Can Not Wearing Hearing Aids Cause Dementia

Evidence That Hearing Aids May Improve Cognitive Function

A recent study by Jamie Desjardins, PhD, an assistant professor in the speech-language pathology program at The University of Texas at El Paso, has shown that hearing aids actually improve the function of the brain in people with hearing loss. We know that untreated hearing loss can lead to emotional and social difficulties, reduced job performance, and a diminished quality of life. As people age, cognitive skills like working memory, the ability to pay attention to a speaker in a noisy environment, or the ability to process information rapidly, begin to decline.

The study was designed to explore the effects of hearing loss on brain function. The study was undertaken on a group of individuals in their 50s and 60s with bilateral sensorineural hearing loss who had never used hearing aids. The study participants took cognitive tests to measure their working memory, selective attention, and processing speed abilities before and after using hearing aids.

Two Weeks Of Hearing Aid Use Showed Improvement

Just two weeks of hearing aid use showed improvements in cognitive abilities, tests revealed an increase in percent scores for recalling words in working memory and selective attention tests. They also showed an increase in cognitive processing speed, in essence the time for participants to select the correct response was faster. By the end of the study, participants had shown significant improvement in their cognitive function..

Other Measures Including Safety Measures

General physical & mental health

Participants will be asked to complete the following widely used and validated assessments:

• Cognitive reserve questionnaire to obtain information on participant age, gender, education, work history and leisure activities .

• Health status and Quality of life: Short Form survey .

• Physical function: Functional Comorbidity Index .

• Depressive symptoms: Patient Health Questionnaire .

• Anxiety symptoms: Geriatric Anxiety Inventory .

• Function: Lawton & Brody Instrumental Activities of Daily Living .

• Social Support and interaction: de Jong Gierveld social support questionnaire .

• Frailty: handgrip strength will be measured using a Jamar Analogue Hand Dynamometer .

• Psychological and social adjustment problems resulting from hearing loss: Hearing Handicap Inventory of the Elderly .

• Effectiveness of the HAs application: International Outcome Inventory for HAs .

• Demographic questionnaire

Hearing Assessment

The assessment of hearing will consist of two parts:

How Hearing Loss May Change The Brain

Hearing loss does seem to shrink some parts of the brain responsible for auditory response. In a study led by Jonathan Peelle, now at Washington University in St. Louis, older adults underwent brain scans while they listened to sentences of varying complexity. They also took tests that measured gray matter, the regions of the brain involved in muscle control, and sensory perception such as seeing and hearing, memory, emotions, speech, decision making, and self-control.

It turned out that the neurons in people with hearing loss were less active when they focused on complex sentences. They also had less gray matter in the auditory areas. These effects may accumulate with time or be triggered by age: In other research, Peelle found that older adults with hearing loss do worse on speech comprehension tasks than younger adults with hearing loss.

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Can Hearing Aids Help Prevent Dementia

• Betsy Mills, PhD

Hearing loss is the third most common health condition affecting older adults, occurring in one-third of people over age 65 and in two-thirds of those over age 70 . It has been identified as one of the top potentially modifiable risk factors for dementia by the Lancet Commission on Dementia Prevention, Intervention, and Care . Although studies suggest that restoring auditory input may help protect cognitive function and improve quality of life , hearing aids are expensive. There are several factors to consider when determining how to cope with hearing loss.

WHAT THE EVIDENCE SAYS

Mild hearing loss is associated with two-fold greater risk for dementia, while severe hearing loss is associated with 5 times greater risk over 10 years . Several longitudinal studies have found that the rate of cognitive decline is accelerated in dementia patients with hearing loss . Participants with hearing loss experienced rates of cognitive decline that were 30-50% faster than those with normal hearing .

A recent study following over 1,000 participants in the Rancho Bernardo Study of Healthy Aging for up to 24 years found that hearing impairment was associated with faster age-related declines in global and executive cognitive function . The cognitive decline associated with mild hearing loss was reduced in individuals who attained higher education, but education could not protect against declines associated with moderate to severe hearing loss.

IMPORTANT CONSIDERATIONS

Cost:

Get The Help You Need

Chances are youve been living with hearing loss. Nearly 27 million Americans age 50 and older have hearing loss, but only one in seven uses a hearing aid. On average, people with hearing aids waited a decade before getting help.

What you may not realize is that even a slight loss carries serious risks: Research at Johns Hopkins University School of Medicine has found that mild hearing loss doubles dementia risk over 12 years. It also raises your risk of falls. Our ears pick up cues as we walk that help us balance. If you have hearing loss, your brain needs to work harder to hear conversation and other ambient sounds and this could interfere with your balance as well. That’s why hearing aids are so important for quality of life.

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Hearing Aids Can Help Those Who Have Alzheimers

If a loved one is showing signs of dementia,help them get their hearing checked sooner than later. Sometimes, undiagnosed hearing loss symptoms are thought to be Alzheimers symptoms when theyre really not.

For those with Alzheimers, hearing loss can aggravate symptoms. A hearing impairment makes it difficult to listen, reply, and respond to verbal cues. It escalates feelings of confusion, isolation, and paranoia.Hearing aids can help relieve Alzheimers symptoms, and several styles are easy for a person with cognitive impairment to use. An American Journal of Epidemiology study found that hearing aids slowed the rate of memory decline and improved the quality of life for Alzheimers patients with hearing loss.Its important to find out the facts. Partner with the hearing care experts at Beltone to understand all the options.

A Careful Reading Of The Facts

It is important that we carefully look at the facts that we know, those facts need to be based on scientific study. The facts are not so clear-cut as the headlines would have you believe, yes it appears that there is a link, but it is by no means a causative link. Let me explain, the outcome of a study can show no link, a causative or causal link or a correlative link.

Causative links are proven links, for instance, smoking is a causative link for cancer. We know after much study that smoking has a direct link to the causation of cancer. Correlative links are different when something is correlative, it means that we know that when one thing happens it is often the case that something else is happening.

The data has not reached the stage where we can say there is a definite causative link. In fact, the data may never exist, it could be proved that there was ever only a correlative relationship. With this in mind I want to review a couple of studies in relation to cognitive decline, hearing loss and hearing aid use.

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Aha News: Hearing Loss And The Link To Dementia

THURSDAY, Oct. 21, 2021 — Hearing loss is a natural part of aging nobody likes to admit is happening. But happen it does and ignoring it comes with a cost. It could put you at risk for another feared consequence of aging: dementia.

“The greater your hearing loss, the more likely you are to develop dementia,” said Dr. Alexander Chern, an ear, nose and throat doctor at New York-Presbyterian Hospital in New York City.

But why that is remains unclear.

Just as there are many causes for dementia, there also are many potential mechanisms linking hearing loss to a decline in brain health, experts say. And as with dementia, it’s possible more than one is operating at the same time, said Timothy Griffiths, a professor of cognitive neurology at Newcastle University in Newcastle Upon Tyne, England.

One possibility is that the same disease process causing hearing to deteriorate is likewise harming cognition, said Griffiths, who co-authored a 2020 study in the journal Neuron reviewing evidence linking the two. For example, the small strokes that cause vascular dementia could be affecting the inner ear, he said. Another possibility is that hearing loss decreases activity in key regions of the brain responsible for thinking, leading to an increase in neurodegeneration.

Whether treating hearing loss would slow or stop the progression to dementia remains unclear.

Part of the reason for the mixed results, Griffiths said, could be that so many potential pathways are involved.

Misdiagnosis And Further Links

Hearing loss can sometimes be misdiagnosed as dementia. People with dementia can have difficulty communicating with others, including finding the right words, or signs, for what they want to say. They may have difficulty processing what theyve heard, particularly if there are distractions. According to some researchers, this difficulty in processing information can be one of the first signs of cognitive impairment.

We also know that hearing loss can speed up the onset of dementia, or make the symptoms of dementia appear worse, and dementia can heighten the impact of hearing loss.

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What To Do If You Have Hearing Trouble

If you notice youre having difficulty hearingfrequently turning the TV up, asking people to repeat themselves, or missing parts of in-person or over-the-phone conversationssee your doctor.

Hearing loss may be reversible, if its caused by a problem such as earwax clogging your ear canal, an infection, or a damaged ear drum. A doctor can evaluate your ears for potential physical problems that could be interfering.

And have your hearing tested. If the problem with your hearing isnt fixable, you can find out how extensive the damage is. A hearing professional can tell you whether you might benefit from a hearing aid.

And if your healthcare providers think a hearing aid will help you, its best to start using the device sooner rather than later. Research suggests that the earlier you adopt , the better the outcome, Deal says.

What Are The Best Hearing Aids For Dementia

For patients living with both dementia, hearing loss should never be ignored, as it may exacerbate dementia symptoms, increase their disorientation and make their environment less safe .

While there are no hearing products made specifically for dementia patients, there are plenty of devices out there that can still be helpful. They range from the relatively simple, such as a wearable microphone to premium hearing aids.

Hearing loss makes living with diseases like Alzheimer’s even more challenging. For people currently affected by dementia, hearing aids or other hearing devices are recommended to improve their quality of life and make communication easier.

If you are the caretaker of someone with Alzheimer’s or a similar disease that affects cognition, you are wise to investigate what hearing devices might work best. A hearing care provider will be your ally in this journey, as they’ll know the latest products that may work for your loved one. You’ll also be able to discuss your loved one’s specific needs, habits and abilities with the hearing care specialist.

For example, hearing aids may not always be the best solution. Most premium hearing aids are designed to be discreet, so they may be too small and too easy to lose for a patient with dementia, especially if they have dexterity problems. Hearing aids also require that a person remember to keep the batteries fresh and the device clean and in good working condition. Instead, assistive listening devices may work better.

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Mechanism : Impoverished Environment Causing Decreased Cognitive Reserve

A second possible mechanism is that hearing loss leads to the decreased stimulation of cognitive processing. The idea is that auditory deprivation creates an impoverished environment, particularly with the diminishment of speech and language input, that negatively affects brain structure and function. This change in brain structure and function is a risk factor for the subsequent development of dementia.

A large number of animal studies, mainly on rodents, have demonstrated changes in brain and behavior deriving from the experience of enriched environments. Structural changes can be seen macroscopically and at the level of synapses, dendrites, somata, axons, glia, and vasculature ). Based on animal models, it has been proposed that such changes may establish cognitive reserve, which is argued to protect against dementia in humans .

A variety of lines of evidence suggest that listening experience may have a direct impact on the human brain. In parallel to the enriched environment studies with mice, the active listening experience of musicians is associated with positive effects on the structure of auditory cortex and the hippocampus and functional changes in the hippocampus . Piano tuners, expert listeners who spend large amounts of time carrying out a highly specialized form of selective listening, demonstrate hippocampal structural correlates of that experience .

Hearing Loss And Dementia: Nancys Story

It is essential to recognise and respond sensitively to hearing loss in people with dementia. If a person with dementia is unable to communicate problems they are having with their hearing, this is likely to cause distress. They may well be frustrated or aggressive, but unable to say why and these reactions then may be interpreted as being a result of the dementia.

Both identification and management of hearing loss are particularly important where a person has dementia. Without this, the dementia may appear worse or get worse. For example, if a person with dementia is having difficulty using their hearing aid say they dont remember to use it or dont recognise it as their hearing aid this is likely to make it harder for them to follow communication and may make them seem more confused and withdrawn.

Both hearing loss and dementia can cause social isolation. Where someone is experiencing both of these, this can be compounded. For example, the person may be unwilling to attend social functions or participate in activities because their problems with hearing and memory make social situations so much more uncomfortable.

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Whats The Connection Between Dementia And Hearing Aids

So whats the real connection between hearing loss and dementia? Analysts themselves arent exactly sure, but some theories are associated with social isolation. When dealing with loss of hearing, some people isolate themselves socially. Another theory concerns sensory stimulation. All senses induce activity in the brain, and some experts theorize that the loss of stimulation can cause cognitive decline over a period of time.

You hear better when you wear your hearing aid. And that can help keep your brain active, delivering a more powerful natural defense against dementia and cognitive decline. Thats why treating hearing loss can delay dementia by up to 75% percent and why it shouldnt be unexpected that there is a connection between the two.

Expert Reaction To A Conference Poster On Hearing Aids And Dementia Risk

Research presented in a conference poster at the Alzheimers Association International Conference, reports that use of hearing aids in older adults can maintain brain function over time, compared to those that do not use them.

Dr Llwyd Orton, Lecturer in Neurophysiology, Manchester Metropolitan University, said:

This is an exciting preliminary finding that suggests that people with age-related hearing loss, may mitigate against cognitive decline by wearing hearing aids. The recent Lancet report found that mid-life hearing loss increased dementia risk by double any other single factor, including smoking and obesity, though this is now widely known. One argument against an association between hearing loss and cognitive decline is that no such associations are apparent in people with hearing loss early in life. That benefits were found in people with age-related hearing loss, the most common form or hearing loss, suggests that hearing aids can be of benefit beyond just improving hearing, in the most affected patient group. There are however, important unanswered questions to be addressed, such as what mechanisms led to these improvements, such as reduced social isolation, reduced cognitive load, or physical changes within the ear and brain. A reason hearing aids may work in this patient group is that losing hearing function later in life is socially isolating, while younger people develop sign language and social groups where communication is not dependent on sound.

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What Earlier Studies Have Found

A lot of prior research has found that hearing loss is connected with an increased risk of memory problems.

In a 2018 analysis published in JAMA OtolaryngologyHead & Neck Surgery, researchers pooled the results of 36 studies and found that age-related hearing loss was linked to an increased risk of dementia and cognitive decline and impairment.

Fewer studies have been conducted on whether the use of a hearing aid might delay or prevent the onset of dementia, says Jennifer Deal, Ph.D., an assistant scientist in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health, who wasnt involved in the new study.

But like the new research, several small studies that have addressed the question in recent years have found that the use of hearing aids is linked with a lower risk of dementia.

Do Hearing Aids Reverse Cognitive Decline

Dr. Curhans research didnt get a clear answer to this question. Among volunteers with severe hearing loss, those who wore hearing aids had a slightly lower risk of subsequent subjective cognitive decline than those who didnt. But the effect was too small to be statistically significant.

Because they keep you connected withothers, hearing aids can help preventsocial isolation.

She would like to see hearing aids and cognitive decline get a hard look. There isnt much evidence over long periods of time and what we have isnt conclusive, she notes. Several studies have found no relation between hearing aid use and cognitive function decline, while others have been suggestive of a possible association, she told Healthy Hearing. This relation merits further study.

One recent and very large observational study did shed more light on this issue, finding that hearing aids appeared to delay the onset of cognitive impairment and dementia, along with depression and falls that cause injuries. However, it was not a randomized controlled trial, so the results could have been for other reasons .

As well, one large 2018 study analyzed results from more than 2,000 Americans age 50 and up who took word recall tests every two years for up to 18 years. Among those who acquired hearing aids along the way, the evidence suggested that the aids slowed the rate they lost memory of words.

His answer, Do they do it from the drawer?

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