Managing Hearing Loss To Prevent Dementia
A study led by Dr. Frank Lin at Johns Hopkins University sought to better understand the connection to untreated hearing loss and dementia. He led a study in which 639 adults were tracked over about 12 years. The study showed how dementia was much more present in patients who had untreated hearing loss. A mild case of hearing loss doubled the risk, while a moderate case tripled the risk. For those in the study with severe hearing loss, not treating hearing loss created a five-fold risk in the development of dementia.
The most common type of dementia is Alzheimers accounting for 60% -80% of all dementia cases each year. The Alzheimers Action Plan began in 2012, presenting five ambitious goals to both prevent future cases of Alzheimers disease and related dementias. The co-author of the Alzheimers Action Plan, P. Murali Doraiswamy, M.D. explains The benefits of correcting hearing loss on cognition are twice as large as the benefits from any cognitive-enhancing drugs now on the market. It should be the first thing we focus on.
Definitely Possibly Well The Jury Is Still Out
There are many studies that have linked untreated hearing loss to a higher risk of developing various forms of dementia, including Alzheimers disease. At present the links are of correlative quality, which is important to understand. There is a strong correlation between untreated hearing loss and dementia. It simply means where there is one, it seems that there is a high possibility of another. It doesnt prove a direct link or a causative link such as one definitely causing the other.
Untreated Hearing Loss Linked To Dementia
Nearly 27 million Americans age 50 and older have hearing loss, however studies show that only one in seven uses a hearing aid. Those with hearing loss wait, on average, 7-10 years before seeking help for their hearing loss. During that time, overall communication becomes more difficult, and the risk for social isolation and comorbid health conditions increase. Recent research from Johns Hopkins suggests that untreated hearing loss is linked with increased difficulty walking, falls and even dementia.
Dr. Lin, a leading researcher from Johns Hopkins says Brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain, Lin says. Hearing loss also contributes to social isolation. You may not want to be with people as much, and when you are you may not engage in conversation as much. These factors may contribute to dementia.
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What To Do If You Have Hearing Trouble
If you notice youre having difficulty hearing frequently turning the television up, asking people to repeat themselves or missing parts of in-person or over-the-phone conversations see 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 eardrum. 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 health-care 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.
Copyright 2019, Consumer Reports Inc.
What Can You Do
If you want try to lower your chances of hearing loss as you age, try to keep your heart healthy, protect your hearing from loud noises, and dont smoke.
Smoking is a big risk factor for sensory loss — vision and hearing, says Heather Whitson, MD, at Duke Health.
Even when they take precautions, some people are simply more likely to get hearing loss in older age. In those cases, can using hearing aids protect you from dementia?
Thats the billion-dollar question, Lin says.
Lin is leading a 5-year clinical trial studying 850 people to see if hearing aids can cut dementia.
Even without the proof, Lin says theres no downside to using hearing aids. In fact, theres often a big upside to getting help for your hearing loss.
With a very simple intervention, we could make a big difference improving quality of life, Lin said.
In a pilot study, people with dementia started wearing inexpensive, over-the-counter devices to boost their hearing. A month later, their caregivers reported improved communication, more laughter, and more storytelling.
If youre an older adult with hearing loss, it would make sense to treat that hearing loss, says Richard Gurgel, MD, of the University of Utah.
If you think your hearing has gotten worse with age, Gurgel recommends a hearing screening. The relatively quick, painless test can help you notice how your hearing changes as you get older and if a hearing aid would help you.
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High Blood Pressure And Dementia Risk
High blood pressure can cause blood clots in arteries, blocking blood flow to the brain. Stroke and the loss of brain cells may follow, and the brain could subsequently shrink.
People with high blood pressure in midlife are more likely to develop dementia later in life .
Heres what you can do:Make sure you know your blood pressure if you are 40, Livingston said. The Lancet team recommended aiming for a systolic blood pressure the pressure of the blood against artery walls as the heart beats of 130mm Hg or less in midlife, though Larson cautioned against reaching an overly low blood pressure.
Experts say managing stress and sleeping well, maintaining a stable weight and eating a healthy diet of less sugary foods, exercising regularly and refraining from smoking can help control blood pressure.
Read more about past research on the link between hypertension and dementia, and insights on how hypertensive treatment may reduce risk of cognitive decline
So What Is The Best Hearing Aid For A Patient That Already Has Significant Dementia Or Alzheimers Disease
These patients have unique challenges mainly because they have a very difficult time learning new tasks and often lose items. A new hearing aid can be difficult to learn how to use.
Often people have a difficult time getting them correctly inserted into their ear canal, changing the batteries and wax filters. Hearing aids can often be too difficult for a person with dementia or Alzheimers to figure out on their own.
A traditional hearing aid would require significant help from a care giver to fully take care of the hearing aids.
Often these hearing aids also get lost. If a hearing aid already has been purchased and you are fearful of it getting lost, please read our recommendations on products to prevent hearing aids from getting lost.
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Hearing Aid Myths That Hold You Back
Can hearing aids reduce these risks? Lin hopes to find out in a new study, still in the planning stages. These studies have never been done before, he notes. What we do know is that theres no downside to using hearing aids. They help most people who try them. And in those people, they can make all the difference in the worldallowing people to reengage with friends and family and to be more involved again.
Although nearly 27 million Americans age 50 and older have hearing loss, only one in seven uses a hearing aid. If you think your hearing has diminished, its worth making an appointment with an audiologist for a hearing check, Lin says. If you have hearing loss, dont let the following myths keep you from getting help.
Hearing Loss And Dementia: The Silent Connection
Scientists are finding more and more evidence that trouble with hearing makes you more likely to go on to have dementia, a condition marked by memory loss and trouble with thinking, problem-solving, and other mental tasks.
That doesnt mean that people with hearing loss are guaranteed to have dementia — simply that the odds are higher. There may be things you can do to lower your chances for mental decline, even if you start to have trouble hearing.
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Hearing Loss And Dementia By The Numbers
- People with a mild hearing loss are nearly twice as likely to develop dementia as those with normal hearing
- People with a moderate hearing loss are three times as likely to develop dementia
- People with a severe loss are five times as likely to develop dementia
- For every 10-decibel increase in hearing loss, the extra risk for dementia jumps by 20 percent. For people over the age of 60, 36 percent of their dementia risk is associated with hearing loss.
Many people who have mild hearing loss do not even realize it. Start with the online hearing testits a fast, easy way to learn about your hearing.
Pilot Test And Sample Size
In preparation of this trial, we conducted a pilot observational intervention study of two groups of hearing-impaired older adults: Group 1 and Group 2 . A control group of 19 normal-hearing participants was also included. All participants completed hearing and a non-verbal cognitive assessment using the CANTAB test battery at baseline, 6 and 12months. Hearing aids were fitted to Group 2 participants after the baseline assessment. Analysis of variance revealed that Group 2 participants performed significantly better than Group 1 on the delayed matching-to-sample test of the CANTAB battery . We used G*Power software to determine the required sample size for the study. Based on these pilot data, we calculated that a total of 140 participants would be required to detect a conservative effect size of the intervention of d=0.27 with two-sided set at .05 and power of .90. To account for 25% of attrition over time, we estimated that a total of 180 participants would need to be recruited.
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As Research Piles Up On The Health Effects Of Hearing Loss A Study Suggests These Devices Might Help Reduce Dementia Risks
For people with hearing loss, using a hearing aid is associated with a reduced risk of three common health problems of agingdementia, depression, and fallsaccording to a new study in the Journal of the American Geriatrics Society.
This study adds to the growing body of research that links hearing loss to memory issues and dementia. Cognitive decline is much higher among people with hearing loss, says study author Elham Mahmoudi, Ph.D., an assistant professor in the department of family medicine at the University of Michigan.
The new study also suggests using hearing aids might help delay the onset of dementia in some people, and it’s the largest study to date to look at this possible connection, according to Mahmoudi.
Here, what this and other research has shown about hearing loss and the brain, and what it all means for you.
The Hidden Risks Of Hearing Loss
Hearing loss is frustrating for those who have it and for their loved ones. But recent research from Johns Hopkins reveals that it also is linked with walking problems, falls and even dementia.
In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D, and his colleagues found that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.
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Who Gets A Hearing Aid
The secondary goal of the study was to determine the adoption rate of hearing devices among different demographic groups.
Overall, the study found that just 12% of those diagnosed with hearing loss decide to use a hearing aid. The authors identified differences in adoption rates among different sexes, racial and ethnic backgrounds, and geographic locations.
13.3% of men with hearing loss in the United States are likely to acquire a hearing aid, as opposed to 11.3% of women with hearing loss.
13.6% of white participants with hearing loss received hearing aids, 9.8% of African Americans, and 6.5% of people with Latino heritage.
What Research On Dementia And Hearing Loss Reveals
Most recently, a study published in July 2021 found that people who struggle to hear speech in noise were more likely to develop dementia than those with normal hearing, as measured over an 11-year period. This was the first time that speech in noise was specifically studied. However, the study wasn’t capable of determining if untreated hearing loss caused the dementia, only that they’re linked.
In a different study, a team at Johns Hopkins looked at cognitive impairment scores over six years for nearly 2,000 seniors. They concluded that those with hearing loss had a faster decline. The volunteers were all cognitively normal when the research began. But by the studys end, people with hearing loss were 24 percent more likely to meet the standard of cognitive impairment compared to people with normal hearing.
Another approach is to ask people whether theyve noticed a change. Measures of subjective decline can pick up losses before theyll show up on a test. A large studyusing data drawn from more than 10,000 men age 62 and upran over eight years. It found that the greater their hearing loss, the more likely men were to express concerns about their memory or thinking over time. With even a mild hearing loss, their chance of reporting cognitive decline was 30 percent higher than among those who did not report any hearing loss. With moderate or severe hearing loss, the risk was 42 and 52 percent higher.
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Hearing Aids Cost Too Much
At present, very few states require health insurers to cover the cost of hearing aids for people of all ages. As a result, 61 percent of users pay the bill themselves. At an average price of $1,675 per ear for equipment, fittings and evaluations, hearing aids can take a bite out of your budget. Factor in the high cost of hearing loss, however, and it is money well spent.
Hearing Loss And Social Isolation
The third link between hearing loss and Alzheimers is social isolation. A study by The National Council on the Aging of 2,300 hearing impaired adults found that people with untreated hearing loss are more likely to experience loneliness, worry, depression, anxiety, and paranoiaand are less likely to join organized and casual social activities. When a person withdraws from life, their risk for dementia intensifies. In short, the less we stimulate our brains by interacting with other people, places, and thingsand the less we use our brains to hear and listenthe more quickly our brains decline, putting us at greater risk for dementia.
How Hearing Loss Might Affect The Brain
Scientists dont have definitive answers about the effects of hearing loss on brain health. One theory, Deal said, is that when your hearing is damaged, the brain must expend more effort to decode the sound signals it takes in, possibly at the expense of other brain functions.
Another hypothesis is that hearing loss changes the physical structure of the brain in a way that could harm memory and some evidence from brain imaging studies supports this theory.
Hearing loss can also increase a persons feeling of social isolation, because the condition makes it harder to communicate. And social isolation is linked to a number of health problems, including heart disease and Alzheimers.
Q& a: Do Hearing Aids Prevent Dementia In Elderly
My father is 74 year-old who suffers from hearing loss. He turns up the volume for the TV and radio, doesnt always respond when we call his name, and mishears conversations. My family and I are frustrated with having to repeat ourselves frequently when talking to him.
I recently brought him to a hearing aid shop in Singapore. I was told by the shop owner that hearing loss causes dementia. And my father needs to wear hearing aids now or face the consequences of dementia in future.
Do hearing aids really prevent dementia?
You are not the first person to ask this question. Over the years, Ive had patients who visited hearing aid shops in their neighborhood after reading about the link between hearing loss and dementia reported in the newspaper.
After being told that they had a hearing loss, they were all given the same message: buy hearing aids now to prevent dementia.
Let me start by saying a lot of well published articles are heavily misinterpreted or misused tosell hearing aids. This is a practice I do not condone.
Dementia in its severe form can be debilitating for both sufferers and caregivers. Scaring an individual with threats of dementia so that he/she wears hearing aids usually does more harm than good.
Furthermore, as an audiologist to patients with both hearing loss and dementia, I can attest to the statement being inaccurate.
What is dementia?
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How Loneliness And Social Isolation Can Lead To Dementia
Forming social connections can enhance a persons cognitive reserve. In other words, paying attention to others and interacting with them keeps our brains active and healthy, Livingston said.
Additionally, some studies find the opposite social isolation may increase peoples risk of dementia. One study shows that people who are single lifelong and those who are widowed are more likely to have dementia compared to married couples.
Heres what you can do:Livingston suggested seeing and talking to people, walking with others and chatting over tea, coffee or food activities you may find pleasure in doing with others. She reminded us of an important point amid the coronavirus shutdown, a public health crisis which has left many feeling socially isolated: Try to be physically distant but not socially distant.
Read more about past research on the link between social connection and dementia