NOT TOO LONG AGO, I had a gentleman come in to our office with his mother. After testing his mother’s hearing and giving recommendations, he stated, “My mother’s doctor wants her to get hearing aids because we can’t figure out if the problem she is having with her memory is due to dementia or due to the fact that she doesn’t hear well.” We see many patients in our office with some sort of cognitive disability. If these patients would have worn hearing aids sooner, would it have slowed their cognitive decline?
In a 2011 study from John Hopkins University, Frank Lin, MD, PhD, looked at ways hearing loss affected cognitive brain function. He, along with his colleagues, used data from the Baltimore Longitudinal Study on Aging. The study focused on 639 people whose hearing and cognitive ability was tested over a 12- to 18-year period. About a quarter of those people had hearing loss, but none of them had dementia. After years of monitoring the patients, 58 of them developed dementia. The study showed that people with mild, moderate, or severe hearing loss were more likely to develop dementia. The risk increased in conjunction with the severity of the hearing loss; the greater the loss, the higher the likelihood of developing dementia.
The next question was, how is hearing loss leading to dementia? Lin presents four theories. One suggests that hearing loss and cognitive decline have common physiological pathways in the brain, but due to the way the study was done, Lin does not hold this theory very credible.
Another thought is that hearing loss and straining to hear stresses the brain. According to Arthur Wingfield, who heads the neuroscience program at Brandeis University, “If you put in a lot of effort just to comprehend what you’re hearing, it takes resources that would otherwise be available for encoding [what you hear] in memory.” Wingfield’s lab has documented this effect on a short-term basis. The big question, he says, is whether years of drawing resources away from brain functions like working memory eventually reduces the brain’s resilience.
A third theory suggested by Wingfield and Lin is that hearing loss may affect the brain structure. Looking at images of the brain, it was shown that older adults with hearing loss have less gray matter in the part of the brain that processes speech. Wingfield stated that certain parts of the brain shrink when they don’t get enough stimulation. Getting a clear signal to the brain may allow the brain structures to grow back to their previous size and function.
Finally, the last theory of how hearing loss could lead to dementia is the social isolation that is common in people with hearing loss. When hearing is difficult, people are less likely to socialize. Social isolation is known to be a risk factor in dementia development. (AARP, August 8, 2013.)
Knowing all this information, does wearing hearing aids reduce the risk of dementia? Well, the answer is yes and no. Studies did not show a direct benefit of hearing aid use and decreases in dementia risk, but wearing hearing aids can decrease other factors that indirectly increase the risk of dementia. According to a study by the National Council on Aging, hearing-impaired adults over the age of 50 who do not wear amplification were more likely to develop depression, anxiety, and paranoia and were less likely to participate in organized social activities when compared to the same population of people with hearing aids. As mentioned above, this social isolation is known to be a risk factor in the development of dementia. So, with the use of hearing aids, this risk factor is greatly reduced. Unfortunately, only about 15% of people who could benefit from hearing aids are actually using them.
With our patients, we have seen amplification improve their quality of life. Our patients report being able to participate in activities that were once deemed too difficult because of their inability to hear and understand speech. Their family members have also reported noticing an increase in confidence and self esteem with their loved one after they received their hearing aids.
The use of hearing aids is one way to stay active and engage in social activities, but what are some other ways to maintain your brain health? According to geriatric medicine specialist Ronan Factora, MD, keeping your brain active by reading or engaging in hobbies that are challenging, like dancing, learning a foreign language, or playing a musical instrument, is a way to maintain a healthy brain. He also stated that regular exercise and a healthy diet, like the Mediterranean diet, will also promote brain health.
Communication with family and friends can improve your quality of life, keep your brain active, and decrease your risk of dementia. Socializing not only staves off feelings of loneliness, but also helps sharpen memory and cognitive skills, increases your sense of happiness and well-being, and may even help you live longer. This leads us back to having the ability to hear clearly and properly. Without good hearing, being able to socialize with others will be very difficult and people with untreated hearing loss will then start to isolate themselves instead.
We have seen firsthand how hearing aids can improve one’s quality of life. The ability to have meaningful conversations with our friends and family is so important for our well-being. To have untreated hearing loss be the cause of one’s social isolation is very distressing. Yes, hearing aids are an investment and many people cannot afford them, but some people do have coverage through their insurance, and for those with no coverage and no other means to afford hearing aids, we have a non-profit called HearAide.
HearAide is a program designed to help those who cannot afford amplification. Through donated funds and hearing aids, our patients who qualify can be fit with hearing aids with the cost based on their income. Also, there is a volunteer component to the payments. We call this the Circle of Giving. We provide the individual with independence and confidence through better hearing, then they pass that on through their volunteer efforts to help someone else in need.
Having a family member or a loved one with dementia is hard enough, but adding hearing loss on top of it can make communicating with them even more difficult. Taking hearing loss out of the equation by using amplification could make living with dementia a little easier. At Northwest Ohio Hearing Clinic, we will discuss your needs with you and determine the right type of amplification for you or your loved one with cognitive issues.
Dianna Randolph, AuD, CCC-A, is a Doctor of Audiology with Northwest Ohio Hearing Clinic, located at 1125 Hospital Dr., Suite 50 in Toledo (419-383-4012) and 1601 Brigham Dr., Suite 160 in Perrysburg (419-873-4327).
