In the summer, at Alzheimer’s Association International Conference in Amsterdam, researchers presented a new study that prescribed hearing aids could cut the risk of cognitive decline by about half in older adults, particularly among those with other dementia risk factors. Experts call three-year study of long-term cognitive effects of hearing aid use “truly groundbreaking.” It’s the latest proof that hearing health and general health are inextricably linked.
With World Alzheimer’s Month on us, scientists have much to be optimistic about when it comes to treating Alzheimer’s disease. However, Alzheimer’s disease – and by extension, dementia in general – is so far irreversible. Which makes preventing it as important as ever.
The theme of this year’s World Alzheimer’s Month is “Never too early, never too late”, with an emphasis on identifying risk factors and encouraging preventive measures to reduce them. As it becomes clear that hearing loss can contribute to the onset of dementia, preventive hearing care is one of the most critical, preventative measures.
Increasing Risks
The numbers can seem overwhelming. The estimates of the World Health Organization that by 2050, nearly one in four people worldwide will experience hearing loss, and about 700 million of them will need hearing care. In the same period of time, more than 130 million people are predicted to suffer from dementia. Hearing aids can certainly help, but it all starts with caution — and the earlier the better.
Although Alzheimer’s disease and dementia usually occur later in life – usually diagnosed in people over 65 – research now indicates that hearing loss in middle age (45 to 65) is the most important risk factor for dementia. More dangerous than alcohol consumption, high blood pressure, and even traumatic brain injury. Moreover, there are signs that even mild hearing loss — usually considered borderline or “subclinical” hearing loss — can also affect cognitive function.
Beyond the age of 65, after which hearing loss often takes its toll, the biggest risks for dementia are smoking, followed by depression and social isolation. All three factors have their own relationship to hearing loss.
While scientists continue to investigate why hearing loss contributes to cognitive decline, there is a body of evidence that suggests that those with hearing loss often withdraw from social situations. This withdrawal can negatively affect their cognitive health. Studies also show that hearing loss alone can lead to changes in your brain chemistry. So the research tells us that hearing loss can have a heritable, negative effect on cognitive function that is only exacerbated by social isolation.
Those with hearing loss have difficulty hearing what others say to them. In addition, they often struggle to follow conversations between friends, family or colleagues because the noise of voices – or even background noise – makes it difficult to pick up words or transitions. For example, there are millisecond gaps in group chats that are part of the conversation dynamic and encourage participation and engagement. People with hearing loss they struggle to work out these “turn-taking” gaps., especially in the presence of background noise. This makes it difficult for them to follow and contribute.
All people with hearing loss, whether they are at a performance, dinner, or a business meeting, usually end up tired from the experience. They avoid fatigue by avoiding the situations that cause it, leading to Social isolation and cognitive impairment.
The importance of hearing care
Hearing aids can help. Not only do modern hearing aids amplify sound, but they also intelligently process the entire listening environment to make speech clearer and more natural, reduce the impact of background noise, and enhance conversational dynamics that facilitate participation and engagement . They can be customized by a hearing professional to the user’s specific hearing loss, with features that allow people to improve even further and address other issues such as noise-induced tinnitus.
The challenge is to get more people who need them to wear hearing aids. Overall, less than one in five people who could benefit from hearing aids actually use them (the number is only slightly higher among adults 70 and older), and it usually takes seven years from diagnosis to adoption. With what we now know about the relationship between hearing health and cognitive health, any delay could have serious consequences.
Global initiatives to make hearing aids more widely available and accessible will certainly help. From his side, HearUSA offers prescription and non-prescription hearing aids through its networks of hearing centers.
But in the future, access to hearing care will be paramount. At the 2023 Alzheimer’s Association International Conference, other experts presented findings on the impact of affordable, accessible, community-based intervention for people experiencing cognitive decline. In a study from Johns Hopkins University, people in Baltimore, Maryland, who received hearing care were compared to those placed on a temporary screening waiting list. Those who received hearing care saw a significant improvement in their ability to communicate.
The fact is, there is a lot we don’t know about the causes of dementia and Alzheimer’s disease. But we do know that social isolation affects cognitive health. So when there is a risk factor we I am doing know how to treat, it is the duty of hearing professionals, health care providers and the public to take preventive measures. In this case, that means maintaining cognitive health by addressing hearing health.
At the Alzheimer’s conference, a researcher from the University of Western Australia presented, “The role of hearing health professionals in supporting patients at risk of dementia.” That role, he concluded, is “essential.”
Agreed.
Bio
Sheneekra Adams, AuD, is Sr. Director of Professional Development at HearUSA. As a senior clinical leader at HearUSA, she provides leadership and advice on the design and implementation of key initiatives.
Dr. Adams began her career as an audiologist, and her focus for the past two decades has been helping people hear better. In her current role, Dr. Adams leads HearUSA’s Learning & Development team to ensure best practices are followed consistently across all HearUSA hearing centers.
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