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 Audi Experts. He is the co-founder
of the Hearing and Brain Centers of America. Dr. Darrow has chosen to lead the excellence in
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 1200
times. And we just found out that we live in the small suburban town, Sterling, Massachusetts.
Keith, thanks for joining me. Absolutely. No, thank you for having me. It's not often I get
to do a podcast with a neighbor. 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 it? It's one of those things where I didn't know we were going to start
at high school, but I'm glad you brought it up. It's one of those things where 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. I don't know if I believe in it, but I'm actually living proof of it.
For me, I don't have one of those stories where, oh, 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.
Now, once I got in, the hearing just, I mean, still to this day, I'm out of college. I'm not
going to 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 snowballed, graduate
school, then my doctoral work, and I'm still doing it today and loving every minute. 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? 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.
Look, I'm not saying this. I'm just going to 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
ostracized from society. They had difficulty getting jobs. They had difficulty in school.
Difficulty in school. And they were kind of just brushed under the rug.
How have you seen the field if it's only a generation two 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? 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.
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 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 definitely still a stigma in the older population, I would
say 60 plus wherein hearing losses 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 about it. So they go 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. 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? Can I just
say yes to all of the above? Maybe. 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 going to 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 know, 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. Now you also mentioned price. I think the issue
is into the price because Americans in general spend a lot of money on things. Obviously there
are people that have difficulty, that don't have the means, but then there's a lot of people who
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. How do you put a monetary value on those
things? 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.
Yeah, maybe let's dive into that topic. You talked 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?
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 minutes. Consolidate in the four minutes, please.
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. 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 2010,
a landmark study came out of Johns Hopkins, right? So this isn't just some random research,
you know, 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 100% of the population with hearing loss.
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
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 in 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, 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. Yeah, I was going to 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 yeah, well, it's, you know, 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, 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. Is there a specific subset of
the population or maybe even an occupation that seems to be most prone to tinnitus? 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, oh, that's a little loud,
I promise you, it's too loud and it's damaging your ears.
Yeah, I was going to ask if it was dose dependent or amplitude dependent, but it's probably too
hard to quantify. It absolutely is. 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 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'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 want to catch it early and treat
it early. Yeah. I was going to, when you mentioned that statistic, I was just thinking like, 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? Yeah. Again, I'm going to go with D,
all of the above. 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, which in 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,
you know, 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 70s.
If I say her age, she'll kill me, but she's in her 70s. 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, you know,
older adults are out playing pickleball, they're out at, you know, senior centers,
they're just having a lot of fun. Yeah, we talked about health span versus lifespan. 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.
And 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 these symptoms, where would you recommend that they go
or find out? 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, it's excellenceinaudiology.org.
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 excellenceinaudiology.org. There's
tons of education, tons of resources. And if you're looking for a provider, there's one of
those maps. 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? So excellenceinaudiology.org. 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 stoptheringingtoday.com. 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. Yeah. Well, actually, I would 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
between the show and... I just want to say about that. I hope you don't mind, but I always find
this one funny. I'll give a talk or a patient will come in and they'll tell me, 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. So 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. 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?
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 going to 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 going to screen for that. And this is, again,
this is FDA cleared technology that we're using. Then we're going to 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 going to 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 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 in 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. 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? 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, but so, you know, sometimes I kind of have to think it was, 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.
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, concerned 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. 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 going to be in one,
five, 10 years? You've got to 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 is probably just the one easy word I could say, but training also never ends, right?
Just because you hired somebody and you gave them, you know, the 120 page binder, it doesn't end.
Right. I mean, look at some of the big fast food chains, you know, 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,
you know, 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. Yeah, absolutely. Systems are definitely necessary for scaling,
for sure. Going back to 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? 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 who are in the field who are
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 yeah, yeah, absolutely. Maybe on that topic of
accommodations, our podcast is kind of fitness specific. We hope that people take away tips as
to make gyms more accessible and inclusive. Do you have any ideas what a fitness facility could do
to be more accommodating or accessible for those with hearing loss? Give me a second to answer that
because this is fitness focused. And so I imagine people that are listening are, well,
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 and tinnitus 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. 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. 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, like stuff like that. But maybe how could
a fitness instructor be more accommodating for a member that has a hearing loss or hearing?
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. 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. 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 want to listen to.
Right? So if they want to listen to the gym'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. I would say one of the most important things is what does the ceiling look like?
Right? Can you hang acoustic tiles? Those tiles you see in all the classrooms and elementary school,
like schools didn't buy that because it 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.
Absolutely. Some of our members probably wish they could tune out my music throughout the
sessions as well. I get a lot of complaints, but one more-
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.
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?
Look, I said in the beginning, I don't like cliches, but I'm going to 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, 7, 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 going
to 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. You know,
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.
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. 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 was 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 going to
say it's too late, but that's very late, right? That's like, you know, you waited until something
like 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.
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 so, so the great thing about the FDA clear technology we use, it's called cognitive view
thrive is it's actually age based. So if you're 35, I put that in, it then compares you to age,
you know, age norms. I'm not going to 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
a even worse. Yeah, the healthcare is very reactive instead of proactive. But I think
thanks to like 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 it's 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. 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? Yeah. I mean, look, if excellence and audiology.org
is really your sort of catch base for all things hearing loss and tinnitus, we have
a new line of preventing decline.com 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. 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 and 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. Brendan, thank you so much.
And I'll keep an eye out for you around town. Thank you for listening to the AdaptX Podcast.
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