Dementia & Hearing Loss: Methinks Hearing Aids Are Not Enough

Note from Gael:  I am pleased to welcome Dr. Sandra Vandenhoff as my guest author this week.  Her post on hearing loss and dementia contains links to a number of interesting articles and studies. Sandra is an audiologist with hearing loss, founder of HEARa, Hearing Strategies coach, speaker, and Canadian author.  She does not remember saying on her first day of wearing hearing aids: “Mom, I can hear my shoelaces!”

Imagine yourself at a fundraiser for a posh literary magazine. The room is buzzing with conversations and the excitement of meeting a well-known author. You’ve read his books, and you’d love to discuss his latest best-seller. But your mind goes blank. You can’t remember the name of his new book.  As you muddle through your opening sentence, you realize that you can’t remember the name of any of his books.

Welcome to Katherine Bouton’s world, an editor and writer for the New York Times. She also happens to have severe hearing loss. Bouton recalled this frustrating incident in her book Shouting Won’t Help: Why I—and 50 million other Americans—Can’t Hear You.  She told her story to point out  the links between hearing loss and dementia. Compared with normal hearing, people with hearing loss are more likely to have dementia. The Baltimore Longitudinal study of Aging found that the more severe the hearing loss, the greater the risk.

Does this mean that hearing loss causes dementia?

Not so fast.

Hearing loss and dementia are definitely linked, but the nature of the connection between the two needs to be studied further. Three possible links are suggested by Dr. Frank Lin, a researcher and professor at Johns Hopkins University.

Social isolation:  People with hearing loss tend to isolate themselves. Social isolation is a risk factor for dementia whether you have hearing loss or not.  Perceived isolation is the important factor. Consider a family dinner party. What others do to include you (or not), has no bearing. When you feel left out and lonely, you experience isolation.

Brain overload:  As hearing loss occurs, more of your brain’s resources are dedicated to hearing and understanding, at the expense of other brain functions. “If you’re constantly expending more resources to help with hearing, that probably comes at the expense of systems such as thinking and memory and cognition,” said Dr. Lin.

Underlying cause: It may be that hearing loss and dementia share a common cause. What this common cause might be is still unclear and needs further study. Perhaps as we learn more, the connection will become clear.

Whatever the link between hearing loss and dementia, what can we do to help ourselves? It turns out that there are four important steps that you can take.

Balance your daily stress. Chronic stress leads to chronically high levels of cortisol in the body. Chronic high concentrations of cortisol can cause memory loss. A lifetime of high cortisol levels may contribute to Alzheimer’s disease. People with stressful lives are around 2-3 times more likely to develop Alzheimer’s disease.

Balancing your daily stress  is a vital part of healthy living and an important strategy to prevent Alzheimer’s.

Strengthen connections.  We know that too much cortisol is bad for the brain. Yet, research shows that 30% of older adults start to produce too much cortisol. Lack of social support was shown in one study to correlate with high cortisol levels.  Social support is critical in reducing stress in older adults, which in turn, lowers cortisol. So it turns out that being with others helps improve your memory.

Wear hearing aids.  Unfortunately, hearing loss can introduce stress into daily communication with friends and family members. Our social networks can’t help being affected. Hearing aids are an obvious first step in reducing listening effort. When listening is easier, the likelihood increases you’ll want to go out for dinner or other social engagements and you’ll stay engaged in the conversation.

Hearing aids have not yet been proven to reduce the risk of dementia. The Baltimore study relied on self-reporting of hearing aid use—by asking people to indicate if they had hearing aids, but not how much they wore them. Self reports of hearing aid use are notoriously unreliable. 

When appropriate studies are conducted, I am confident that consistent hearing aid use will be shown to reduce the risk of dementia. Why? We know social isolation and stress are risk factors for dementia. We also know hearing aids reduce the prospect of social isolation and stresses associated with communication.

Go beyond hearing aids. Another strong gut feeling is that hearing aids are not enough. Hearing aids are an important first step, but they shouldn’t be the only step. Lip-reading instruction, communication strategies, and auditory training can increase confidence in social situations in addition to training your brain. These strategies are an important part of making use of what you already know, and can maximize the benefit that you get from hearing aids.

Here is a related article that might set your mind at ease: Six memory problems that shouldn’t worry you.

There is no downside to investing time and effort into communication. After all, communication is at the heart of connecting to others.