Hearing Loss And Dementia Risk

When you speak to your aging parent, do they keep saying, “what?” Do they answer with something that is not what you asked? These are hints that hearing loss may be a problem. Typically, it gradually gets worse over time. And perhaps you have noticed that when anyone suggests hearing aids, there is resistance. That annoying thing of having to repeat yourself to an aging loved one who didn’t hear you is not just an inconvenience. It can also be a sign of increased risk for cognitive decline and dementia.

The Research: Hearing Loss and Dementia Are Connected

According to numerous studies, adults with even mild hearing loss face an increased risk of developing dementia compared to those with normal hearing. The risk increases for those with moderate hearing loss and becomes significantly higher for those with severe untreated hearing impairment.

Academic researchers report identified hearing loss as the largest potentially modifiable risk factor for dementia—responsible for about 8% of dementia cases. That’s a higher percentage than more widely recognized risk factors like smoking or depression. What is different about hearing loss from many other risk factors for dementia is that in most cases, it can be fixed or improved quickly with devices. We can’t say the same for risk factors like obesity, diabetes, unhealthy diet or sedentary lifestyle.

Why Does Hearing Loss Affect Brain Health?

Scientists have proposed several mechanisms that might explain this connection:

1. Cognitive load: When the brain must constantly struggle to process sounds, it diverts resources away from other cognitive functions like memory and thinking.
2. Brain structure changes: Neuroimaging studies show that untreated hearing loss is associated with accelerated brain atrophy, particularly in regions responsible for sound processing that also play roles in memory and sensory integration.
3. Social isolation: Hearing loss often leads to withdrawal from social activities, and social isolation is a well-established risk factor for cognitive decline.
4. Common pathology: Some researchers suggest that hearing loss and cognitive decline might share underlying causes, such as vascular damage or inflammation.

What Can Family With Aging Loved Ones Do About This Risk?

We may all know someone who has an obvious hearing loss who doesn’t seem to recognize it. It gets politely mentioned but the elder won’t acknowledge this. We also know that a lot of aging parents may be told they have a problem hearing but they refuse to get hearing aids. Then there’s the issue of having hearing aids but not wearing them or frequently losing them. To some, a hearing aid shows “I’m old.” Not for me, they think.

Takeaways:

Here are a few things that work for others and have worked in our own family with my mother-in-law, at age 87 who definitely had an untreated hearing loss.

1. The “intervention”. We asked her, in a group dinner with four friends whether she thought she was missing any of the conversations they had when they were together. She reluctantly admitted that she did have trouble sometimes. We asked what percentage of these conversations she thought she was missing. She said “maybe 10%”. We then asked the friends. They said, “maybe 60-80%”. She was shocked. But it was enough to motivate her to get a hearing test and then get hearing aids. Once she had them, she did very well. And due to many other factors, she had no signs of dementia until about age 95. She lived to be 96. Not bad!
2. Get an evaluation. Offering to go with an aging loved one to get a hearing test is not a complicated matter. The in-person testing is certainly more reliable than one done remotely, as seeing a hearing specialist face to face can help identify most accurately what kind of hearing loss is present. Test results will reveal the extent of loss in percentages for each ear. That kind of data is not an opinion. It may help an aging parent deal with a reality they have not wanted to face before testing.
3. Do your research. Find out costs, where to get the device, and provide information to your loved one about the products available. Yes, one can buy hearing aids online or from inexpensive sources, but these may not match the specific need your aging parent has. Hearing aids are not always covered by Medicare but with newer rules about getting them without a prescription, one need not spend many thousands of dollars to solve the problem. (One AgingParents.com client got his rechargeable, blue tooth compatible hearing aids at Costco for about $1900).
4. Use the “risk for dementia” information as a possible motivator. Most folks fear developing dementia more than any other health problem. This writing barely touches the subject. Many studies in academia and public health connect hearing loss with dementia. Unlike a lot of other health concerns that need a remedy, this one does not require a doctor’s prescription. Yes, it’s an inconvenience, something new to have to do every day and it can be itchy or uncomfortable. But the reward is surely worth the effort.
5. Most encouraging of all, a 2022 study in JAMA Neurology found that hearing aid use was associated with a 19% reduction in risk of long-term cognitive decline.