remote.png

Do you need to turn up the volume when watching TV?

soc-hard-hearing.png

Do you struggle to follow everyday conversations?

soc-crowd.png

Do you find noisy environments challenging?

soc-repeat.png

Do you ask people to repeat themselves often?

soc-phone.png

Is it difficult to hear clearly while talking on the phone?

If your patients answer yes to 1 or more of these questions, refer them to a hearing specialist.

Treatment can make a difference

It’s important to know that there are effective treatment options that can help improve hearing and quality of life for patients with sensorineural hearing loss, which is often caused by age-related changes in the inner ear. Choosing the right treatment and listening device is dependent on the cause and grade of hearing loss. Patients will have a separate Hearing Number for each ear, so their treatment options may not be the same for both ears.

Hearing Grade
(Hearing Number)

Grade 0
(<20)

Grade 1
(21-34)

Grade 2
(35-49)

Grade 3
(50-64)

Grade 4
(65-79)

Grade 5
(80-94)

Grade 6
(95+)

Hearing Number

  1. 0
  2. 10
  3. 20
  4. 30
  5. 40
  6. 50
  7. 60
  8. 70
  9. 80
  10. 90
  11. 100

Over-the-counter (OTC) hearing aids

Boosts sounds to make them easier to hear; can be purchased on your own and do not require a prescription

Hearing Number: 10-60

Prescription hearing aids

Programmed to manage an individual's specific hearing loss; fitted and fine tuned by an ear doctor

Hearing Number 25-90

Cochlear implants

Designed to enhance clarity of sound; surgically implanted by an ear doctor

Hearing Number: 60+

Grade 1 Hearing loss

Hearing Number 26-34

Over-the-counter (OTC) hearing aids

Boosts sounds to make them easier to hear; can be purchased on your own and do not require a prescription

Prescription hearing aids

Programmed to manage an individual’s specific hearing loss; fitted and fine tuned by an ear doctor

Grade 2 Hearing loss

Hearing Number 35-49

Over-the-counter (OTC) hearing aids

Boosts sounds to make them easier to hear; can be purchased on your own and do not require a prescription

Prescription hearing aids

Programmed to manage an individual’s specific hearing loss; fitted and fine tuned by an ear doctor

Grade 3 Hearing loss

Hearing Number 50-64

Over-the-counter (OTC) hearing aids

Boosts sounds to make them easier to hear; can be purchased on your own and do not require a prescription

Prescription hearing aids

Programmed to manage an individual’s specific hearing loss; fitted and fine tuned by an ear doctor

Cochlear implants

Designed to enhance clarity of sound; surgically implanted by an ear doctor

Grade 4 Hearing loss

Hearing Number 65-79

Prescription hearing aids

Programmed to manage an individual’s specific hearing loss; fitted and fine tuned by an ear doctor

Cochlear implants

Designed to enhance clarity of sound; surgically implanted by an ear doctor

Grade 5 Hearing loss

Hearing Number 80+

Prescription hearing aids

Programmed to manage an individual’s specific hearing loss; fitted and fine tuned by an ear doctor

Cochlear implants

Designed to enhance clarity of sound; surgically implanted by an ear doctor

Grade 6 Hearing loss

Cochlear implants

Designed to enhance clarity of sound; surgically implanted by an ear doctor

Refer your patients to a hearing specialist

If your patients confide in you about their struggle to hear clearly and have not yet tried prescription hearing aids, it’s important to refer them to a hearing healthcare professional. If your patient struggles even with hearing aids, refer them to an audiologist, who can perform comprehensive audiograms and treatment assessments. An audiologist can then refer the patient to an ear, nose, and throat doctor (ENT) if they need a consult on hearing or cochlear implants11.

Also, per new global guidelines for age-related hearing loss, every adult should have a regular hearing test every 1-3 years12.

Access resources for you and your patients

Refer to these clinical resources to help establish guidelines for hearing loss treatment:

world health hearing number acad sudio
asha american academy of ophthalmology

References

  1. Deafness and hearing loss. World Health Organization. Published February 27, 2023. Accessed April 1, 2023. https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
  2. Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet. 2023;402(10404):786-797. doi:10.1016/S0140-6736(23)01406-X
  3. Ramage-Morin, P.L., Banks, R., Pineault, D., & Atrach, M. (2019). Unperceived hearing loss among Canadians aged 40 to 79. Health Rep, 30(8), 11-20
  4. Kelsall D, Lupo J, Biever A. Longitudinal outcomes of cochlear implantation and bimodal hearing in a large group of adults: a multicenter clinical study. Am J Otolaryngol. 2021;42(1):102773. doi:10.1016/j.amjoto.2020.102773
  5. World Report on Hearing. Geneva: World Health Organization; 2021. License: CC BY-NC-SA 3.0 IGO (page 17)
  6. Besser J, Stropahl M, Urry E, Launer S. Comorbidities of hearing loss and the implications of multimorbidity for audiological care. Hearing research [Internet]. 2018;369:3–14.
  7. Qian P, Zhao Z, Liu S, Xin J, Liu Y, Hao Y, et al. Alcohol as a risk factor for hearing loss: A systematic review and meta-analysis. PloS one [Internet]. 2023;18(1):e0280641.
  8. Tonelli M, Wiebe N, Lunney M, Donald M, Howarth T, Evans J, et al. Associations between hearing loss and clinical outcomes: population-based cohort study. eClinicalMedicine [Internet]. 2023;61.
  9. Baiduc RR, Sun JW, Berry CM, Anderson M, Vance EA. Relationship of cardiovascular disease risk and hearing loss in a clinical population. Scientific reports [Internet]. 2023;13(1):1642.
  10. Lindeborg MM, Jung DH, Chan DK, Mitnick CD. Prevention and management of hearing loss in patients receiving ototoxic medications. Bulletin of the World Health Organization [Internet]. 2022;100(12):789.
  11. Johns Hopkins Cochlear Center for Hearing and Public Health. https://hearingnumber.org/. [Last accessed November 2023].
  12. Cochlear Implant Task Force. Improving the standard of care for adults with hearing loss and the role of cochlear implantation: Living Guidelines. Available at https://app.magicapp.org/#/guideline/6719. Accessed 25th Feb 2023
  13. Viljanen A, Kaprio J, Pyykkö I, Sorri M, Koskenvuo M, Rantanen T. Hearing acuity as a predictor of walking difficulties in older women. Journal of the American Geriatrics Society [Internet]. 2009;57(12):2282–6.
  14. Agmon M, Lavie L, Doumas M. The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review. Journal of the American Academy of Audiology [Internet]. 2017:28(6):575–88.
  15. Foster JI, Williams KL, Timmer BHB, Brauer SG. The Association between Hearing Impairment and Postural Stability in Older Adults: A Systematic Review and Meta-analysis. Trends in Hearing [Internet]. 2022;26:1–22.
  16. Johansson M, Andersson G. Prevalence of dizziness in relation to psychological factors and general health in older adults. AUDIOLOGICAL MEDICINE [Internet]. 2006;4(3):144–50.
  17. Aarhus L, Tambs K, Hoffman HJ, Engdahl B. Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Internet]. 2016;273(8):2047–54.
  18. Shukla A, Harper M, Pedersen E, Goman A, Suen JJ, Price C, et al. Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology—head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. 2020;162(5):622–33
  19. Lawrence BJ, Jayakody DMP, Bennett RJ, Eikelboom RH, Gasson N, Friedland PL. Hearing Loss and Depression in Older Adults: A Systematic Review and Meta-analysis. The Gerontologist [Internet]. 2020: e137–54.
  20. Shoham N, Lewis G, Favarato G, Cooper C. Prevalence of anxiety disorders and symptoms in people with hearing impairment: a systematic review. Social psychiatry and psychiatric epidemiology. 2019;54(6):649–60.
  21. Huang AR, Jiang K, Lin FR, Deal JA, Reed NS. Hearing Loss and Dementia Prevalence in Older Adults in the US. JAMA. 2023;329(2):171–3. doi: 10.1001/jama.2022.20954
  22. Besser J, Stropahl M, Urry E, Launer S. Comorbidities of hearing loss and the implications of multimorbidity for audiological care. Hearing research [Internet]. 2018;369:3–14.
  23. Tonelli M, Wiebe N, Lunney M, Donald M, Howarth T, Evans J, et al. Associations between hearing loss and clinical outcomes: population-based cohort study. eClinicalMedicine [Internet]. 2023;61.
  24. Baiduc RR, Sun JW, Berry CM, Anderson M, Vance EA. Relationship of cardiovascular disease risk and hearing loss in a clinical population. Scientific reports [Internet]. 2023;13(1):1642.
  25. Saperstein AM, Meyler S, Golub JS, Medalia A. Correlates of hearing loss among adults with schizophrenia. Schizophrenia research [Internet]. 2023;257:1–4.
  26. Linszen MMJ, Brouwer RM, Heringa SM, Sommer IE. Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses. Neuroscience & Biobehavioral Reviews [Internet]. 201;62:1–20.
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The information provided above regarding certain health-related conditions and/or potential therapies or treatment options is for educational purposes only. Other therapies or treatment options may be available. Appropriate treatment for individuals is a matter for healthcare professionals in consultation with each individual. Ask your healthcare provider for more information.

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