Hearing loss is often dismissed as a natural part of ageing, something to be lived with rather than addressed.
In many Asian communities in particular, it is frequently overlooked or even joked about, with symptoms brushed aside rather than taken seriously. This cultural tendency means many people delay seeking help until the problem has significantly worsened. Yet growing evidence suggests hearing loss is far more than an inconvenience, with strong links to cognitive decline, mental health, and overall quality of life. Despite this, it is not taken seriously.
In this interview, audiologist and founder of Hear with Ish, Ishvaree Sharma, explains the basics of healthy ear and hearing loss.
What is the recommended timeline for routine hearing and ear check-ups?
The key point is this: people who are 60 or 70 years old simply never had their hearing checked when every adult, especially after the age of 55 or 60, should be having their hearing tested routinely.
It should be normalized. Just as people regularly check things like sugar levels and cholesterol, hearing should be part of the same routine health mindset. The challenge, particularly in our community, is that people often don’t realise the real impact of hearing loss. The attitude is usually, “I can’t hear properly, but so what, people will just speak louder.” But it goes far beyond that.
Could you explain the connection between hearing loss and cognitive decline, and what people most commonly misunderstand about how serious that link can be?
We now have strong evidence linking untreated hearing loss to cognitive decline, memory issues, balance problems, and an increased risk of falls. There are also associations with conditions like depression and even diabetes.
What often happens is that people start withdrawing socially. If you’re regularly meeting friends but struggling to follow conversations, you may begin to avoid those situations altogether. Over time, that leads to social isolation, which can then contribute to depression. It becomes a vicious cycle that keeps reinforcing itself.
There’s actually a structured way we classify hearing loss through tests—mild, moderate, severe, and then profound deafness. Even with a moderate hearing loss, you can be missing around 40% of sound input. What that means is that the part of the brain responsible for processing sound is no longer receiving normal stimulation. In effect, those auditory regions become underused or “silent.”
As a result, the brain has to work much harder to fill in the gaps, straining to understand speech and process conversations. Over time, this increased cognitive load can contribute to cognitive decline. In simple terms, it’s like constantly overworking your brain just to keep up with everyday communication.
I often explain it in comparison to eyesight because everyone understands that. When you go for an eye test and are told you need glasses, most people accept it immediately because they can see the benefit: reduced strain and clearer vision. But with hearing, even when someone is told they have a mild loss, there is often resistance. People say, “I’m managing fine for now,” and delay taking action. By that stage, some of the cognitive effects may already have begun.
Another important link is balance and mobility. As people age, they often experience falls or balance issues and attribute them to problems like weak knees or joint issues. While those factors can play a role, many people don’t realise that the inner ear is a key organ responsible for balance.
So instead of having a hearing assessment, they often focus on other areas of the body. People simply aren’t educated on the connection between hearing, balance, and overall health. As a result, symptoms may be misattributed to knees, hips, or general ageing. This is why education is so important. Hearing loss has long been a topic people avoid.
With younger people regularly exposed to loud music or through constant earphone use, how concerned should we be about the long-term impact on hearing health?
Listening to music at a comfortable volume for short periods is absolutely fine, the ear and the cochlea can cope with that. The problem arises with prolonged exposure to loud sound over many hours. Anything consistently above around 80 decibels, over time, can contribute to hearing damage.
The challenge is that younger people often don’t realise the long-term implications. Unfortunately, hearing loss is not reversible, once the hair cells in the cochlea are damaged or die, they do not regenerate. Noise exposure accelerates this process. While we cannot stop ageing, we can control our exposure to harmful noise.
That’s why the key advice is protection. If you work in environments like construction or factories, appropriate hearing protection is essential. Similarly, for activities such as riding motorbikes, which is extremely common in India, ear protection should also be considered, as continuous exposure to engine and road noise adds up over time.
All of these factors contribute cumulatively to hearing damage later in life, and prevention is far more effective than trying to manage loss once it has already occurred.
What are some simple, everyday steps people can take to protect their hearing, and what symptoms should not be ignored?
What should not be ignored is:
- Any pain in the ear
- Any unusual discharge from the ear—anything other than normal earwax
- Rotational vertigo, a sensation where you feel off-balance or as though the room is spinning
- Sudden hearing loss.
- Tinnitus—any ringing, buzzing, or unusual sounds in the ears that begin suddenly.
In terms of protecting your hearing in daily life, one of the biggest issues is how people clean their ears. Many individuals still use cotton buds or insert objects into their ears. This is not recommended. The ear is self-cleaning, and nothing should be inserted into it. Using cotton buds or other objects can actually cause more harm than good.
Beyond that, ears generally require very little intervention. However, managing noise exposure is crucial.
