Posted: Saturday, July 19, 2014 7:00 pm in the Santa Fe New Mexican
I would like to discuss one aspect of hearing loss that is not widely appreciated — the association between age-related hearing loss and dementia. Given that age-related hearing loss is the most common reason for hearing loss and dementia is associated with aging, what can each of us do to help ourselves?
First, some hard facts: Who has hearing loss?
• 1 in 10 Americans.
• 15 percent of baby boomers (age 46-65).
• 30 percent of people over age 60.
And who has dementia?
• 1 in 9 Americans over the age of 65.
• 30 percent of people over the age of 85.
• By 2050, 1 in 30 Americans will have dementia.
So what is the association between age-related hearing loss and dementia?
• Mild hearing loss is associated with twice the risk of developing dementia.
• Moderate hearing loss is associated with three times the risk of developing dementia.
• Severe hearing loss is associated with five times the risk of developing dementia.
So, how are age-related hearing loss and dementia linked?
Hearing loss is “associated” with dementia. But this is different than saying, “hearing loss causes dementia.” At this time, while hearing loss has not been shown to cause dementia, a current area of aging and hearing research suggests that hearing loss makes the brain work extra hard to understand what is going on in our immediate surroundings.
But as our brain does all this extra work associated with our hearing loss, we limit our other brain functions such as memory and the ability to interact socially.
As individuals with hearing loss isolate themselves from family and friends, they become depressed. This isolation and depression have been linked to an increase in inflammation throughout the body, and this inflammation can add to other age-related disorders like heart disease and dementia. Not a pretty picture.
What questions help identify our risk of hearing loss?
• Does a hearing problem cause either you or your family to feel frustrated?
• Do you feel your hearing hampers your personal or social life?
• Does a hearing problem cause you to have arguments with family members?
• Do you have a hard time understanding the TV or radio?
• Do you have a hard time understanding conversation in a restaurant or at family gatherings?
If you answer either “sometimes” or “frequently” to the above questions, then you should have a hearing evaluation (audiogram) with an audiologist.
So, what can do you have if your hearing test shows significant hearing loss?
• Lip reading and educating your family about good communication skills.
• There are a broad variety of assistive listening devices that can amplify telephone, television and speech in your home.
• Hearing aids probably offer the best support for the hearing impaired patient.
• Cochlear implants may provide relief for some patients with severe hearing loss and loss of speech discrimination. Age does not matter.
Here are my thoughts on life and hearing aids:
• I believe that not wearing hearing aids and not participating in ongoing counseling and training with an audiologist leads to a condition called “auditory deprivation” — the loss of our ear and brain’s ability to recognize and understand speech when the ear and brain are not stimulated by normal conversation. Bottom line — your hearing operates on a “use it or lose it” basis.
• While it is clear that hearing loss impacts normal brain function, studies showing a benefit to brain function due to hearing aids are still “a work in progress.” But ENT physicians and audiologists who take care of patients with hearing loss are convinced that hearing aids help create alert, mentally engaged patients.
• One last realty check. While I believe hearing aids will be shown to help brain function, I also believe the complaint of “I can hear, but I can’t understand” is more difficult than just putting on a pair of hearing aids. Each patient needs ongoing counseling and training with their audiologist about how to make their hearing aids work for them.
If you visit our office, I’m the 60-year-old bald guy with hearing aids.
Visit our website, www.swentnm.com, for the extended version of this article and the referenced hearing loss questionnaire.
Dr. David Brown is an Ear, Nose and Throat Physician with Southwestern Ear, Nose and Throat Associates. SWENT has offices in Santa Fe, Los Alamos, Española and Las Vegas, N.M.