Which Will it Be? Dementia, or Hearing Better Than a Normal-Hearing Person

In my work, I keep track of technology developments across a variety of fields to try to better anticipate what the future might be like (especially for media and news). Since getting hearing aids about a year and a half ago, and becoming a contributor to this blog, I’ve (of course) included advancements in hearing technology as well as hearing medicine and research to my scanning routine.

Lately, there’s been a lot of activity in the “hearing” space, both positive and worrying. (Since I am, for the most part, a technology optimist, I believe — and hope — that a positive hearing future is more likely.)

JANUS  (from Vatican Collection)
Photo credit: Jim Gardner

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How Exponential Growth in Computing Power Will Bring About ‘Magical’ Hearing Aids

On National Public Radio’s “All Things Considered” recently was the story of a woman whose hearing problems were diagnosed at age 5, in 1993. She had moderate to severe loss of high- and low-frequency hearing, and got her first hearing aids — which were large and crude compared to today’s hearing-aid technology.

You can read or listen to the story here: “Hearing Aid Evolution Unveils What The World Sounds Like In ‘3-D’.”Music to the ear, notes flow into an ear

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Test Your Own or Family Members’ Hearing Yourself: Why Not?!

If a child has a hearing problem, it’s usually the case that a parent or teacher will notice it, and the kid gets a first visit with an audiologist for testing.

With adults who experience hearing loss over a long, slow period of time, it’s too common for a trip to the audiologist to get delayed, often on the order of several years. (The average procrastination period from first noticing a possible hearing issue to getting hearing aids is seven years, as I’ve noted in previous posts here. An estimated 50% of people who could benefit from hearing amplification do nothing about it, ever.)

All involved parties — the hearing-impaired person, that person’s family and friends, audiologists, and hearing-aid manufacturers — benefit from reducing that seven-year wait to get the technology in the ear in such cases. Fortunately, new technology for personal computers, smartphones, and digital tablets appear poised to address this problem.

One of my fellow bloggers here on Open Ears recently pointed me to Mimi, a nice app for Apple iPhones and iPads. (Sorry, it’s only for the Apple crowd for now; but, there are alternative self-hearing-test solutions for everyone else. More on that later.) It’s a brilliant free app, developed by audiology entrepreneurs Philipp Skribanowitz and Pascal Werner, which allows you to quickly test your hearing and get results that aren’t much different than if you got tested by an audiologist. It can then simulate what your corrected hearing would be like, which can be an eye-opener, or perhaps “ear-opener” is the better term. To do a Mimi test, you can use either a good-quality pair of over-the-ear headphones or the earbuds that came with your iPhone or iPad, and find as quiet a place as possible to run the test.

(This TechCrunch article gives a good overview of the app and Mimi’s founders’ hopes for their technology.)

OK, let’s get this out of the way first: you wouldn’t want to depend on the results of an at-home hearing test on your phone to order hearing aids using your do-it-yourself audiogram. One big reason: you won’t be testing in a soundproof room. But, a quick self-test might just make some people realize that they have some hearing loss, and motivate them to get a professional hearing test sooner.

After testing myself, sans hearing aids, using Mimi and a pair of over-the-ear headphones and confirming the obvious — that I have hearing loss bad enough to require a solution — I convinced my wife to test her ears using the Mimi app. Her self-perception is that she does not have hearing loss yet, at age 54. In recent months, I’ve wondered if she’s got a bit of hearing impairment going on, since it’s happened more often that she can’t understand something I’ve said. (It’s also possible that I sometimes speak a bit quieter in private conversations since getting my hearing aids one year ago, the result of perceiving my own voice as being louder when I speak than pre-hearing aids.)

She agreed to let me post the results of her Mimi test here:


So, not great, but not terrible. Her Mimi-calculated “hearing age” is three years older than her physical age. And as the chart on the left shows, she has a bit of trouble hearing at higher frequencies; and her left ear appears to be functioning not quite as well as her right.

What really raised my wife’s eyebrows in amazement was when she had Mimi simulate hearing as if it was corrected based on the profile above. She noticed a significant difference, and told me that she was quite surprised by that.

While she still doesn’t think she’s ready to get hearing aids, this little experiment did make her aware of the typical hearing loss of an adult in her mid 50s compared to when she was younger. Her plan is to get an appointment at our audiologist’s office for earwax removal, which she suspects will improve her hearing.

Sure, this test with my spouse was anecdotal, but I believe that if more people who suspect that their hearing isn’t what it used to be — or who hear from family and friends that they should consider getting their hearing checked — could be exposed to the existence of the Mimi app and other alternatives, many more people would check their own hearing at home. It’s less threatening or scary than visiting an audiologist, who “might find something seriously wrong with my ears” or be an “unnecessary expense.” Such self-tests most likely will result in more people with age-related hearing loss making that appointment with an audiologist sooner, since the app’s data will show what their minds have been denying.

As mentioned above, Mimi is not the only self-test application out there. Here are a few other options:

  • Self-Test for Hearing Loss Checklist: this is simply a list of symptoms that may indicate hearing impairment. It’s a good place to start prior to taking a self-serve online or mobile-device hearing test.
  • Online Hearing Test at OnlineAudioClinic.com.au: use your computer and headphones for this; it tests ability to decipher spoken words over varying background-noise levels.
  • Online Audiogram Hearing Test: another computer-and-headphones test; this one uses tones to determine your personal audiogram.
  • Test Your Hearing (Android app): less sophisticated than Mimi, but works on smartphones running the Android operating system.
  • Hearing Test (Android app): another smartphone app for Android that creates a self-test audiogram.
  • Hearing Test (iPhone/iPad app): here’s one more for Apple users; this one costs US 99 cents.
  • Search Google for more. There are lots of online hearing tests, and a lesser number of mobile apps. Fortunately, most of them are free.

Flaunt It Or Hide It? A Future Hearing-Aid Scenario

The hearing-impaired community is diverse, and certainly not of one mind. Such is obvious when it comes to the “debate” that surfaced on one of my Open Ears posts from April, about my personal desire to use hearing aids that are as “invisible” as possible.

Do you flaunt it or hide it?
Do you flaunt it or hide it when it comes to your hearing aids? (Photos by UMHealthSystem and Erik Holfelder)

There are plenty of hearing-impaired people who prefer to flaunt their hearing aids, not only as a way to make their devices a fashion statement — in the same way as most people who wear eyeglasses spend a lot of time selecting just the right, fashionable frames — but also to make a different kind of statement. One commenter on my April post nicely explained the “flaunt them” point of view:

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Future Ears: What If You Could Have ‘Super Hearing’?

For most readers of this blog, the biggest concern is how to improve hearing that’s degraded over the years, or that’s been impaired since birth, or due to overexposure to loud noises, an accident or disease.

But in the not-too-distant future, the hearing-impaired community as well as those with normal hearing could also be thinking about adding “super hearing” abilities.

I’m not kidding. In research labs today are working prototypes of “bionic ears” that can far surpass the capabilities of even the healthiest human ear. It’s just a matter of time before we mere humans can be augmented with “cybernetic” technology that allows us to hear sounds that the human ear is not capable of discerning, or focus our hearing on a specific spot in order to hear, say, a conversation taking place a football-field’s length away, or even listen to radio frequencies (for a real-life voice in your head that only you can hear).

This is the stuff of science fiction and fantasy novels. If you’re a Harry Potter fan, either the books or the movies, you’ll recall Harry’s handy Extendible Ears. Popular culture also has brought us The Six Million Dollar Man (Lee Majors) of the 1970s TV series, and earlier this year, the remake of Robocop — both almost-dead people given new lives with technology replacing once-biological capabilities.

Blue Ear Deaf Superhero
New technologies and research are turning super-hearing fantasy into reality. (Illustration: ‘Blue Ear’ superhero concept by Marvel Comics)

There’s even the hearing-impaired Marvel Comics superhero, BlueEar, who was created by the media company at the request of a mother whose young hearing-impaired son didn’t want to wear his hearing aids. While BlueEar was limited to a poster and a marketing campaign to promote acceptance of hearing aids by young users, Marvel’s Hawkeye superhero actually did use hearing aids for part of his “career,” after losing much of his hearing during an epic battle with an archenemy.

But enough fantasy; back to reality. Check out the video below which shows how researchers at Princeton University were able to create an actual ear replacement using low-cost 3-D printing that interwove biological tissue with functional electronics.

[youtube http://www.youtube.com/watch?v=duusG6LBWoo]

The researchers still have to solve the challenge of interfacing hard electronic materials (such as the coiled wire that protrudes from the bionic ear) to soft biological materials (i.e., connecting the electronic output to the body’s nerves). The Princeton work shown above is considered a successful proof-of-principle study demonstrating that tissues and electronics can be combined to form hybrid, bionic organs. And the “ear” you see in the video picks up radio signals only, but to add picking up audible sounds is just a matter of incorporating another type of sensor.

The Princeton and similar research is good news for people of the future who may be born deaf, with an ear deformity, and anyone who is severely hearing impaired who may opt to have the ear that nature gave them replaced by a cosmetically identical bionic ear which will provide far better hearing than even the best hearing aid can offer them. Of course, such a procedure won’t be inexpensive; it’s a coming solution for the worst cases.

As a futurist, I get excited thinking about scientific and technological advances like these. People like me with mild hearing loss can regain normal or close-to-it hearing with today’s hearing aids. (I hear well with my hearing aids, but since I still perceive a constant high-pitched tone from my tinnitus, my hearing isn’t what it was when I was younger.) But gazing ahead just a few years, we should be looking at hearing aids that offer better-than-before hearing ability, and additional hearing powers that aren’t part of the standard human capabilities that we’re born with.

So, no, having a surgeon replace my natural ear with a bionic ear isn’t for me — or most of us. (Actually having this available is estimated to be about three years away.) But what I am looking forward to is when future hearing aids do more than just “fix” my hearing problem. Here are some ideas for a hearing aid of the future that would give you auditory “super powers” (without the surgery part):

Hearing aids that have user-directed, super-directional listening “beams” to clearly hear sound from where you’re looking, while noise from elsewhere is mostly blocked out. Many high-end hearing aids on the market today can do this to a degree, but researchers in Australia are working on technology that will improve on this vastly. (This is the kind of hearing super-power that might attract purchases and usage from non-hearing impaired people who often find themselves in high-noise environments. Surely it also will be coveted by CIA agents, detectives, private investigators, and their ilk.)

“Super-powered” hearing aids incorporated into “smart glasses.” Futurist Thomas Frey has described a future where smart glasses like Google Glass (of which there are a growing number of competitors) include augmented-hearing functionality. (“How Google Glass will Disrupt the Hearing Aid Industry?“)

Frey notes that Glass currently has an audio component:

“Glass does not have a typical earpiece but instead transmits sound through bone conduction. The use of this kind of non-obtrusive sound amplification creates the possibility for a device used as a hearing aid for those with low-level hearing loss. … Naturally a number of in-ear attachments could also be attached to compensate for whatever kind of hearing loss issues an individual is dealing with.”

Google Glass attempts to do a lot of things; it’s like having a computer on your face (albeit the computing power comes largely from Glass’ wireless link to the smartphone that you’re carrying). But not all smart glasses need to do so much. I envision a product that combines my eyeglasses and hearing aid into a single unit. Perhaps it would use bone conduction, or an in-ear receiver could be attached by a wire or cord to the glasses’ temples. … But here’s the great extra feature: stereo mini “shotgun” microphones on the sides of the eyewear facing forward, which can be enabled to allow focused hearing on what you’re looking at (to help in those noisy-environment situations I described earlier).

As Frey points out in the article linked to above, the future likely will bring “apps” — like those you can add to your smartphone, or to Google Glass — to hearing aids. Hearing apps might be installed on your smartphone, if it is communicating and controlling your hearing aids; or, in the case of smart glasses with built-in hearing aids, the apps are for the glasses.

Hearing-aid apps? Huh? … There are many, many possibilities. Perhaps you’d be interested in an app that allowed you to turn on police communication within a 1-mile radius of your current location and feed it directly to your ears. Or how about an audio translation app that let’s you understand a foreign-language speaker?

The future really is exciting for those of us with ears — whether they work well or are impaired.

Baby Boomers Will Be Sporting More Hearing Devices

As a media futurist, I’ve been pondering what’s ahead for hearing aids since I first got a pair less than a year ago to improve my own deteriorating hearing. “Futurists” can’t precisely predict the future — no one can — but it is possible to identify likely “plausible” futures, or forecasts that are among the most likely to be accurate.

I’ve been thinking for a while that people with mild hearing issues who are in middle age today will begin to purchase hearing aids at a younger age than their elders did. A bit of support for that prediction came this week in a well-done New York Times article, “Conjuring Images of a Bionic Future,” by technology columnist Farhad Manjoo. He wrote:

“It’s only a slight exaggeration to say that the latest crop of advanced hearing aids are better than the ears most of us were born with. The devices can stream phone calls and music directly to your ears from your phone. They can tailor their acoustic systems to your location; when the phone detects that you have entered your favorite sports bar, it adjusts the hearing aids to that environment.

“The hearing aids even let you transform your phone into an extra set of ears. If you’re chatting with your co-worker across a long table, set the phone in front of her, and her words will stream directly to your ears.

“… I’m 35 and I have normal hearing. But if I could, I’d wear these hearing aids all the time.”

Most longtime hearing-aid users, I’m certain, don’t consider hearing aids “sexy.” But the new surge of features that turn new models into something “more than just hearing aids” have the potential to become desired wearable-technology devices.

You may be familiar with the term “wearables” used to describe small advanced technology devices that are worn on the body: fitness trackers, smart watches, smart glasses, wearable tiny cameras, etc. Get ready for “hearables” to be the next big thing. In fact, analyst Nick Hunn predicts in an upcoming market forecast that hearables, or smart earbuds, will be a $5 billion market by 2018. Of course, many of these coming-soon in-ear computing devices will not be primarily for solving hearing problems, but rather to provide users with entertainment, information, and communication direct to the ears.

Photo from Warner Bros. Pictures
In the recent movie “Her,” the main character (Joaquin Phoenix) wears a cordless ear device to communicate with his custom artificial-intelligence operating system, or digital assistant.

Now, I don’t expect that non-hearing-impaired teenagers and young adults will begin appearing in public wearing hearing aids. But the coming wave of cordless smart earbuds — no more tangled earbud wires! — using some of the same technology mentioned in the Times article to provide streaming music and phone calls directly to the ears, should sell well to the mass market. That strikes me as a safe prediction. Early devices in that category — for those with normal hearing — are still too visible to others and have short battery life, but it’s only a matter of time before they get better and are made more “invisible.”

What’s more likely (i.e., a plausible future) is that people with still-mild hearing problems will get tested, fitted for, and purchase new and coming-soon models of hearing aids with innovative, dare I say it, “sexy” features, earlier than the generation ahead of them did.

Currently, the average time that it takes a person who first recognizes that his or her hearing is declining to actually purchase hearing aids is about 7 years! (USA-only figures.) That sounds about right; my own experience was noticing some tinnitus and high-frequency hearing loss several years before purchasing my first pair of hearing aids.

Pete, a friend in his late 40s (I’m 57), seemed to confirm the validity of my prediction. I’ve told him about my experience, from the traditional (vast improvement in quality of life since my hearing aids restored the ability to hear birds sing and hold a cogent conversation in a noisy restaurant) to the innovative (how I love walking the family dog with music streaming in my ears and smartphone in a pocket, sans wires). Pete told me that while he had noticed some mild hearing loss, he hadn’t considered exploring hearing aids until he had that conversation with me.

Pete also noticed the Times coverage mentioned above, and forwarded me the article with these words: “I am starting to consider this hearing-aid thing, even before my hearing gets worse. Why wouldn’t I want to hear better than the average person?”

So, as far as “plausible scenarios” for the future of hearing aids, I’ll confidently predict that one is that of those people, especially in the Baby Boom age bracket, who begin to experience hearing decline, the time between recognition of the (still-minor) problem and resolution (purchasing hearing aids) will drop significantly from the current 7-year-average lag.

I hope that this future scenario does play out. It will improve the lives of many hearing-impaired individuals who otherwise would have procrastinated about finding a solution. And, of course, the makers of hearing aids will benefit from a growing customer base with a lower average age than current hearing-aid users. This likely future scenario also could be expected to increase the percentage of people with hearing problems who actually purchase and use hearing aids (which MarkeTrak estimates at only 25%), especially if hearing-aid prices drop due to technology trends and manufacturers getting a much larger customer base.

This sounds all rosy, I realize, but it’s not so simple. Modern hearing aids remain expensive, and millions of people suffer with untreated hearing loss because they cannot afford to purchase them. This is especially a problem in countries like the USA, where health insurance most often excludes coverage for hearing aids. The U.S. Affordable Care Act (better known as “Obamacare”) takes hearing aids into consideration, but most states’ ACA health insurance offerings don’t cover hearing devices, nor does Medicare.

Nations with more-generous healthcare systems (e.g., Finland) don’t leave behind as many poor people with impaired hearing — but even with hearing-aid assistance from a single-payer health-insurance system, the less affluent probably won’t be able to afford to upgrade to models that include “fancy” features such as linking with a smartphone.

Still, this technological revolution in hearing-aid technology should improve what today are some dismal statistics. Indeed, if hearing-aid manufacturers can succeed in making their products “sexy” and thus reduce the stigma that many people feel about wearing hearing aids, perhaps someday we’ll be walking in public and on close observation realize that a large percentage of our fellow citizens also have digital devices in their ears. … That’s a pleasant future scenario.

It’s a Vanity Thing: Why I Care That My Hearing Aids Are ‘Invisible’

It’s been 8 months since I picked up my first pair of hearing aids from the audiologist’s office. Of course, as with many other men in middle age, my hearing had been on the decline for several years prior to the Big Day. I just suffered silently during those earlier years as my hearing declined — frankly, in the name of vanity (with plenty of denial thrown in). My wife and daughters suffered not so silently: “When are you going to get your ears checked? That’s way overdue!”

It really was a significant day in my life. I can best describe adding hearing aids to my daily personal accessories for the first time as similar to the day at 15 years old when I donned my first pair of prescription eyeglasses. Walking into my high school the next day, I expected every student and teacher in the building to gawk at me. … What a surprise when hardly anyone paid any notice. Even my friends barely joked about my change in appearance. (I wear eyeglasses to this day.)

Steve's invisible hearing aid

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