Hearing loss, from discomfort to disability



Most often, this sets in gradually. Conversations in restaurants become difficult to follow, dialogue on television less understandable, music less subtle. According to the Directorate of Research, Studies, Evaluation and Statistics (DREES), 10 million people live with hearing loss in France. Without always recognizing it or even realizing it.

→ COVID-19. Being deaf in a masked world: “It’s like losing an additional meaning”

“Many get used to and compensate as best they can, especially when reading lips. Even if with the mask, it became complicated ”, notes Daphné Pauchet, ENT at Saint-Joseph hospital, in Paris. This specialist works with this invisible handicap on a daily basis. “All ages are affected, but not for the same reasons, she exposes. In young people, it is often linked to genetic or congenital factors, trauma to the inner ear following an accident, or even drug toxicities. In older people, this is most often due to the aging of the inner ear. We then speak of presbycusis ”, explains the doctor, who recommends not to wait to worry about it.

A first assessment around 45-50 years old

“Ideally, a first hearing assessment should be done around 45-50 years old. Like presbyopia, it is at this age that the first signs appear ”, she emphasizes. A reality that is sometimes difficult to accept for this generation, already faced with the aging of its elders. “At 40, we don’t necessarily want people to start talking to us about the risk of dependence and fragility that threatens us, concedes Doctor Antoine Piau, geriatrician at Toulouse University Hospital and member of the French Society of Geriatrics and Gerontology (SFGG). But the message can be much more positive than that. Because by thinking about these things very early on, we give ourselves the opportunity to face them ”, he relativizes.

→ TESTIMONIALS. Upset daily life, incomprehension of loved ones: the loneliness of the deaf and hard of hearing

In fact, early treatment remains the best way to avoid the aggravation of the disorders. “In some cases, prostheses hearing aids will be necessary, but they are not recommended for all deafness ”, specifies Daphné Pauchet. And for them to be effective, you have to arrive on time. “The ideal is to equip yourself when the loss of intelligibility is around 30 decibels, which corresponds to the voice of someone whispering”, indicates the latter.

Prescribed in this firing window, these aids can represent “A very significant gain”, continues the doctor. “The earlier patients are fitted, the more they will preserve their hearing capital and the better they will tolerate prostheses. This will allow people who had “let go” to reinsert themselves into conversations. For some it is a real life change. “

Late pick-up

Unfortunately, many patients are slow to consult, often for lack of information or fatalism – hearing less well when you get older, it’s “normal”. Results, “When they are finally taken care of, their hearing loss is already advanced, the fitting has failed and they are deadlocked”, deplores Doctor Antoine Piau. Hearing aids, they, “Sleep on the bedside table or end up in the trash”, regrets this doctor who regularly sees patients “Clueless”. “We do not always measure it, but hearing loss has a significant social impact”, confirms Daphné Pauchet.

A source of isolation, it also has an impact on the cognitive level. “Today we have very robust scientific data on the links between hearing loss and cognitive disorders”, especially memory and perception, underlines Bernard Fraysse, president of the World ENT Society (Ifos). “Mild deafness represents twice the risk of cognitive impairment, average deafness three times more and severe deafness five times more”, he explains.

There are several reasons for this, including the very important attention paid to people with hearing loss on a daily basis. “They wear themselves out to stay in communication and de-stock their memory”, describes the professor, who adds that the deprivation of sensory stimulation, whether visual or auditory, causes brain atrophy. Hence the need for an early diagnosis, insists the doctor. “We now know that the longer the deprivation of stimulation, the more difficult it will be for the auditory cortex to reorganize the region of perception. “

One in four people affected in 2050

“The World Health Organization has made hearing health one of its public health priorities for these reasons”, observes Bernard Fraysse, especially, he adds, “That hearing is the third criterion of healthy aging”. One in four people expected to have hearing problems, according to a report released by the WHO in March 2021 “To varying degrees” by 2050, in particular due to the widespread use of headphones. “If nothing is done, at least 700 million of these people will need ear and hearing care and other rehabilitation services,” warns the organization, which recommends “To rapidly step up the prevention and treatment of hearing loss”, by facilitating access to hearing care.

France has tried to respond to this issue with the “100% health”. Installed gradually since January 2019, this system allows all subscribers of a mutual health insurance to benefit from hearing aids fully reimbursed by health insurance. A major advance in the eyes of ENT Daphné Pauchet. “Not so long ago, a hearing aid cost between € 800 and € 2,000 per ear, with often significant out-of-pocket costs for the patient”, she recalls.

→ READ. 100% health, a duty to inform professionals

Due to lack of financial means, 67% of hearing impaired people were not equipped in 2014. If the doctor regrets that the reform of “100% health” is still little known to the general public, never so many patients will have benefited from aid hearing. According to the union of hearing aid acousticians, nearly 384,000 people were equipped during the first six months of 2021, or 68% more than over the same period in 2019. Among them, 39% used the 100% health basket.

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To assess your hearing

The HHIE-S (Hearinghandicap inventoryfortheelderlyscreening) self-test: available on the Bordeaux University Hospital website, this questionnaire is intended for people over 60 years of age wishing to identify possible hearing problems.

The Höra application: developed by the Foundation for Hearing, this free downloadable smartphone application allows you to test your hearing in a noisy environment but also to measure the sound level of your environment.

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