[Theme II ] Hearing aids and age

This article is part of a logical sequence of 13 articles published in the form of “themes”, which group together all the questions asked by Internet users about hearing aids, questions to which we try to provide complete answers.

Each theme groups together a set of questions whose grammatical structure is reproduced as the questions are asked on search engines.

To navigate through these 13 different articles, go back to the introductory article, which provides the summary.

At what age should I start wearing a hearing aid ?

There is no age limit for wearing a hearing aid. As mentioned in the previous topic “Why wear a hearing aid ?”, the use of a hearing aid is necessary if the person experiences hearing discomfort, whether it is occasional (in certain places or environments – usually noisy such as restaurants or during family or professional gatherings or on certain media such as television, radio, telephone).

How old do I have to be to wear a hearing aid for a hearing impairment ?

In the case of hearing disability / deafness, hearing aids, if possible, are recommended as soon as possible, as soon as the disability is detected, to allow the individual to acquire language and socialize. In other words, the sooner the better. Detecting hearing disability can be time-consuming, as it is not the first thing one thinks of when a person has difficulty socializing. Thus, many doctors are consulted (psychiatrist, speech therapist, etc.), until one of them, by an attitude or a specific behavior of the patient (generally, of the child), detects a potential hearing handicap and refers to an ENT, who carries out the hearing examination. Based on this examination, the patient is then referred to a hearing aid specialist. The reimbursement of hearing aids for people with disabilities is excellent. In France, it is based on a disability rate which is based on the guide-barême of the annex 2-4 of the code of social action and families as well as on the decree n°2007-1574 of November 6, 2007 published in the Official Journal of November 8 of the same year.

(France) – for bilateral deafness (i.e. affecting both ears) detected before the age of 3, the disability rate of 80% is applied (taking into account associated language disorders). After the age of 3, the disability rate is determined by calculating the average hearing loss in both ears and the disability card is granted if this rate is equal to or greater than 80% (i.e. the hearing loss must be at least 80dB in both ears). The disability rate may be increased by 2% to 5% if the individual also has :

• Tinnitus,
• Dizziness,
• Speech difficulties,
• Another disability,
• A real loss of autonomy.

The MDPH Deafness file allows for almost complete coverage of hearing equipment for the people concerned. This file includes :

• The application form, CERFA 15692*01 ;
• The medical certificate of less than one year, CERFA 15695*01 ;
• The standard report of the hearing test.

These medical documents must be accompanied by :

• A copy of both sides of the applicant’s identity card,
• A copy of the proof of address less than 3 months old,
• And a certificate of legal protection if the applicant is concerned by any legal protection.

What is the right age to wear a hearing aid in the case of presbycusis ?

Presbycusis is defined as the loss of hearing due to the natural aging of the hearing system. It affects everyone – men and women – over time. Since we live in a noisy world today, its onset is a decade earlier: it appears around the age of 60 and evolves over the years. Presbycusis affects :

• 60% of people over 65,
• 85% of people aged 80 and over.

However, presbycusis is no longer the prerogative of seniors: recent studies show that one third of people under 30 years of age suffer from a hearing loss of more than 20dB.

Several factors favor its occurrence :

• Noise aggression, whether caused by us (DIY at home, headphones worn for more than 30 minutes continuously at high volume, discos) or not (urban noise, work on the public highway) ;
• Pressure aggressions (especially in the practice of certain sports such as diving and apnea with Valsalva compensation) ;
• Diet and lifestyle (especially smoking) ;
• The accidents of life (blast of the ear) ;
• Certain drugs, known as ototoxic.

As for the hearing impairment, the sooner the hearing loss is fitted, the better the user will be. Fitting a hearing aid at the first sign of discomfort allows the user to get used to the amplification provided by the device and to wearing it. This wearing can be punctual or continuous: it is, in fact, advised to wear a hearing aid punctually – when the need is there – rather than not wearing one, at the risk of becoming progressively isolated and not being able to bear certain sounds of life, forgotten with time, when the hearing aid becomes a necessity.

What is the average age of the first hearing aid ?

When it comes to hearing impairment, there is no average age, strictly speaking: some people are fitted with hearing aids as early as 3 years old, while others, due to life’s accidents, will be fitted with hearing aids in their 40s, 50s or later. One reality remains: when the hearing disability is detected and if it can be fitted, the person is fitted with a hearing aid: 90% of people with a hearing disability are now using a hearing aid.

The situation is different when it comes to presbycusis. On the one hand, because its onset is gradual, awareness of it remains difficult; on the other hand, because, being perceived as a “simple inconvenience”, the people concerned are reluctant to “take the plunge” and spend a substantial amount of money on a visible hearing aid. The main reasons for the massive rejection of these individuals are: the cost (1550€ on average per ear according to UFC Que Choisir); the aesthetics of the device (80% of worldwide sales of hearing aids are BTE); the complexity of the device. Thus, while the first signs of discomfort appear around the age of 60, the average age of the first fitting is 75. It is accompanied by many dropouts along the health path. Indeed, if 42% of the people consult an ENT under the pressure of their close relations:

• 35% stop after the medical consultation and do not make an appointment with the hearing aid specialist,
• 7% give up after the first appointment with the hearing aid specialist (trial of the hearing aid),
• And 10% to 15% of hearing aids sold end up in a drawer.

It is precisely for these people that pre-configured, non-prescription, ready-to-hear hearing aids have been developed. The average age of users of preconfigured devices is 62, a decade earlier, on average, than traditional hearing aids. These devices have been the subject of a U.S. double-blind, placebo-controlled clinical trial that underlines their benefits.

Does early hearing aid / from the 1st discomfort worsen the loss ?

Not at all. A hearing aid is intended to compensate for your hearing loss and provide you with hearing comfort. That is its role.

Early hearing aids do not make the hearing loss worse. As mentioned above, hearing loss is aggravated by various factors (noise, pressure, lifestyle, diet, sports, medication, etc.), not by the hearing aid, which compensates for it. The early fitting of hearing aids has many benefits, as we have already mentioned: it favors the progressive habituation to the device, maintains an efficient stimulation of the cerebral cortex, thus avoiding the progressive appearance of cognitive disorders and the progressive isolation of the individual (which can lead, in the long run, to depression and/or dementia). In addition, it has been found that unilateral hearing aids give the user the (verifiable) feeling of hearing better on the unaid ear as well, which is due to an obvious reason: the hearing aid used maintains cortical stimulation and the proper functioning of the brain.

The other side of the coin is also true: a hearing aid does not slow down the progression of a hearing loss. To say this would be a lie. Only by taking care of your ears and your hearing can you protect your hearing acuity: thus, simple gestures are to be adopted throughout your life to preserve, as long as possible, a normal hearing: protect yourself from sound aggressions by always carrying anti-noise protections; do not wear headphones for more than 30 minutes continuously; do not put the volume of music at full blast (prefer HD formats rather than PM3 for this reason); avoid pressure aggressions (especially in sports); adopt a healthy lifestyle are the keys to this. It is, of course, common sense.

Until what age should I wear a hearing aid ?

Hearing aids should be worn at the first sign of discomfort, in all situations where they are needed and for as long as necessary. In other words, there is no age limit for getting a hearing aid and there is no “limit” to the age at which you can use it . To answer the other two questions asked by the Internet users on this subject :

• Can you wear a hearing aid after age 80 ? Yes, you can (should) wear a hearing aid as long as you need it.
• Is there any contraindication to wearing a hearing aid at an advanced age? Absolutely not. Whatever your age, as long as you are alive, you need to hear well and your hearing aid is essential, whether you are 80 or over 100 !

(France) – MDPH Hearing aid coverage up to what age ?

The MDPH deafness file (mentioned above), in the context of hearing disability, can be requested for children and adults.

MDPH Deafness for children

Up to the age of 20, children with significant bilateral deafness resulting in dependence in the essential acts of daily life can benefit from the disabled child’s allowance (AEH), which aims to compensate for the costs of education and care that are necessary for them. This allowance is paid to the person responsible for the child and can be supplemented by additional allowances. It is to be requested, upon presentation of a complete file, from the MDPH. We specify that, according to the Decree of May 21, 2014 on the conditions of assumption of responsibility and the limit prices of sale of hearing aids applicable to beneficiaries of complementary coverage, the audioprosthetist is required to offer hearing aids at a price that does not exceed the reimbursement rates.

MDPH deafness for adults

For adults with significant bilateral deafness (criteria stated earlier in this article) or in case of associated disabilities that occurred before the age of 60, a file can be submitted to the MDPH to obtain coverage for hearing aids and to have access to the disability compensation benefit (PCH). This benefit aims to help you cover the costs of various types of assistance related to your disability (human and technical aids, adaptations, vehicle, transportation, animals, aso.).

For adults over 60 years of age, 2 conditions must be met in order to benefit from this aid :

• If you met these conditions before you turned 60, you must apply before you turn 75 ;
• You are still working after your 60th birthday and your disability meets the criteria for the benefit.

If you are a disabled worker recognized as such by the MDPH and you are still working, you are eligible for the AGEFIPH (private sector) or the FIPHFP (public sector).

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To go further on this topic, you can consult our previous articles:

• Vertigo, did you say vertigo ?
• Tinnitus, what is it ?
• Presbycusis, what is it ?
• Audiometry: measurement principle and practical application
• Noise pollution and hearing risks
• Factors other than noise aggression in the genesis of deafness
• Can we prevent hearing loss ?

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