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Of the 4.5 million 50- to 59-year-olds in the United States experiencing hearing loss, only about 4.3 percent are using hearing aids.

"These people are still working and going to meetings," said Dr. Frank Lin, assistant professor in the department of otolaryngology and epidemiology at John Hopkins University. "They are the people who need it the most."

In "The Prevalence of Hearing Aid Use Among Older Adults in the US," which was published today in the Archives of Internal Medicine, Lin and Dr. Wade Chien, also of Johns Hopkins, found that of the 26.7 million Americans age 50 and older suffering from "clinically significant, audiometrically defined," or real, hearing loss, just one in seven used hearing aids.

For the publication, the two examined data from the National Health and Nutritional Examination Surveys, which has collected health information from thousands of Americans since 1971.

Lin said there were several reasons for the gap between those suffering hearing loss and those using hearing aids. He said that hearing aids were rarely covered by medical insurance in the U.S., but noted that even in parts of the world where aids were covered, the rate of people using them was not much higher than that of the U.S.

"The biggest thing is the overall perception that hearing loss is an inconsequential part of aging," Lin said.

He said that because of the perception, people felt there was nothing they could do to treat hearing loss and little research was done on the condition.

Pam Mason, the director of audiology professional practices at the American Speech-Language-Hearing Association, said that many Americans 50 and older didn't know the dangers of untreated hearing loss.

"Those that have mild or even moderate hearing loss may tell themselves: 'I can get by,'" she said. "Somebody who has been a typical hearing person … if the hearing loss has been creeping on them … may not be aware that they are experience hearing loss. They don't recognize they are having a problem."

Both Lin and Mason said that ignoring hearing loss had broader, negative consequences. It's been associated with poor thinking and memory ability and can lead to social isolation, depression and even dementia.

Lin said that most people 50 and older who did get hearing aids stopped using them because of improper counseling and training.  As with prosthetic devices, he said, hearing aids required two or three months of auditory rehabilitation to use them properly.

"They're complex devices," he said. "It's not like putting on eyeglasses."

Mason said that treating hearing loss was a process.

"It may even include auditory training, retraining your brain. It may include lip-reading skill improvement, recognizing how sounds look on the face," she said. "Everybody is unique. Hearing needs are unique."

"The most important parts for this population of people [ages 50 and older] is to recognize the signs of hearing loss and understand the negative consequences of untreated hearing loss and where to go for help you may need," Mason said.