Hearing loss is often gradual, and in many cases, family members and friends are aware of hearing problems before the hearing-impaired person notices a problem.
Many people in the early stages of hearing loss of this sort will find themselves asking "What?" more frequently.
Other signs include offering inappropriate answers because they have misheard a conversation or question, or socializing less with others.
While hearing loss can result from hereditary factors, illness or unprotected ear coverage in high-noise occupations, it is more commonly associated with the aging process.
Presbycusis is the gradual loss of hearing as people age. Typically the hearing sensitivity is the same in both ears.
"This begins in the late 50s and early 60s," said Dr. Dana Fiske of the Professional Audiology Center in Portsmouth and Stratham. Fiske has been practicing in the area since 1977. Two other audiologists practice at the center, and a fourth will be joining them in May 2013.
Many shy away from putting a hearing aid in their ear for vanity reasons. Others don't like the extraneous noise that was a problem with the older analog models. But technology has improved greatly over the last four years, Fiske said.
"We are able to offer digital open-ear hearing aids that are more comfortable and do not have the sound quality problems of the older models," Fiske said. "Right now, 95 percent of our new patients are able to be fitted with the open-ear technology."
Patients will undergo an initial evaluation to determine the degree of hearing loss, frequencies most impaired, speech discrimination ability and type of classification of hearing loss.
Hearing aids are then custom fitted and programmed to provide optimal results. A thorough counseling session is also provided and the patient's spouse and other interested relatives are encouraged to attend this session.
"The older molded aids would last about five to six years," Fiske said. "The newer ones can last six to seven years."
Batteries cost around $1 and need to be changed weekly. Professional Audiology does purchase batteries in bulk and can offer discounted savings.
The average cost of good quality hearing aids can run from $3,000 to $6,000 a pair.
While many patients who require hearing aids are on Medicare, the aids are not covered by the basic Medicare plan. Some supplemental plans have a partial reimbursement benefit. Audiological testing is covered by most health insurance plans including Medicare.
Other plans have a hearing aid allowance that can reimburse anywhere from $500 to $1,500 per aid.
It is an expensive investment. Fiske said his office offers financing for patients unable to pay the full amount up front.
While hearing loss is definitely troubling to both the patient and his or her family and friends if left untreated, there is another, more serious matter to take into consideration.
The risk of dementia appears to rise as hearing loss declines, Fiske said. Even those with a mild hearing impairment are nearly twice as likely than those with normal hearing to develop dementia.
"Delaying treatment can lead to auditory deprivation," Fiske said. "Auditory deprivation describes a significant decrease in an ear's ability to understand speech and a decrease in general hearing ability due to lack of auditory stimulation."
Earlier this year, Fiske did some research on the topic and found the ability of the auditory system to process speech declines due to lack of stimulation (hearing loss). With auditory deprivation, the brain gradually loses some of its auditory processing ability.
When the hearing nerves and areas within the brain are deprived of sound, they tend to atrophy or weaken over time.
"There is now new information that suggests a correlation between the degree of hearing loss and dementia," Fiske said.
"Because we listen with our ears but hear with our brains, it is not possible to separate audition and cognition," he said.
"Whether hearing aids or other medical treatments can stave off dementia needs further investigation."
Researchers are currently investigating the effects of hearing aids on the risk of dementia and whether or not it can delay the onset or the severity of the dementia, he said. To read Fiske's entire report, visit http://www.professionalaudiology.com/february-2012/.