March 2019 Mother Nature Network blog by Lloyd Alter

Livio AIThe author learning to use the Livio AI

It's almost five years since I first wrote "forget wearables; let's talk hearables, the devices formerly known as hearing aids." Back then having hearing aids that connected to the internet seemed magical and world-changing. Now, they are no longer hearables; Starkey's new Livio AIs are being called "Healthables." At first I thought this sounded like a lunch snack, but it makes a lot of sense, because they're not just about hearing. As many as 35 million Americans suffer from hearing loss, a number increasing every day as the baby boomers age. It's estimated that fully 45 percent of Americans in their 60s need hearing aids, but only 15 percent of them wear them. The reasons include cost, lack of insurance, and vanity or the stigma attached to them.

But the Livio AIs aren't just hearing aids, and that stigma is less of an issue than it used to be with so many people having white Apple thingies sticking out of their ears. In fact, if people knew what the Livio AIs could do, the sheer envy would bypass those obstacles. With the Livio AIs, Starkey has transformed them from being just hearing aids into far more useful devices. Like most hearing aids that connect to smartphones via Bluetooth, you can take a call and listen to music. Google and Apple maps whisper directions in your ear. The Livio AIs happen to be the best sounding ones yet, with really good sound quality and a surprising amount of bass. You open the app on your phone, which translates up to 27 languages and plays the translation into your ears. It takes notes and transcribes what you say. It's got a "hearing assistant" that answers questions, although it's pretty basic. It's also friends with Alexa.

So what makes it a Healthable?

A lot of people wear Apple Watches and Fitbits for health tracking, but in fact, the ear is a much more sensible place to get this kind of information because it's almost inside the body. The Thrive app picks up information from the accelerometers in the Livio AIs and tracks activity, steps and overall movement to develop a Body Score. I will be monitoring it and comparing results to my Apple Watch. The hearing aids talk to the Apple Health app, so it can provide all this information even to people who don't have the watch. Heart rate monitoring is coming soon.

health tracking

But perhaps more interesting is the Brain Score. We have noted before that there's a possible connection between hearing loss and dementia, quoting a study that found "those who had hearing loss at the start of the study were more than twice as likely to be found to have mild cognitive impairment four years later than those with no auditory problems." So the Brain Score measures the time people spend in social engagement and active listening to ensure that people aren't withdrawing from the world, something that's easy to do when your hearing deteriorates.

Both physical and mental exercise is needed as we age, so this Thrive Wellness Score, a combination of Body and Brain, is an important idea.

Another thing that happens to older people is they tend to fall more, and according to a study at Johns Hopkins, "researchers found that people with mild hearing loss were nearly three times more likely to have a history of falling." So it makes a lot of sense to combine fall detection with a hearing aid. Since your head doesn't usually move as much as your wrist, it will probably work a lot better than the fall detection feature on the Apple Watch, which I had to disable as it would go off every time I chopped wood or hit a Toronto pothole on my bike.

All these things add up to make this so much more than a hearing aid, which is precisely the point, as noted by the president of Starkey Hearing Technologies, Brandon Sawalich. We want our customers to feel connected to all the people and activities they love. Fall detection, language translation, body- and cognitive-wellness tracking and heart measurement allow us to enable that. It’s about helping people hear the best they can possibly hear and using state-of-the-art technology and great design to lessen the stigma of hearing aids, ultimately allowing people to hear better, and live better.

But do they work as hearing aids?

Which brings us to the final question, which perhaps should have been the first: How are they as hearing aids? To me, the key is speech. How well do I hear my wife speaking in a restaurant and how well can I hear my students in class at Ryerson University? I have tested a few different hearing aids in Cano Restaurant in Toronto, a typical modern restaurant with hard, reflective surfaces and a noisy environment. These were uncanny in that they just picked up Kelly's voice out of the noise and made her sound perfectly natural. Dave Fabry of Starkey told Digby Cook of Hearing Loss Journal that "in effect, the hearing aids constantly monitor the acoustic environment you find yourself in and then respond by applying any needed changes to what you hear. For example, it may compensate for an increase in reverberation." They seem to be learning as they go.

https://www.cicada.org.au/4c9136eb-b0b1-4902-bcb0-f1b54341864e" alt="pastedGraphic_2.png">It's hard to hear my students when their faces are facing the screen

In the classroom, I often had trouble hearing the voices some of my students, yet again, somehow the new devices just picked the voices out, amplified them and dialled everything else back. With one particularly quiet student talking into her computer, I had to open the app and turn up the volume a bit. But that was the only time I ever even thought about them. This is the most remarkable feature of the Livio AIs; you don't think about them. Like other hearing aids, it has settings for restaurants and crowds and I even made up a custom classroom one. You can geotag each location so that the hearing aids change automatically. I used to use this feature a lot on other hearing aids. With the Livio AIs, I never seem to have to touch them; they just work. I don't bother with the different environments.

No more batteries!

batteriesBuck a battery, waiting to get recycled

And finally, there's one new feature they share with other companies: The batteries are rechargeable! For years, I've been spending a buck a battery on these little things that didn't last a week. Opening and closing the battery door was the switch, and the batteries were really fiddly to get in and out. In fact, for the last decade of my mom's life, I had to change her batteries because she couldn't do it.

charging batteries Charging batteries is a lot easier than changing them

Now I just drop them into the charging box. I keep it beside my bed because I always forget that I'm wearing the hearing aids and it's quick and easy. I had no idea what a luxury this was until I started doing it. I can imagine that for people with manual dexterity issues, this is a huge plus.

There are some who worry about rechargeable batteries being so close to their ears, because rechargeables are more likely to catch fire. Others complain that rechargeable batteries don't last; lots of owners of Airpods are complaining. Starkey's Dave Fabry tells us that these batteries are safe, tested and sealed inside for water resistance, but they are replaceable by Starkey. "We weren’t going to introduce a rechargeable technology without ensuring end-user safety.”

My privacy-obsessed wife is dubious about whether I should be sharing so much intimate health information with this app. I know an audiologist who worries about the health effects of having Bluetooth transmitters so close to the brain. There are risks that for some, would offset these rewards. Personally, I'm just in awe of this technology, that these little things can do so much. They are way more than hearing aids, or even hearables. I suppose I shall have to get used to that "Healthables" term because it really does describe them perfectly.

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