In a recent article, Philly.com asked an important question: How might hearing loss contribute to dementia? (Dec 8, 2017). The article points to a study performed by the Johns Hopkins Center on Aging and Health that attempted to find a correlation between hearing loss and cognitive decline.
Two thousand older adults took part in the study which concluded that:
- Older adults with hearing loss did, in fact, show an increased risk of cognitive decline
- Cognitive decline appeared to accelerate over the six-year period in which the study was performed
- Older adults with hearing loss (impairment) had a 25% greater risk of dementia than the control group
According to the United States Census Bureau, the US population is much older than it was just 16 years ago. The median age grew from 36 years to almost 38 years due largely to the advancing age of the Baby Boomer generation. Moreover, the amount of people aged 65+ grew from 35 million in 2000 to just under 50 million in 2016 which correlates to a higher incidence of hearing loss and a higher risk of cognitive decline and dementia.
How Does Hearing Loss Contribute to or Worsen Dementia? Three Theories
Theory 1: A Shared Neuro-Pathological Process
There is a shared neuro-pathological process meaning that as the brain naturally declines so too does your inner ear (along with your hearing). Thus far, studies of patients with neuropathology have not indicated abnormalities in the inner ear that correlate to dementia.
Theory 2: Social Isolation
If older adults are isolated from the rest of society and are not engaged with the world, they will show signs of cognitive decline. It’s basically “use-it-or-lose-it.”
Dr. Marta Becker, an expert in hearing loss at BergerHenry ENT Specialty Group and author of Buy Hearing Aids with Telecoil and Bluetooth Wireless Technology, confirms that “verbal communication is one of the most important ways we have to stay connected with each other. People with hearing loss who avoid conversation because it is frustrating run the risk of becoming isolated from friends and loved ones.”
Theory 3: Cognitive Overload
When older adults suffer with hearing loss, their brains have to work harder to hear, process, and interpret sound. With so much energy devoted to hearing, the brain may not be able to keep up with other functions such as memory, comprehension, concentration, etc. We may forget what to buy at the grocery store, where our keys are, or perhaps even mis-identify those close to us. We are reaching into other areas of our brains to manage our hearing. As a result, our brains may be on cognitive overload.
The author, Sandy Bauers, adds that she has seen patients with severe hearing loss that were candidates for cochlear implants. Prior to the implant procedures, not only would her patients not hear well but they also were not as sharp as they once were. Fast-forward 6 months after the procedures and she notices sharper, more energetic personalities. She is clearly forming a correlation between hearing loss and functional cognitive decline.
Can Dementia be Slowed or Prevented with Hearing Aids?
The Johns Hopkins study data indicates that it is possible that senility (they avoided using the term dementia*) can be slowed or prevented with hearing aids. However, the sample is not sufficient yet to confirm it. Thus, it still remains a theory. The author believes that older adults who appear to have senility can improve with hearing aid sound amplification.
*Dementia is a combination of conditions and illnesses that contribute to memory loss, processing of thought, personality changes, and loss of verbal communication skills. Senility incorporates a decline in cognitive health (like dementia) as well as a decline in physical health (which can include hearing loss).
What Can You Do to Prevent Hearing Loss?
Age-related hearing loss typically occurs in both ears and the loss is gradual. Its causes arise from changes in the inner ear, the middle ear, or from nerve pathway disruptions from the ear to the brain.
Conditions that affect age-related hearing loss include diabetes, high blood pressure, heart disease, smoking, medications toxic to the ears’ sensory cells, and exposure to loud noises (also referred to as noise-induced hearing loss or NIHL).
Dr. Becker, BergerHenry ENT Otolaryngologist, recommendeds that people under the age of 50 schedule a hearing test every 10 years and then every 3-5 years for those over the age of 50. If hearing changes are noticeable, schedule them more frequently. If it is determined that you have significant hearing loss, your ENT or hearing specialist may recommend a hearing aid.
Most hearing aid manufacturers have embraced technology in the advancement of hearing aids. For example, most offer models with a telecoil wireless feature that converts electromagnetic energy from a cell phone into an audio signal that is carried straight into the hearing aid wearer’s ear, and a bluetooth-enabled feature that allows hearing aids to accept a wireless signal from a cell phone. In addition, you can choose from multiple hearing aid models from small and invisible to in-the-ear (ITE) and behind-the-ear (BTE).
The real value of a hearing aid really lies in the service you receive from your hearing specialist, i.e., helping you to determine the correct hearing aid, correctly and comfortably fitting the hearing aid, tuning it properly, and maintaining it in the months and years to follow.
Marta T. Becker, M.D.
Board Certified Otolaryngologist
BergerHenry ENT Specialty Group
References
5 Questions: How Might Hearing Loss Contribute to Dementia?
http://www.philly.com/philly/health/health-news/5-questions-how-might-hearing-loss-contribute-to-dementia-20171208.html
The Nation’s Older Population Is Still Growing, Census Bureau Reports
https://census.gov/newsroom/press-releases/2017/cb17-100.html
The Difference Between Dementia and Senility
http://www.elmcroft.com/article/alzheimers-and-dementia-care/the-difference-between-dementia-and-senility/