Slate – unpaywalled: Millions of Americans who could benefit from them don’t use them. Why not? – “One morning this past March, I stirred from slumber convinced that someone had snuck in overnight and packed my ear with Jell-O. Still drowsy, I registered that the fullness seemed to extend horizontally toward the window, some six feet away. I sat up, thinking this would bring some sense to the situation. It did not. I later learned that I had experienced “unilateral sudden sensorineural hearing loss,” commonly known as sudden deafness. There are an estimated 66,000 new cases in the United States each year; its cause is rarely identified. In around half of those cases, people will recover their hearing spontaneously or with timely medical care. For the rest of us, the hearing loss will be permanent. I was doing research overseas, on sabbatical from the law school where I teach, when my case of sudden deafness struck. The hearing loss wasn’t total: I could still hear loud noises clearly, like a ringing phone or a police siren, but I struggled to make out speech. Unless I was in a quiet space, with a single person speaking directly to my face, conversations involved a lot of guesswork. It would be five months before I’d be back home and able to access the follow-up treatment needed to get hearing aids. In that time, I developed some adaptation strategies and began, to a degree I was unaware of, to normalize moving about in a world where my brain got only part of the auditory input that those around me were receiving. This has given me a glimpse into a few of the reasons why just 16 percent of Americans between the ages of 20 and 69 years who would benefit from hearing aids ever use them. Some 20 million go without. Untreated hearing loss generates a cascading set of consequences. Hearing is vital to communication. As communication becomes more difficult, social isolation increases, which in turn can cause or exacerbate loneliness, anxiety, and depression. Social isolation also limits opportunities for cognitive functioning, and navigating the world in the face of hearing loss depletes cognitive resources that would otherwise be used to maintain brain function. Among older adults, the data on the relationship between hearing loss and cognitive decline is clear. Even mild hearing loss is associated with doubling the risk of dementia. As Professor Jan Blustein at NYU School of Medicine puts it, “Hearing better helps you think better.” Nonetheless, for American hearing aid users there is, on average, a 10 year time lag between when they need support and when they start using hearing aids. Why?…”