The Correlation Between Hearing Loss, Physical Health, and Cognition with Dr. Keith Darrow
Brendan Aylward (00:00)
Welcome to the AdaptX Podcast where we have conversations with individuals who are building accessible businesses, advocating for inclusion or excelling in adaptive sports. Our intention is never to speak on behalf of those with disabilities, but provide a platform to share insights to make a more accessible world. Today we are joined by Dr. Keith Darrow, a Harvard Medical School and MIT trained neuroscientist, clinical audiologist, professor, author of two Amazon.com bestselling books, and director of treatment at AudiExperts. He is the co-founder of the Hearing and Brain Centers of America.
and audiology movement across the country to improve the lives of the 1.5 billion people worldwide living with untreated hearing loss. Dr. Darrow is a nationally recognized speaker, trainer, and his research conducted at the Massachusetts Eye and Ear Infirmary has been cited over 1,200 times, and we just found out that we live in the small suburban town, Sterling, Massachusetts. Keith, thanks for joining me.
Dr. Keith N. Darrow (00:49)
Absolutely, no, thank you for having me. It's not often I get to do a podcast with a neighbor.
Brendan Aylward (00:58)
Yeah, yeah. So I've heard you talk on other podcasts that I listened to before this episode about struggling maybe to find your passion academically through high school. But then that changing drastically in college. So what was it that drew you to hearing loss research and learning about the
Dr. Keith N. Darrow (01:18)
Look, it's one of those things where, I didn't know we were gonna start at high school, but I'm glad you brought it up. It's one of those things where, you know, that old adage, when you do what you love, you don't work a day in your life. Look, I'm the first person to say, it's a cliche, it's, you know, I don't know if I believe in it, but I'm actually living proof of it. And I don't, you know, for me, I don't have one of those stories where, oh, you know, I grew up with a deaf brother or a parent. I mean, honestly, I stumbled into it. And the way it was basically my mom saying, hey, look, you've always wanted to be a social worker, a therapist, why not consider communication disorders, helping people to find their voice, helping people to be able to communicate, surround themselves with others. And that's what brought me to taking classes in speech and hearing.
Still to this day, I'm out of college. I'm not gonna say how long, but it's been a while. I'm still so drawn to everything that has to do with hearing. And I think one of the most profound things that I learned early on is not only do the sounds we hear, the experiences we have go from the ear up to the brain, but there's also this return passage wherein the brain sort of then communicates with the ear and there's this back and forth communication that allows you to really understand, to embrace what you hear, to understand, recognize, and it's just a fascinating sense. And my argument for why it's the most important sense is actually rooted in evolution and anatomy. You know, the ear, your inner ear, deep down in your skull is housed in the hardest bone in the body. And the way our body works is if there's something important, it will figure out how to protect it. Kind of like your heart and your lungs are protected by your chest. Well, the ears are protected by the hardest bone in the body. So that early on told me there's something about this sense that's really important. And so I just, it snowballed. Graduate school, then my doctoral work, and I'm still doing it today and loving every minute.
Brendan Aylward (03:40)
You talk about communication disorders, and maybe this would fall in the category of hidden disabilities or invisible disabilities. Do you think the not having an outward facing physical presence when we're talking about hearing loss makes it less understood, or people might not be taken as seriously by medical professionals?
Dr. Keith N. Darrow (04:00)
I think it's both. I think you just nailed it there. It really is the silent disability. It really is the hidden disability. You don't see it. And there's definitely a stigma to it in that, oh, if you do have hearing loss, you wear big beige bananas, you can't understand. And look, I'm not saying this, I'm just gonna give a historical perspective. It used to be children born with hearing loss were the deaf and dumb. So it wasn't that long ago, and I'm talking like 50 years ago, which in the human lifespan is not that long ago, just a generation or two ago, where people with hearing loss, the quote unquote deaf person was basically, you know, ostracized from society. They had difficulty getting jobs, they had difficulty in school, and they were kind of just brushed under the rug.
Brendan Aylward (04:59)
How have you seen the field, if it's only a generation or two ago where these stigmas were kind of dispelled and addressed, how have you seen the field evolve, maybe even over the course of your career?
Dr. Keith N. Darrow (05:12.814)
Well, you know, Darwin taught us evolution is very, very slow. So with that, I think the biggest change definitely comes in the youth, definitely comes in people who are, you know, I call them the post ADA babies. So they were born after the Americans with Disability Act, born in the 90s and the 2000s. I teach at a local university. And when I have these conversations, I feel like they look at me in disbelief, like that can't be real. They didn't really do that to people with hearing loss. Like they just, they don't get it. And so I have, I'd say at least two to five students a year who are significantly hearing impaired and they're sometimes they're running circles around their classmates. They're the smartest in the classroom probably because they're the most motivated. They work so hard, but they're completely the same as you and I, they just have a little less hearing. Some have a lot less hearing. So for the younger generations right now, for the youth, it's amazing to see that people with hearing impairment are, dare I say, just completely accepted. Oh, okay, you need help. They'll help with note taking, they'll help with transcribing classrooms. I mean, I have seen such wonderful compassion and empathy in my students. Now, remember, right, we said one to two generations ago, some of those people are still around. I'm talking 60, 70, 80 years old, the pre-ADA, who grew up potentially with friends who had hearing loss and were, you know, ostracized, were shipped off to live, you know, somewhere other than home, couldn't get a good career, couldn't go to school. And so there is population, I would say 60 plus, wherein hearing loss is still looked at as a significant disability, a significant difference. It makes you look old. It makes you look stupid. It makes you... I mean, I've heard all the adjectives out there. And I think the proof of that is that we're still living in a day and age where less than 20% of adults with hearing loss actually do anything without treating their hearing loss. And what we've learned in the last decade is how traumatic that can be for your body and your brain.
Brendan Aylward (07:46)
Do you think less than 20% are seeking help because they're not even aware that it's declining? Or do you think there's a financial reason or a social stigma? Maybe.
Dr. Keith N. Darrow (07:57)
Can I just say yes to all of the above? Is that an option on the multiple choice? Yes, so the stigma is definitely there, it's real. Although, and if you're listening to this and you're an older adult with hearing loss, I'm gonna let you in on a little secret. You look a lot older if you can't hear and follow the conversation. What happens... If you're the mom and you're visiting your kids and everybody's together for a holiday dinner and you leave the room, everybody's talking about you behind your back saying, I'm worried about mom. She's not interacting anymore. She's not leaving the house anymore. She's becoming more frail. I'm worried about her memory. So not being an active participant in a conversation is a much bigger stigma than having hearing loss, right?
Now you also mentioned price. I think the issue is into the price because Americans in general spend a lot of money on things, right? Obviously there are people that have difficulty, that don't have the means, but then there's a lot of people who, you know, drive cars, have cell phones, they do a lot of things. They spend a good amount of money, but they look at hearing loss as not a value.
They don't see how important it is. And that's really part of my mission, because yes, it will probably cost you a couple of grand a year to treat hearing loss properly. Now, we all have cell phone bills, cable bills that add up to a couple of grand a year, and we're happy to pay that. We don't bitch and complain, we don't live without. I hope I'm allowed to say that. I think ultimately, if you ask somebody, why do you spend two grand a year on TV or on a cell phone? They'll tell you all about the value it provides. My mission is to teach older adults about the value in treating hearing loss, like reducing the risk of cognitive decline and dementia, reducing the risk of a traumatic fall, improving quality of life, reducing the tinnitus in your ears, improving memory, right? How do you put a monetary value on those things?
Dr. Keith N. Darrow (10:20)
To me, that's a bargain at a couple of grand a year, sorry, not a month, a couple of grand a year to live your best life, to be an active part of the conversation. But yeah, I think ultimately it boils down to the lack of public knowledge and education about hearing loss.
Brendan Aylward (10:42)
Yeah, maybe let's dive into that topic. You talk a bit on your website about the link between tinnitus and dementia or memory loss. Can you maybe give us kind of like an overarching view into what causes that relationship, if that's known, or where the research is going in that area?
Dr. Keith N. Darrow (11:00)
So historically, and I'll make this quick because I could give you a four hour lecture, but I won't do that. I'll give you the three minute. Four minutes. Four minutes, got it. Start the timer. Basically about 70 years ago, the first paper came out, and this was in psychology that said, it looks like people with hearing loss, something's not cognitively right.
Brendan Aylward (11:08)
Consolidate in the four minutes, please. Yeah. I'm kidding.
Dr. Keith N. Darrow (11:38)
And then there was more research in the 60s, in the 80s, in the early 2000s that all seemed to indicate, hey, this group of people over here, this group of older adults with significant hearing loss, there seems to be a higher rate of cognitive decline and dementia. And then finally, and I promise, I will come back to tinnitus, finally in 2011, a landmark study came out of Johns Hopkins, right? So this isn't just some random research from some foreign country. This is John Hopkins, this is a leading medical research institute that basically said, here's the summary. People with hearing loss have an increased risk of developing cognitive decline and dementia. And the numbers that they put on it, they said that you're 200 to 500% more likely to develop cognitive decline and dementia with hearing loss, right? Now, you asked specifically about tinnitus.
And I promise I didn't forget the question. What we've learned, what a lot of people don't realize is that tinnitus and hearing loss are actually the same thing. Okay, and what I mean by that is they're the result of the same neurologic disorder. They're just different symptoms. So hearing loss, not being able to follow a conversation and background noise, that's a symptom not being able to tolerate loud sounds. A lot of older adults will tell me that. That's a symptom. Tinnitus is a symptom. They're all symptoms of the chronic neurologic condition that we know as hearing loss. So hearing loss and tinnitus, probably 99% of the time are actually the same thing. And so there's been a number of research reports that have shown the presence of tinnitus, which makes sense.
It also seems to increase your risk of cognitive decline and dementia. A great study came out of South Korea that actually found people with bothersome tinnitus are more likely to develop early onset Alzheimer's, which is really scary. But I think it just goes to show that when you deprive the brain of sound, when you have tinnitus, your brain is significantly compromised. I heard this analogy once. Tinnitus is like your check engine light for your brain. It's telling you there's something wrong. So if you have tinnitus, if you lie in bed at night and you hear ringing or roaring or buzzing or whatever adjective, something's not right because that's not supposed to be there.
Brendan Aylward (14:13)
Yeah, I was gonna ask if you could succinctly define it in case people that are listening don't know what tinnitus is as a whole, but you kind of said it there, so ringing...
Dr. Keith N. Darrow (14:21)
Yeah, well, some people will say, hey, look, they'll say, oh, is this tinnitus? Once a month, I get a little bit of ringing in one of my ears that lasts for about 10 seconds. That's not what we're talking about, right? I often joke and say, that's just people talking about you behind your back, right? That was the sort of the old saying with that. I'm talking about that ringing that comes and goes that can last for hours, days, weeks. I'm talking about the buzzing that when the world is quiet, when you lie down at night or you get up to go to the bathroom in the middle of the night and the world is pretty quiet and you hear, that's the tinnitus I'm talking about. That is a part of a neurologic condition. Here's what most people don't understand. They don't think it can be treated. They don't think there's anything that can be done about tinnitus and it's just not true. We effectively treat.
90% of our patients with tinnitus, meaning we can dial it down, in some cases completely eradicate it. And it's not just at our practices. This is the research data that's out there.
Brendan Aylward (15:32)
Is there a specific subset of the population or maybe even an occupation that seems to be most prone to tinnitus?
Dr. Keith N. Darrow (15:39)
Well, let me answer your question in a second. Let me just state this. As fact, mammals, as we get older, almost every mammal has hearing loss written into their genetic code. So it's sort of a fact of life. It's got a fancy term. It's called presbycusis. It's age-related hearing loss. Presbyopia, older people who wear glasses, right? Our senses diminish as we get older. That makes sense to everyone.
The question is what about occupations, what about noise exposure, what can make that hearing loss and tinnitus worse? And you really hit the nail on the head there in that what the science out of Massachusetts Eye and Ear, out of Harvard Medical School, my thesis advisor, Dr. Charlie Liberman, what he taught us over 20 years ago, was that we all get hearing loss as we get older, but if you're exposed to noise throughout your life, instead of hearing loss starting at, let's just say 72, it'll start at 55. It'll start anywhere from 10 to 20 years earlier. And so it could be one rock concert, it could be going to work in a noisy environment over the course of eight years. Defining noise exposure is difficult because you have to consider volume and time, but noise exposure, if you feel uncomfortable, if you feel like, ooh, that's a little loud.
I promise you, it's too loud and it's damaging your ears.
Brendan Aylward (17:13)
Yeah, I was gonna ask if it was dose dependent or amplitude dependent, but it's probably too hard to quantify, really.
Dr. Keith N. Darrow (17:17)
It absolutely is, but yeah, and that's just so hard to define, right? Because it really, the research tells us it says if you went to a concert when you were 20, and it was really loud, and you had the hearing hangover for three days, meaning your ears were ringing for three days, that was really bad. And that will speed up the aging process in your ear. But, you know, on an individual case by case basis, it's nearly impossible to say.
Is it seven years? Is it 10 years? We just looked at average data that found anywhere from 10 to 20 years younger. And we see this in our population. We see, I've been in clinical audiology for over 20 years. And I would say the average age of a patient when I first started was closer to 76. Now we're down closer to about 65. And I think that's because, while we're getting the word out, number one, we live in a pretty noisy environment, right? This post-industrial revolution world we live in is very loud. Our ears never evolved to handle this much noise. And so we are seeing people younger, which is a shame, but it's also good because you wanna catch it early and treat it early.
Brendan Aylward (18:32)
Yeah, when you mentioned that statistic, I was just thinking, is it just a matter of being more educated and more committed to health and longevity, or whether it's actually a physiological consequence of our environment?
Dr. Keith N. Darrow (18:44)
Yeah, again, I'm gonna go with D, all of the above, right? It really, so look, here's the way I put it. Science and medicine has enabled human beings to double their lifespan in the last 120 years or so, right? We went from living to about 40s to about 80s. And we did that all in the last 120 years, and the span of human life is really just a little blip on the radar, right? So what we're doing now is we're trying to figure out how to add more life to those years. And I look at my own family and I'm sure everybody listening can kind of come up with their own story. I remember my great aunt, my own grandmother, when they were like 65, 70, they pretty much shut it down, right?
They lived at home, they were in their house dress, they watched their TV. Now, I look at my own mother who's in her seventies. If I say her age, she'll kill me, but she's in her seventies. She has a way more active social life than I do. So the way we approach aging is very different. And so I think that's a major component, probably more so even than, you know, what I wake up every day and try to do is educate more people about how important it is to treat hearing loss. But I think that social activity that older adults are out playing, pickleball, they're out at senior centers, they're just having a lot of fun.
Brendan Aylward (20:24)
Yeah, we talk about health span versus life span. So not just the number of years that you have, but the quality of those years for sure. And we have members at our gym that are into their 80s. And I hope that my body functions in the same way in 45 or 50 years. But you said that addressing some of this tinnitus is one of the most important things you can do for your health. And at your clinic, you guys have a success rate of over 90%. If someone is interested in addressing, where would you recommend that they go or find out about?
Dr. Keith N. Darrow (20:57)
Yeah, so I would say there's actually two things. I always like to give options, right? So if you're looking for a provider, we have a network. This is a national organization, which is actually going international, that is providing you, the patient on the other end, the person who's suffering with tinnitus, suffering with hearing loss, worried about dementia, worried about falling, at excetons of education, tons of resources. And if you're looking for a provider, there's one of those maps. You know, you put in your zip code and you can find your local certified provider, right? I mean, look, it's no easy feat to get into this network. This isn't a pay to play thing. This is a, have you gone through the certified dementia practitioner course? Do you follow best practices? There's a number of check boxes that you need. Do you follow our proven method for treating tinnitus?
If you're looking for just some education, I recently put out a new book, brand new book. It's called Silenced. It's all about the medical treatment of tinnitus. You can go to stop I'm actually giving away free copies, okay? I've always said to my publisher, I don't write books to make money. I write books to educate people. And so, I would rather give them away, have somebody pay a couple of bucks for shipping. I would rather give it away so that they are empowered to then do something and treat their tinnitus and live their best life.
Brendan Aylward (22:37)
Yeah, we'll actually definitely include that in the show notes and even if someone isn't currently dealing with it They almost certainly will know someone who is or come up in conversation with someone who is facing those things. So the more knowledge that they have to kind of support those Individuals the better what differentiates a clinician.
Dr. Keith N. Darrow (23:08)
And one of my, I just want to say about that. I hope you don't mind, but like, I always find this one funny. You know, I'll give a talk or a patient will come in and they'll tell me, I just, you know, tell me about your tinnitus, tell me about the sounds. I only have a little bit of tinnitus. And I just look at them and I'm like, how would you feel if the doctor said I have a little bit of cancer? I have a little bit of diabetes. You only have a little bit of Parkinson's.
Right? Like people in general, and this is one of those issues where I think we've got to inform the public. I love this type of podcast that is about access and education because we have to look at tinnitus and hearing loss for what they are. They are a major chronic neurologic condition. It's actually the most common neurologic condition on the planet affecting 1.5 billion people worldwide.
Everybody knows somebody. So a little bit of tinnitus is you're in the early stage of this neurologic condition. Your future is at risk for decline, for dementia. And so the best bet, just like cancer, just like diabetes, is to catch it early and treat it early.
Brendan Aylward (24:17)
Yeah, this podcast has been such a treat for me, just getting to talk to people that are experts in all these various niches. I'm very grateful for everyone that kind of shares their expertise with our audience, but going back to that excellence in audiology network, what differentiates, and you don't have to throw people under the bus, but what differentiates an excellent clinician from one that maybe doesn't meet those standards, and how can the general public recognize outside of finding someone in that network?
Dr. Keith N. Darrow (24:47)
Yeah, so here's, you're right. It's not about throwing anybody under the bus. It's not about, you know, I think it boils down to, you can only get the best treatment if you have the best medical provider who does the best medical testing, who does, I mean, it just keeps going on and on. So for example, right, anybody that comes into one of the hearing and brain centers, which are our clinics, anybody that goes to an excellence in audiology approved provider, you will go through a seven step cognitive screening and diagnostic evaluation. So we're gonna do an FDA cleared cognitive screening because we know hearing loss, we know tinnitus affects your brain, affects your memory, your ability to process. And so we're gonna screen for that. And this is, again, this is FDA cleared technology that we're using.
Then we're gonna put you through an entire series of tests to figure out what stage of hearing loss you have. So we're staging hearing loss stage one through stage four, just like other major neurologic conditions. Here's the difference. And if you're out there and you've experienced this, I'm just gonna tell you, you were gypped. So I bump into people all the time or they come into my own clinic and they say, oh yeah, I got my hearing tested down the street. Okay, great. What was that like?
Oh, you know, they played some beeps and I raised my hand. And then they just, they said some words to me over the microphone and I just repeated them back.
That's not a hearing test. It's just not. It is the most basic component, right? By the way, no patient ever comes in and says, I can't hear beeps. They come in and they say, I have tinnitus. So we quantify that. They come in and they say, we have difficulty, you know, hearing at restaurants, which is a cognitive thing. It's not a hearing thing. We have a special battery of tests to actually measure how difficult it is to hear in background noise, which helps us get you, the patient, the right prescription. All of our providers are certified dementia practitioners. Now that's actually approved by the International Council of Certified Dementia Practitioners. It basically goes to show that we truly understand how hearing loss and the brain interact. We understand everything possible about dementia, about prevention, about new medications, treatments. Now we don't diagnose cognitive decline or dementia.
And never should as a hearing healthcare provider, but we can help you on that path should it be a concern. So there are a number of significant differences.
Brendan Aylward (27:32)
Absolutely. I'd love to dive in a little bit into the growth of that Hearing and Brain Centers of America. How many locations do you guys currently have?
Dr. Keith N. Darrow (27:42)
So we're up to 14 locations from the hearing and brain centers. What started in our backyard in Worcester, Massachusetts has now grown to over 14 locations in four different states. I pause for a second because it's growing so fast and I'm not genuinely, I'm on the medical clinical side, not on the business development side, although I train all the providers.
So, you know, sometimes I kind of have to think, it was 12 about two months ago, but now it's 14. Basically in Texas, in Arizona, in Utah, like I said, Massachusetts, the network that we started, the Excellence in Audiology Network, now that Hawaii, Alaska, across to Maine, down to Florida, Canada, South Africa.
There's international members coming on board every day. So we've got you covered almost no matter where you are, especially in North America.
Brendan Aylward (28:44)
Yeah, maybe it's a question more so for the people handling the scalability of the business. But one thing I'm interested in is how to create more inclusive gyms. So we teach our course to health and fitness professionals on accessibility, as well as strategies to train different diagnoses.
But I'm very concerned, I guess. Concern might be too strong of a word that the quality will be sustained as we branch out to more locations. So when I was reading about the development of that program, I was just kind of thinking about how it related to what I hope my next five years of business growth will look like, more locations, etcetera.
Dr. Keith N. Darrow (29:25)
Well, yeah, okay, so I can definitely address that a little bit more. I guess I'll start by saying it's no easy feat, right? Because what happens is, number one, you have to obviously define the vision, define the goals, where are you gonna be in one, five, 10 years? You've gotta lay out the groundwork for how to get there. And then the single most important thing is you have to establish processes that your team has to follow.
And so you need a rigorous hiring process. You need a rigorous onboarding and training process. You need daily check-ins, daily huddles. You need role play. You need recalibration. You know, what a lot of people in business don't seem to understand is all the time and effort that you have to put into training. Training's probably just the one easy word I could say.
Training also never ends, right? Just cause you hired somebody and you gave them the 120 page binder, it doesn't end, right? I mean, look at some of the big fast food chains. For example, I guess I won't say a name, but there's a chicken establishment out there where everybody you interact with there says, my pleasure. Well, guess what? You don't say my pleasure a few times, you can't work there anymore. They have a process and it must be followed. And so you need data, you need tracking systems to follow that. So I mean, I know that's not what the podcast is about, but yeah, a lot goes into when it comes to scaling.
Brendan Aylward (30:59)
Yeah, absolutely. Systems are definitely necessary for scaling for sure. Going back you mentioned some of your students at Worcester State that are most successful are the ones who have the lived experience. How important is lived experience and understanding the needs of individuals with hearing loss?
Dr. Keith N. Darrow (31:21)
That's a tough one because I could easily throw myself under the bus. As somebody who doesn't have hearing loss, doesn't suffer with tinnitus, right? Does that potentially disqualify me? I mean, I certainly don't think so because after my four years of undergrad college, I went on for an extra two for clinical degree and an extra six for doctoral work and another six for postdoctoral work. I mean...
I did my best to learn everything I could and to bring that back to my patients. Now with that said, I think one of the best things that I've done is I have surrounded myself, friends, colleagues, with people who are in this field who themselves suffer with the disability. And they're always very open to discuss it. And so while I don't have the firsthand account, I certainly learn from every single patient, but I also learn from people in the field with hearing loss, with tinnitus, with hearing aids, with cochlear implants. I mean, so many things that I've learned from these people. You know, here's an example, right? I'm sure people with cochlear implants listen to this. And I'll be the first to admit, I never thought of this. But if you have a cochlear implant, just the simple act of going into the dressing room.
You go to a store to get some new clothes going into the dressing room. You have to take off your ears, right? So that you don't like knock it off. So you go from, you're walking around shopping and you can hear, now you have to be deaf again for a few seconds. Then you go back to hearing, then you go back to no hearing. It's just these tiny little things, whether it be intimate moments, whether it be shopping, these little things that hearing loss tinnitus can really, it invades, maybe that's not the right word, but it invades every part of your life. Everything, social, right, economic, so.
Brendan Aylward (33:29)
Yeah, yeah, absolutely. Um, maybe on, on that topic of accommodations, um, our podcast is kind of fitness specific. Uh, we hope that people will take away tips as to make gyms more accessible and inclusive. Um, do you have any ideas what a fitness facility could do to be more accommodating or accessible for those with hearing loss?
Dr. Keith N. Darrow (33:54)
Give me a second to answer that, because this is fitness-focused, and so I imagine people that are listening are, well, I'll just put them in the category of fitness buffs, or at least people who are interested in fitness. There have been numerous studies that have found these two things, because I think everybody can relate to this. People with hearing loss antennas do less socially, and social interactions, our ability to communicate with others, be part of a community, is really important for our brain health. Like social isolation and dementia, they've been tied together for 30, 40, 50 years. So people with hearing loss do less socially. Physical activity. There's been a number of studies that have shown people with hearing loss and tinnitus do less physically. And you can probably educate me on how devastating a lack of physical ability is to the body and what I care more about is the brain. And so there are so many links. I mean, look on the list of modifiable factors for preventing dementia, physical activity is on that list because it's so important. And so you can't just think of hearing loss as a nuisance. Eh, it's something that happens when you get older. It significantly impacts social, physical, emotional, economic, and cognitive wellbeing. So I'm sorry, I know I didn't answer your question directly, but because you mentioned the physical fitness, I thought I just had to talk about that.
Brendan Aylward (35:34)
Yeah, absolutely. Maybe also within the built environment. Are there any other practical recommendations? Obviously, it can't be like, oh, turn off the music. Make sure it's not too loud. Stuff like that. But maybe how could a fitness instructor be more accommodating for a member that has a hearing loss or hearing impairment?
Dr. Keith N. Darrow (35:56)
So look, I hate to oversimplify things, but because we can't spend hours getting into the weeds here, the most important thing is access to important sounds. And so when I say that, it's relatively easy technologically, it's relatively cheap economically to outfit a fitness facility. You can insert any facility there. But it's... specifically a fitness facility with direct audio input, right? So yes, the background radio that's blasting is probably very annoying to somebody who's got a cochlear implant or a hearing aids because it doesn't process the way we do, right? If you have normal hearing, your brain just tunes that out. I had to just think for a minute, is there music at my gym? Yeah, of course there is, but I can tune it out. You can't tune it out if you have hearing loss. And so, with direct audio input, you can have it so, basically hearing aids, cochlear implant become direct access to that music, if that's what they wanna listen to, right? So if they wanna listen to the Jim's music, but at their volume, without the distractions of all the machines and the background noise, that direct audio input would be huge for them by sort of cutting out the middle noise. And the same would go for a fitness class.
So the instructor, I mean, this stuff is not expensive anymore, right? Could wear a little lapel microphone that gives direct audio input to the end user's cochlear implant or hearing aid. Again, getting rid of all the bicycle noises and giving them direct sound input to what the instructor is saying or yoga. I mean, there are a lot of things that can be done. And then there's, you could actually outfit the space.
You know, I would say one of the most important things is what does the ceiling look like, right? Can you hang acoustic tiles? You know, those tiles you see in all the classrooms and elementary school, like, schools didn't buy that because there was a discount. Schools bought that because they're mandated to control the acoustics of the room. And classroom acoustics are not great, but they're pretty good because of acoustic tiles. You can put acoustic tiles on the wall. So there's lots of easy things you could do to make going to the gym more accessible for somebody with hearing loss.
Brendan Aylward (38:26)
Absolutely, some of our members probably wish they could tune out my music throughout the sessions as well, I get a lot of complaints.
Dr. Keith N. Darrow (38:34)
But I hope you learned, right, Brendan? I hope you learned. They can't tune it out. That's the problem, right? They can't, so that's why they're begging you for help.
Brendan Aylward (38:38)
They can't do that. That is the problem.
I apologize. You wrote about nutrition's relation to hearing loss in one of your books. Any simple practical, I know sorry I'm asking you to consolidate 15 years of academics and 20 years of work into a 45-minute discussion, but any practical nutritional recommendations?
Dr. Keith N. Darrow (39:04)
Look, I said in the beginning, I don't like cliches, but I'm gonna give you another one. You are what you eat. It's really that simple, right? And your brain relies on two things. Your nervous system relies on two things. Oxygen, which is the obvious, which is why we breathe, nonstop 24, seven, 365 days a year, because our nervous system and every tissue and cell in our body needs oxygen, but we also need nutrients.
We also need protein. We need sugars. We need greens. We need vitamins. And so your diet, and this shouldn't be a newsflash for anybody, your diet directly affects not just your body. See, everybody thinks, oh, diet, I'm just gonna get fat if I eat crap. Sure, that might happen to you. You might gain some weight. But more importantly is the devastating effects of unhealthy food on the brain. Now look, I'm not a health nut. I don't even pretend to be one, but it's more about moderation, right? Do we eat out? Do I have fast food once every couple of months? Sure. But it's two, three times a week where it becomes concerning. Do I try to eat more greens? Absolutely. Am I great at it? No. If I had to boil it down, the mind diet, which a lot of people know about, it's really easy to Google.
That's probably the one true diet, which includes Mediterranean, the oils, the nuts, the green leaves. That's probably the one true diet that has evidence-based data, like scientifically proven data, to show it can reduce the risk of cognitive decline and dementia.
Brendan Aylward (40:54)
So a lot of, I guess if we could summarize some of the things that people could do to improve their hearing health to translate to their overall physical health. I would be addressing symptoms as early as they onset, better diet, nutrition, physical activity, any other low-hanging fruit.
Dr. Keith N. Darrow (41:20)
Well, so, you know, here's the thing, because you said this very early when we first started this conversation. You talked about people with hearing loss. I think you said one of the three things I'm remembering now is they don't realize it. You don't even realize that you have hearing loss, right? Yes, there is such a thing as sudden onset, very rare. Wake up one day and you can't hear. Most people, it's a progressive, gradual... disorder that happens very slowly over time. And so if you wait until the symptoms are getting in the way of life, dare I say, I'm not gonna say it's too late, but that's very late, right? That's like, you know, you waited until stage three, maybe even stage four, cancer or cardiovascular disease. What I'm trying to push is not just at the earliest sign, but... can we, and there's been a lot of consideration from this, from the American Academy of Audiology, the American Medical Association, can we set a date? Can we set a year that people should have their first complete hearing evaluation? My push is for 50, right? And so my little catchphrase is ears and rears. The two things that you need to get checked when you turn 50. Everybody gets a colonoscopy when they turn 50. My push is to have your hearing tested first when you're 50, and then, and there's a debate about this, and I'm open to it, every two years thereafter. Look, we start checking our vision, we start doing cancer screenings, colonoscopies, I mean, we have to build this into the way we think about medicine.
Brendan Aylward (43:08)
If someone's asymptomatic, could they still benefit from one of those cognitive screens? So for example, I'm 30, so should I really wait 20 more years until I get my first hearing assessment or?
Dr. Keith N. Darrow (43:19)
So the great thing about the FDA clear technology we use, it's called Cognivue Youth Thrive, is it's actually age-based. So if you're 35, I put that in, it then compares you to age norms. I'm not gonna compare you to a bunch of 70 year olds that went through the cognitive screening. So yeah, I mean, look, it's never too early to screen. I mean, that's just a no brainer, right? But- that requires a seismic shift in the way we think about healthcare. Our current healthcare model is break something, bruise something, hurt something, disorder, something, try to fix it after, try to treat the symptoms after. We need to shift to a preventative medicine model. And that would be, like you said, cognitive screenings, hearing evaluations, like all these things that just get built in so that we can treat them before they actually become even worse.
Brendan Aylward (44:17)
Yeah, the healthcare is very reactive instead of proactive, but I think, thanks to the Huberman podcast and Peter Tia's podcast, I think a lot of people are looking at longevity as a essential component of life and it's on more people's radar now and they do a great job of breaking down every subset of health into science-backed actionable tips. So this definitely fits into that as well. I'd be interested to see if they've done any episodes on the association between hearing loss and longevity and mortality. Well, Keith, it was a pleasure to talk to you. I really appreciate you taking the time to share your expertise.
Dr. Keith N. Darrow (44:37)
Yeah, absolutely.
Brendan Aylward (44:57)
If people want to learn more about what you do or access the resources you provide, is there a specific place we should send them?
Dr. Keith N. Darrow (45:05)
Yeah, I mean, look, if excellence in audiology.org is really your sort of catch base for all things hearing loss and tinnitus, we have a new line of prev wherein there are healthy supplements, access to my different books, you can get the cookbook, you can get vitamin B. I mean, I think that's a great resource for any older adult who's looking to add life to their years.
Brendan Aylward (45:37)
Absolutely, and if anyone is listening to this and wants access to Keith's books, I know he said some of them are free, but shoot me an email and I'll pay for the shipping to get it sent to you. We'll include the website in the show notes so you don't have to worry about spelling excellence in audiology. But Keith, thanks again. I really appreciate it. I've very much enjoyed learning about the association between hearing loss and disability and long-term health. So thank you.
Dr. Keith N. Darrow (46:05)
Brendan, thank you so much. And I'll keep an eye out for you around town.