275. Brandon Sawalich: On The Science of Hearing Loss, Dementia Prevention & AI Hearing Technology

0:00You have one in six teenagers right now have hearing loss. It's a quiet pandemic because they're blowing out their ears, whether it's headphones and, you know, just loud music and a lot of reasons.

0:08Gary Brecka:Once you damage them, they don't come back. It's a health issue, but it's not one that's alarming people because it's quiet and it's invisible. When you have this kind of hearing loss and you don't get an explanation for it, it makes people feel hopeless. Hearing connects you with people. It connects you with your environment, your day job, your kids, and it's the fitness for the brain. It makes sense to me from the standpoint of isolation. I mean, as you lose your hearing, you become increasingly more isolated from your family, from your environment. Hearing is essential. If you want everything to be balanced at work, you got to feed that brain and exercise the brain.

0:39And that's how you do it.

0:39Gary Brecka:Let's say that you go in and you get a hearing assessment and you start to notice that certain frequencies are beginning to degrade. What are the things to mitigate to stop that slide? They talk about the solutions to treat the hearing loss. And it's the two words that always gets everybody because of the stigma associated with it. And that's.

1:08Gary Brecka:Hey, guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist, Gary Brecka, where we go down the road of everything, anti-aging, biohacking, longevity and everything in between. And today's a particularly interesting topic to me because having been in this space for so long and run with so many of my peers on all of the different biohacking modalities that we use, we measure our VO2 max, we do clearly heart scans, full body per novo, we eat a whole food diet, we monitor our BMIs, we monitor our heart rate variability. We have so many measurement tools to see if we're on track, but we rarely talk about today's topic.

1:45Gary Brecka:And there is a very interesting study recently published in The Lancet that I want to bring up on the podcast that really shifted my entire mindset around hearing loss and the impact it has on longevity, isolation, neurocognitive decline, even dementia. And so today's guest is Brandon Sawalich from Starkey Hearing Technologies. And he's here to talk about this study, amongst other things, what you can do about it, when you should start testing. I'm really excited to run this topic with you because rarely do I get a fresh, new, unexplored area of biohacking and biooptimization that could potentially be so impactful.

2:30Gary Brecka:And so I wonder if you might just give my audience a little bit of background, what you do and what's going on over at Starkey. Sure. Thank you, Gary. Honored to be here. This is exciting because you're right. It's hearing and healthy hearing and there's so many stigmas around it and, you know, hearing aids in today's technology. And let's clear some of these myths up. And, you know, we've been in business, Starkey, outside of Minneapolis for 59 years. I've been president and CEO for the last seven. Okay. And been at Starkey for 31 years, started as an intern in college. What do most people, in your opinion, fundamentally misunderstand about the relationship between hearing and brain health?

3:11Well, they don't connect it. I mean, that's the number one. When people think I have a hearing loss, if I say, you know, ask anybody about it, the first thing they say is I'm old age. And then there's, you know, due to whether it's movies, media, you know, it could be now, of course, social media. Sure. The stigma is that associated with hearing aids and hearing loss, right? I always think of the movie Up or, you know, a movie or TV show, hearing aids squealing because it's feeding back and it's big and, you know, it looks like you're disabled.

3:42Gary Brecka:And people have a, it's the social stigma, you know, if you're wearing a hearing aid, then you must be old. Yes, it's the stigma around that. And if I have hearing loss, well, I'm not going to die from it. I don't need to do anything about it. So it's a disadvantage that is out there more than people think. But 44 million in the U.S., estimated 500, half a billion. 44 million have hearing loss, like clinical-grade hearing loss. Wow. And half a billion around the world. So it's a health issue. Yeah. But it's not one that's alarming people because it's, like I said, it's quiet and it's invisible.

4:18Gary Brecka:You know, in preparing for the podcast, I started going down some of the rabbit hole in the science behind hearing loss and its connectivity to brain health, early onset cognitive decline. And I stumbled onto a study in The Lancet, very well done. This was a peer-reviewed, double-blind, randomized, controlled trial. It was a large control group. And essentially what they surmised was that hearing loss is the most preventable. It is the single most, the intervention is the single most preventable way to mitigate the risks of dementia. I found that pretty fascinating. Yeah, we've been waiting for the results of that study for over three years, I believe.

5:00Gary Brecka:Yeah, and I want to be specific about it in the conclusion section. They named untreated hearing loss as the single largest modifiable risk factor for dementia. So can you kind of walk us through the physiology? you know it makes sense to me from the standpoint of isolation right I mean as you lose your hearing you become increasingly more isolated from your family from your environment it's obviously the way that we all interact the way my whole audience is listening to this podcast but can you walk us through the physiology behind that yeah if you look at you know what how the human brain works I mean, we hear with our brains.

5:41And if you look at all the five senses, you know, hearing is, you could argue, they're all important, of course. But hearing connects you with people. It connects you with your environment, your day job, your kids, go down the list. And it's the fitness for the brain. And so, again, it's not something that's been talked about because it's always talked about when, you know, you're older in life. Again, it's not as important. and with today's you know discussions around mental health if you start having a hearing loss let's say 35 40 could be noise induced you know many many reasons you know you start um you know drawing withdrawing from you know your day your day-to-day activities and so what we're what we've been doing is you know educating people on this because again it's not something that's been above the radar.

6:29And if you think about the mental health discussions and somebody that does start having a 35 or 45, they don't do anything about their hearing loss until about seven years. It's about the average because it's never that bad.

6:41Gary Brecka:When it starts to decline and you're talking a little louder to them, they're turning an ear towards you or something. The spouse usually is the one that forces something, go get your hearing checked. So seven years to do something about it, depending on when it came on. And then the mental aspect of, think of, you know, you do start withdrawing. You isolate yourself. You start putting yourself in positions where you don't have to interrupt or say, excuse me, can you say that again? Because people start becoming embarrassed about it. And at a point where they really don't notice it. Wow. And you start forgetting sounds.

7:14Gary Brecka:You know, I remember when we, my mom's father, Barry Blake, you know, in his early 80s, his hearing had significantly declined. Now he had been in World War II and he had had some pretty serious concussive injuries and probably accumulated that over time, my grandfather. And I remember that we would sit around the table and we would literally have to shout at him. And he was very reclusive because of that. And when you would sit in a quiet room and speak loudly to me, he wasn't unintelligent. He didn't become dumber. he just became more reclusive. And, you know, I remember even to this day, you know, some of my aunts and uncles would almost talk to him like a child, kind of like baby talk, just because he couldn't hear.

8:07Gary Brecka:And I knew that that irritated him, you know, because again, he wasn't becoming an invalid. He was just hard of hearing, you know, and he was probably insulted by it now that I think back about it. But, you know, a lot of the physiology around hearing that I am familiar with is, you know, some measures of damage to your hearing, especially those in the cochlea, the cilia, the hairs in there. Once you damage them, they don't come back. Right, that's the one thing people don't recognize is once you lose it, you're not getting it back. And it could continue, obviously, to get worse, whether it's genetic or more noise-induced.

8:45But you have one in six teenagers right now have hearing loss. Really? It's a quiet pandemic, no pun intended, that one in 16 is because they're blowing out their ears whether it's headphones and, you know, just loud music.

8:57Gary Brecka:I'd love to talk about that too. I mean, what are your opinions on like some of these, like earbuds and things like that? I use a corded headset sometimes when I go to the gym, but I keep the noise at a modifiable level. I don't blast myself. I've got a lot of friends that are DJs that are around really loud, noisy environments, you know, consistently. Most of them are either dealing with mild tinnitus or they're also dealing with measurable hearing loss. But once you discover, let's say that you do a hearing test and you discover that you have certain pitches that are missing or certain pitches that are frequencies that are not audible to you or they're diminishing in your ability to hear them, I mean, what can be done about that?

9:42Well, obviously you're going to go see an audiologist or a hearing health care professional that could do the test, look inside the air make sure it's healthy functional you know sometimes um air wax is

9:54Gary Brecka:the problem or gets in the way that's a good one i mean that that makes it easy though right it's rare but it does happen uh and then you know they talk about the solutions to treat the hearing loss and and it's it's the two words that always gets everybody because of the stigma associated with it and that's you know the hearing aid yeah you know this and it's not what it was it wasn't the grandfather's hearing aid. It's like the size of a coffee bean what's going in your ear. There's 310 components in here that has to work all at once and withstand with sweat, hairspray, you name it. And with the 310 components, you're dealing with an AI processor, Bluetooth radio, and many, many other components just to get the sound at the right levels.

10:39And you're talking high-tech sound and sleek.

10:42Gary Brecka:But it's more than just sound amplification. It's more than just that hearing aid receiving the sound and amplifying the signal. That's what they used to do, right? Because it'd amplify everything. Right. So now what we're doing with AI, we were the first to bring in AI into hearing technology in 2017. So what we're doing with that is we're personalizing the sound to the listener. So, I mean, AI is the perfect listening tool that's adjusting and adjusting their sounds and what their daily life needs to be so they could do it, I would say, with hearing ease. Because, you know, I see a lot of these commercials, you know, for hearing aids, and one of the big hallmarks that they're trying to address, you know, at least from these commercials I see, is not picking up the ambient noise.

11:33Gary Brecka:Because, you know, the scenario is always like you're sitting in a restaurant, you know, with two, three, four people at a table, you're having a conversation, but the hearing aid is picking up all the clanking of the dishes at other at other tables and amplifying that sound. And that seems to me like it would actually be, that would give me anxiety if you amplified all that sound. And that's what you were discussing just a bit ago, the amplifying sound. That's the old technology, what it would do. And what we're doing now is again, if I'm sitting here, we were at an event and you and I were talking, it's quieting, knowing the environment that I'm in, the noisy environment, it's quieting the sounds around me and know that I'm talking to you, you're having a conversation and I wanna focus on speech.

12:14You know, it's not going to bring in everything else at the same levels.

12:17Gary Brecka:Yeah. Now, what was wild, which is not related to its ability to improve your hearing at all, was I did a demo with this late last year. One of your docs came over, I think, with Damon. He fitted me for him. And I have a Portuguese-speaking housekeeper that's been with me for a long time. She also speaks English. I don't speak a lick of Portuguese. Yeah. No. So, but we turned on the language translation and it was pretty wild. Like in almost real time, she would speak fluent Portuguese to me and it was translating it into English. I thought that's like a, that's like some spy level shit. I mean, that was like, you know, like James Bond.

12:59Gary Brecka:So, you know, cause like no longer can like the people at the table that, you know, speak Russian or German or whatever. And you're only an English speaker. No longer can they have that quiet conversation. Yeah. That's what Starkey's doing different. I mean, that's what we're doing since 2017 is turning in it from a multipurpose, a single purpose to a multipurpose device. So, you know, there's a whole lot of reasons I'm sure that people can lose their hearing, you know, trauma, head injury, age, you know, declines, stiffening of the tympanic membrane. Medication. Medication. What kind of medications actually run risk?

13:31Well, you're talking, well, I mean, pain medication. You go down the list, there's, you know, other, you get the warning now, but there's quite a bit that are promoted on TV and other places that if you take too much of it, you know, you're going to get tinnitus or it can, you know, lose some hearing. Pain medication, as I mentioned, that's one of the topics if you take too much.

13:52Gary Brecka:And what about tinnitus or tinnitus as you call it? Is that the right way to say it? Tinnitus, yes. Okay, I'll take it from you since you're in the industry. But I always said tinnitus. But, you know, that has been an issue for an increasing number of clients of mine. I've found a number of things. One, when their nervous system is in a heightened state of alert and they're trapped in the sympathetic state, they can't calm down. I mean, it's well known that if you go into a state of fight or flight or you have a panic attack or you experience a traumatic moment, very often you can have ringing in the ears without a traumatic event.

14:32Gary Brecka:You know, gunshot didn't go off next to your ear or anything like that. What, if anything, can you do for chronic tinnitus? Do you match the frequency? Sometimes with the hearing, with our hearing technology, yes, we can mask it and give it that, you know, that white noise effect where it just, you kind of forget about it. It just calms it. You know, I've seen it so bad on people where it's, I won't compare it to chronic pain, but it's at that level where it just drives them crazy, where it's just, it debilitates them. Actually, no, there's some very interesting data on that. I mean, complex regional pain syndrome, I think, is the leading, is right up there with the highest suicide rates.

15:13Gary Brecka:But chronic unrelenting tinnitus is not far behind. I mean, and I've actually had clients of mine that suffered from unrelenting tinnitus, and it just destroyed their life. And people that have struggled with that, I have so much empathy for because it's not something you can get away from. I mean, if your wrist is bothering you, it's kind of distant and you can compartmentalize it, but your hearing is inside your head. And if it doesn't shut off 24 hours a day, seven days a week, it's like Chinese water torture. And no one knows you're suffering but you. I mean, you can't explain it except the way we just did very plainly.

15:53But there's so many things that go into it. And in today's world, we're more exposed to sound, loud sounds than ever. Think about, yes, there's your nightclubs, your musics, sporting events. You know, they're promoting pump up the volume, pump, you know, they want it loud in there. And you're getting it up to jet engine loud. I mean, it's some of that. That's where the ringing can come from, of course, with hearing loss, but the ringing can come from constant exposure from loud sounds.

16:17Gary Brecka:And, you know, I've been reading that even a single event like that, where that noise is that loud, can cause some measure of permanent hearing loss. At the UFC event on Saturday night. I was thinking about it myself, honestly. It was 122. I pulled out my... You have a desk. I do. So we also do... We also work with... I mean, I guess you're in the space. You travel with your own meter, so... We have our SoundGear technology and product that protects healthy hearing. So we work with the Department of Defense, hunters, you know, other device that gives you situational awareness. So, you know, you have the hearing because it's not like plugs or putting cotton in here because then you lose everything.

17:02You can't hear what's going on around you. And at the certain DB level, you know, it'll instantly, within milliseconds, shut it down and protect our soldiers serving along with hunters, industrial workers who go down the line.

17:15Gary Brecka:Oh, so if there's some kind of concussive sound, it would mitigate that. Like a noise canceling. Noise canceling, yes. It shuts it down and protects the hearing. That's great. Absolutely protects it. Because, you know, one of the largest channels that we serve, Starkey works with, is the VA veterans. And I've been and I've talked to senators and others when we're talking about veterans hearing health and, you know, just having discussions. you know they are our number one customer i said i hope in five to ten years that's not the case right because they're more education more technology there can be things done about up front are they starting to be proactive yes they are okay yes and and you know i've got to think that you know i'm going to go back to tonight's again for a second um because there's a large group of sufferers one of one of the best uh most popular podcast shorts that i've done and recently was on tinnitus, tinnitus.

18:17Gary Brecka:What do you do to mitigate that? And I know it's multifactorial. You can have anatomical damage. You can be in a high stress state. Your nervous system can be trapped in a sympathetic state and could be actually causing the perception of sound when there is no sound. But do you see anatomical anomalies that lead to this? I mean, there's classic Meniere's, right? Yeah, but there's so many paths to get there. it really depends on the person's awareness of their environment day in and day out what are they doing you know just like our our eyes what are we doing exposing ourselves to the ears and then you know that person's of course their genetic makeup what are they going to get the hearing loss and tinnitus or how bad i mean there's so many paths to it i wish there was one answer i you know there's a lot of things that are advertised or marketed as you know whether it's drops or pills you know to help with tinnitus and you know i don't have any solution have found anything there that cures it.

19:13But I do know that masking and using hearing aids, if you have a hearing loss or hearing technology, can mask it and suppress it where you're not thinking about it.

19:22Gary Brecka:So this is like similar to how noise canceling would work. It would match the frequency. It matches, yes. Destructive interference says that the two frequencies of opposite wavelength meet, they cancel out. Yes. So you're trying to tune that to match that frequency or frequencies that they're hearing and then provide that as a constant on to snip that band. Because what I could do with the hearing aids I just showed you is, you know, have them on. Yes, I'm using them the way I want to use them, but I could have the masqueron. Because I have tinnitus, but I just remembered it sitting here talking to you.

19:54Gary Brecka:You do have it. Yeah. Yeah. So you're masking right now with these dual hearing aids. It just gives it a little, like in an office. And I got to tell you, had you not brought it up, I would not notice that you're wearing hearing aids. I can't see a thing. No, they're very sleek. That's the thing. People don't – the vanity is the, you know, part of that stigma. They don't want to be seen because they don't want to say, be labeled or feel like I'm disabled or old. We're changing that conversation. This is a superpower. Yeah. Because, you know, think about everything that hearing affects your life, your job.

20:23You know, I mean people that even have a mild hearing loss, you know, today and with the technology we're using, you know, it gives you that edge. You know, you can actually hear better than normal in some situations.

20:34Gary Brecka:So I know that some of the technology that you have now with this new AI generation, it mitigates fall risk or at least it can detect fall risk. You know, there's a number of things that it does, you know, it tracks biometrics. What is it tracking? What kind of feedback and where does that information go? How is it actionable? So, you know, you have to make, you know, number one, people get hearing aids, they want to hear better noise. one channel and i'll say path that we took is how do we again make it a multi-purpose device and you know i view it kind of started thinking about it as um you know jarvis at ironman that's where it's going to go i mean this is going to be your personal assistant it's going to be about productivity helping you to be the best that you can each and every uh every day so you know we look at better hearing we want the best sound best hearing quality for the person and And then Starkey has been the pioneer in driving healthful features.