Hearing loss is a highly prevalent medical condition that currently impacts an estimated 1.5 billion people worldwide (1). Although commonly viewed as an expected natural result of aging with consequences limited to receptive communication, robust data link untreated or undertreated hearing loss with many secondary sequalae including depression (2), social isolation (3), future cognitive impairment (2,4), and falls (5), as well as reduced independence (6), employability, and productivity (7). Thus, reframing perceptions about hearing loss as a bona fide chronic medical disease state with associated health sequelae has become an important priority for hearing health professionals and related organizations.

One primary bottleneck to receiving timely and appropriate access to hearing health care is limited awareness and prevalent misconceptions surrounding available treatment options. For example, a recent study identified that only 38% of 50- to 80-year-old adults believe that hearing loss is treatable (8). Furthermore, only 12% of general US adults report strong familiarity with cochlear implantation (9). The current study seeks to further characterize perceptions about hearing loss and cochlear implants among 400 US adults with estimated moderate to profound hearing loss who are currently using hearing aids—a population of people who may currently or may soon qualify for cochlear implantation.

An online quantitative survey (Supplementary Appendix, Table 1, https://links.lww.com/MAO/B766) was sent to a convenience sample of US adults who were currently using hearing aids and between the ages of 50 and 80 years from August 9 to 24, 2022. Respondent data were weighted to reflect region, age, gender, and hearing loss among this demographic in the United States based on census data. Other variables (e.g., employment, race) were allowed to fall naturally within this controlled sampling frame. The survey was administered by an independent research and analytics firm, Selvedge Consulting Ltd. (London, United Kingdom), via Philomath Research's online consumer panel. Continuous features were summarized with medians and interquartile ranges; categorical features were summarized with frequencies and percentages. Select associations between responses were evaluated using Spearman rank correlation coefficients. Statistical analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC), and p values less than 0.05 were considered statistically significant.

The overall survey response rate was 12%, and the overall conversion rate was 9%. The conversion rate is defined as the number of people who completed the survey divided by the total number who started the survey. Among the 400 respondents currently using hearing aids, 200 self-reported the diagnosis of moderate to moderately severe hearing loss and 200 self-reported moderately severe to profound hearing loss. Median age at time of survey was 66 years (interquartile range, 60–71 yr), 215 (54%) were male, and 254 (64%) were using hearing aids in both ears. Demographics are further detailed in Table 1.

Perceptions about hearing loss and hearing aids are summarized in Table 2. Among all respondents, 48% indicated that they were comfortable with their current level of hearing, although most recognized that their hearing loss would likely worsen in the future. In total, 26% did not think of hearing loss as a medical condition and another 23% were unsure. Furthermore, 28% try to avoid thinking about their hearing loss. Only 13% of respondents were very satisfied with their current hearing aids; this number decreased from 18 to 9% comparing those with moderate to moderately severe versus moderately severe to profound hearing loss.

Perceptions about cochlear implants are detailed in Table 3. Among all respondents, 63% had heard of cochlear implants, but only 2% indicated that they were very familiar with them. Overall, 52% of respondents reported “very positive” or “somewhat positive” feelings about cochlear implants, 36% were neutral, and 11% had varying levels of negative feelings. Out of a list of potential words associated with cochlear implants, the most selected association was “hope,” followed by “confidence,” “control,” and “optimism;” 20% of respondents indicated “fear.” More than half of respondents felt that cochlear implants were relevant to their condition, whereas 26% indicated “cochlear implants are not for people like me.” Respondents felt that their audiologist or ENT provider was the most trusted source of information about cochlear implants, with 50% reporting that they were “very likely” to discuss cochlear implants with these specialists. Nonetheless, only 9% of respondents indicated that they were “very likely” to get a cochlear implant in the future, including 7% of those with moderately severe to profound hearing loss at the time of survey.