When it comes to imagining hearing devices in the patent world, the range is broad, both in terms of goals and body regions.

It’s a Simple Ear-Thing 

 

“Simplified Hearing Aid” is the title of USPTO patent #9,724,241 by Japanese inventor/owner Ogura.  The device (see feature image), which hearkens back to ear trumpets and the “Ear Resonator” (USPTO patent #4556122) is configured to function without an electrical power supply.

Instead, it relies on a “sound collector having such a shape [which] offers an improved sound collection effect.”  With a  nod to Zwislocki, the design inserts “…into the external auditory meatus, the edge of the insertion end reaches the vicinity of the osseous portion of external auditory meatus. …allow[ing] the user to utilize the bone condition and clearly hear a sound even if it is small.”

 

It’s a Complicated Brain-Thing  

 

Oticon’s USPTO #9743197 departs the ear and journeys into the brain, aiming to enhance suppression of “non-wanted auditory percepts”  in working memory by selectively increasing alpha wave activity. Hearing aids of this type are multi-taskers, delivering amplification and neural entrainment in a single package.

The rationale states that “Understanding speech in real world situations, require the involvement of the working memory, which has been linked to alpha activity. … age-related decline in alpha activity together with individual differences might result in subjects being unable to generate enough alpha activity to successfully suppress irrelevant information and thereby overcome difficult listening situations.”

 

It’s a T-Shirt Thing

 

http://pdfpiw.uspto.gov/.piw?PageNum=1&docid=09723403&IDKey=2F9937D40209&HomeUrl=http%3A%2F%2Fpatft.uspto.gov%2Fnetacgi%2Fnph-Parser%3FSect1%3DPTO1%2526Sect2%3DHITOFF%2526d%3DPALL%2526p%3D1%2526u%3D%25252Fnetahtml%25252FPTO%25252Fsrchnum.htm%2526r%3D1%02

Figure 1. A wearable hearable design in USPTO #9723403

For those on the go and in the milieu, with or without hearing loss, USPTO #9723403 is a Hearable/Wearable attached to the shoulders and sewn into the seams of a garment (Fig 1).  Whether the t-shirt is washable or dry-clean only is not specified, but the device design is as follows:

“…a bidirectional microphone system that can be incorporated into a wearable garment, calibrate directionality and time delay at an individual microphone level, and process a high definition digital audio output of a user’s voice in high ambient noise environments.”

 

The List

Description

Patent Number

Assignee

Issued

Auditory sensitivity adjustment device

9717632

Kumagawa, Yosuke (Kanagawa, JP)

8/01/2017

Hearing and speech impaired electronic device control

9721481

Shovkoplias, Yuri (Kharkiv, UA)

8/01/2017

Antenna unit

9722306

Oticon A/S (Smorum, DK)

8/01/2017

Wearable directional microphone array apparatus and system

9723403

Wave Sciences, LLC (Charleston, SC)

8/01/2017

Multi-microphone method for estimation of target and noise spectral variances for speech degraded by reverberation and optionally additive noise

9723422

Oticon A/S (Smorum, DK)

8/01/2017

Binaural hearing aid system with feedback suppression

9723413

GN Hearing A/S (Ballerup, DK)

8/01/2017

Method for signal processing in a binaural hearing device and binaural hearing device

9723414

Sivantos Pte. Ltd. (Singapore, SG)

8/01/2017

Performance based in situ optimization of hearing aids

9723415

GN Hearing A/S (Ballerup, DK)

8/01/2017

Hearing assistance devices and user interfaces for use with same

9723416

Advanced Bionics AG (Staefa, CH)

8/01/2017

Headpieces and implantable cochlear stimulation systems including the same

9717918

Advanced Bionics AG (Staefa, CH)

8/01/2017

Systems and methods for facilitating post-implant acoustic-only operation of an electro-acoustic stimulation (“EAS”) sound processor

9717909

Advanced Bionics AG (Staefa, CH)

8/01/2017

Systems and methods for detecting a compliance state of a current source included in a cochlear implant

9717908

Advanced Bionics AG (Staefa, CH)

8/01/2017

Radio frequency (“RF”) power level management systems and methods for use in a cochlear implant system

9717907

Advanced Bionics AG (Staefa, CH)

8/01/2017

Systems and methods for measuring a current output by a current generation circuit included in a cochlear implant

9717906

Advanced Bionics AG (Staefa, CH)

8/01/2017

Backup sound processor with multi-user functionality

9717905

Advanced Bionics AG (Staefa, CH)

8/01/2017

Simplified hearing aid

9724241

Ogura, Moritakai (Kanagawa, JP)

8/08/2017

Wearable earbuds having a reduced tip dimension

9729953

Logitech Europe S.A. (Lausanne, CH)

8/08/2017

Acoustic feedback event monitoring system for hearing assistance devices

9729976

Starkey Laboratories, Inc. (Eden Prairie, MN)

8/08/2017

Method for operating a hearing device capable of active occlusion control and a hearing device with user adjustable active occlusion control

9729977

Sonova AG (Staefa, CH)

8/08/2017

Antenna system for a hearing aid

9729979

GN Hearing A/S (Ballerup, DK)

8/08/2017

Hearing aid fitting device, hearing aid, and hearing aid fitting method

9729982

Panasonic Intellectual Property Management Co., Ltd. (Osaka, JP)

8/08/2017

Hearing device with model control and associated methods

9729983

GN Hearing A/S (Ballerup, DK)

8/08/2017

Power and data transfer in hearing prostheses

9724525

Cochlear Limited (Macquarie University, NSW, AU)

8/08/2017

Malleable implantable medical device 

9731128

Cochlear Limited (Macquarie University, NSW, AU)

8/15/2017

Magnetic stimulation in tissue-stimulating prostheses

9731142

Cochlear Limited (Macquarie University, NSW, AU)

8/15/2017

Deep electrode insertion fitting in cochlear implant patients with residual hearing

9731129

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

8/15/2017

Audio processing compression system using level-dependent channels

9736583

Starkey Laboratories, Inc. (Eden Prairie, MN)

8/15/2017

Method for evaluating a useful signal and audio device

9736599

Sivantos Pte. Ltd. (Singapore, SG)

8/15/2017

Audio control using auditory event detection

9742372

Dolby Laboratories Licensing Corp (San Francisco, CA)

8/22/2017

Method, device and system for increasing a person’s ability to suppress non-wanted auditory percepts

9743197

Oticon A/S (Smorum, DK)

8/22/2017

Systems and methods for hearing assistance device antenna

9743198

Starkey Laboratories, Inc. (Eden Prairie, MN)

8/22/2017

Parallel antennas for standard fit hearing assistance devices

9743199

Starkey Laboratories, Inc. (Eden Prairie, MN)

8/22/2017

Implantable stimulating assembly arrangements

9744346

Cochlear Limited (Macquarie University, NSW, AU)

8/29/2017

Automatic determination of the threshold of an evoked neural response

9744356

Cochlear Limited (Macquarie University, NSW, AU)

8/29/2017

Optimizing operational control of a hearing prosthesis

9744357

Cochlear Limited (Macquarie University, NSW, AU)

8/29/2017

System and method for neural cochlea stimulation

9744358

Advanced Bionics AG (Staefa, CH)

8/29/2017

Wireless audio signal monitor output for hearing implant system

9744355

Med-El Elektromedizinische Geraete GmbH (Innsbruck, AT)

8/29/2017

General purpose device to assist the hard of hearing

9747814

International Business Machines Corp (Armonk NY)

8/29/2017

Hearing device with low-energy warning

9749753

Oticon A/S (Smorum, DK)

8/29/2017

Hearing aids with adaptive beamformer responsive to off-axis speech

9749754

Starkey Laboratories, Inc. (Eden Prairie, MN)

8/29/2017

Hearing device with sound source localization and related method

9749755

GN Hearing A/S (Ballerup, DK)

8/29/2017

Methods and apparatuses for setting a hearing aid to an omnidirectional microphone mode or a directional microphone mode

9749756

GN Hearing A/S (Ballerup, DK)

8/29/2017

Binaural hearing system and method

9749757

Oticon A/S (Smorum, DK)

8/29/2017

Sound tube for an earpiece, sound tube arrangement, earpiece with such a sound tube or sound tube arrangement and hearing device with such an earpiece

9749759

Sonova AG (Staefa, CH)

8/29/2017

Barbara Weinstein PhD

Barbara Weinstein’s “Downstream Consequences of Aging” appears bi-monthly at HearingHealthMatters.org. Today’s post is part 2 of a series on reframing the clinical conversation with older adults.

 

Numerous top down initiatives directly impact how we may wish to reframe the conversation about ARHL and scope of audiologist practice. Two initiatives most relevant to audiologists are:

  1. The recommendation that health professional schools and professional societies develop and disseminate core competencies, curricula and continuing education opportunities that focus on cognitive health and aging (IOM, 2015).
  2. The decision on behalf of the Lancet International Commission on Dementia Prevention, Intervention and Care (Livingston et al. 2017) to extend the list of modifiable risk factors for addressing dementia to include hearing loss.

It is the latter initiative to which I would like to focus my attention today.

 

Modifiable Risk Factors for Dementia

 

In the Lancet report, authored by 24 international experts on dementia, Livingston and colleagues (2017) shared the results of their review and meta-analysis of recent advances in dementia research. They concluded that based on the evidence and their calculations, close to a third of dementia cases might be preventable.

They proposed mechanisms linking potentially modifiable risk factors to dementia and concluded that at an individual level, older adults have the potential to reduce their risk of cognitive decline, and possibly forestall the onset of dementia, by adopting healthful behavior changes. Consistent with the philosophy that prevention is better than cure, the experts concluded that detecting modifiable risk factors for dementia would be cost effective and to this end they proposed a novel life-course model to dementia based on modifiable risk factors.

 

Social Isolation and Hearing Loss

 

The risk factors they included in their analysis were those listed in the UK National Institute of Health and Care Excellence (NICE) report and the US National Institutes of Health (NIH) guidelines (NICE, 2015; Daviglus et al, 2010). Of relevance to audiologists is that NICE and NIH identified social isolation and peripheral hearing loss as potentially modifiable dementia risk factors. While the mechanisms remain unclear, the experts acknowledged that hearing loss may add to the cognitive load of a vulnerable brain and/or may lead to social disengagement or depression accelerating brain atrophy. 

The team of experts underscored that evidence is lacking at present as to whether hearing aids can alleviate or forestall onset of cognitive decline. However, in their life course model they advocated for identifying hearing loss in mid-life as one of many approaches to earlier identification of dementia or reduction of risk of developing dementia.  This recommendation is justified since longitudinal studies on incident dementia suggest a time course of between ten to fifteen years between recognition of hearing loss and onset of dementia in selected individuals (Lin, et al., 2011; Gallacher et al, 2012).  

 

Social Engagement and Successful Aging

 

A report authored by Ballard, and colleagues (2017) revealed that patient centered activities combined with as little as one hour a week of social interaction could improve quality of life and reduce agitation experienced by older adults with dementia living in care homes. These results underscore the potential for our auditory interventions to play a role in promoting communication and, in turn, social connectedness.

In fact, according to Kim & Park (2017) social engagement has a strong relationship with successful aging. They concluded that health professionals should help older adults by recommending interventions designed to enhance psychological adaptation and prolong social engagement. 

Herein lies the opportunity for audiologists to be part of the solution. 

 

Lifestyle Intervention to Optimize Communication and Promote Social Engagement

 

As eloquently stated by Wilson and colleagues (2017) the reach of hearing loss extends far beyond sensory impairment. In fact sensory function is a basic measure of brain “integrity” serving perhaps to affect cognitive performance (Lindenberger & Baltes, 1994).  

In keeping with the life course model proposed in the Lancet report, the benefits of early screening and perhaps reframing management of hearing loss as a lifestyle intervention may yield significant benefits with few risks. Let us:

  • Be proactive and underscore how our interventions have the potential to enable active engagement with life so important to cognitive well-being. When advocating for hearing enhancements and auditory rehabilitation, it is critical that we quantify and enumerate the social benefits (including engagement with others) that are so important to physical activity levels and cognitive well being.
  • Move out of the sound treated room and emphasize the value added of early identification and treatment and our potential role in promoting cognitive health and the maintenance of cognitive functioning (Fisher et al. 2017). We audiologists are the experts to assist with environmental enrichment and optimizing social interactions and engagement. The potential intervention window to delay onset and reduce incidence and prevalence of dementia is narrow.
  • Since hearing loss is a possible modifiable risk factor, perhaps we should seriously consider engaging indirectly in case finding, or identifying and referring to specialists individuals with whom we work who may be presenting with behaviors consistent with dementia, notably memory problems or changes in social functioning.  As timely diagnosis of dementia allows people to plan for their future, making the appropriate referral may help to reduce or delay the progression of disease. Earlier identification and management of hearing loss may be a lifestyle intervention whose time has finally come.

 

References

 

Ballard C et al. (2017). One social hour a week in dementia care improves lives and saves money.   Retrieved  July 31, 2017 from

Daviglus M et al. (2010). NIH state-of-the-science conference statement: preventing Alzheimer’s disease and cognitive decline. NIH Consens State Sci Statements.  27: 1–30.

Fisher G et al. (2017). Cognitive Functioning, Aging, and Work: A Review and Recommendations for Research and Practice. Journal Of Occupational Health Psychology. 22: 314-336.

Gallacher J et al. (2012). Auditory threshold, phonologic demand, and incident dementia. Neurology, 79: 1583 1590.

IOM (Institute of Medicine). (2015). Cognitive aging: Progress in understanding and opportunities for action. Washington, DC: The National Academies Press.

Kim S & Park S. (2017). A Meta-Analysis of the Correlates of Successful Aging in Older Adults.  Research on Aging. 39: 657–677.

Lin FR et al. (2011). Hearing loss and incident dementia.  Archives of Neurology, 68: 214-220.

Lindenberger U & Baltes PB. (1994). Sensory functioning and intelligence in old age: A strong connection. Psychology and Aging, 9, 339–355.

Livingston et al. (2017). Dementia prevention, intervention, and care. Lancet published online July 20.

National Institute for Health & Care Excellence NICE (2015). Dementia, disability and frailty in later life—mid-life approaches to delay or prevent onset. London: National Institute for Health and Care Excellence, 2015.

Wilson B et al. (2017). Global hearing health care: new findings and perspectives. The Lancet. July 10 2017.

 

 Barbara E. Weinstein, Ph.D. earned her doctorate from Columbia University, where she continued on as a faculty member and developed the Hearing Handicap Inventory with her mentor, Dr. Ira Ventry. Dr. Weinstein’s research interests range from screening, quantification of psychosocial effects of hearing loss, senile dementia, and patient reported outcomes assessment. Her passion is educating health professionals and the public about the trajectory of untreated age-related hearing loss and the importance of referral and management. The author of both editions of Geriatric Audiology, Dr. Weinstein has written numerous manuscripts and spoken worldwide on hearing loss in the elderly.  Dr. Weinstein is the founding Executive Officer of Health Sciences Doctoral Programs at the Graduate Center, CUNY which included doctoral programs in public health, audiology, nursing sciences and physical therapy. She was the first Executive Officer the CUNY AuD program and is a Professor in the Doctor of Audiology program and the Ph.D. program in Speech, Language and Hearing Sciences at the Graduate Center, CUNY.

feature photo courtesy of shannon christy