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!”Sandra_portrait_1

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.

About Gael Hannan

Gael Hannan is a writer, speaker and advocate on hearing loss issues. In addition to her weekly blog for HearingHealthMatters.org, which has an international following, Gael wrote the acclaimed book "The Way I Hear It: A Life with Hearing Loss". She is regularly invited to present her uniquely humorous and insightful work to appreciative audiences around the world. Gael has received many awards for her work, which includes advocacy for a more inclusive society for people with hearing loss. She lives with her husband on Vancouver Island, British Columbia, Canada.

10 Comments

  1. Julie Olsen wrote “It’s upsetting that education on ALDs is not included in every hearing evaluation done in the hearing healthcare delivery system. Personal devices, accepted by the user, can make an amazing difference for those who are affected by hearing loss; that includes those with whom the hard of hearing person associates”

    My 2-bits:
    The problem is that many in the hearing industry see ALD’s as competition to their hearing aid “sales” instead of very important “ADD-ON’s” to hearing aids and hearing aid users. So there is/was a lack of desire to promote these very important items.

    PLUS – you are so right about the lack of training. ALD’s are my field, yet we get asked very rarely to give training.

  2. Yes, without a doubt, it is so very important to ‘go beyond hearing aids’! This includes instruction on how to use assistive listening devices with those aids and cochlea implants. It’s upsetting that education on ALDs is not included in every hearing evaluation done in the hearing healthcare delivery system. Personal devices, accepted by the user, can make an amazing difference for those who are affected by hearing loss; that includes those with whom the hard of hearing person associates. A basic, first generation, Phonak MicroLink FM system was my lifeline for many years prior to receiving a cochlear implant in 2005. Because of that basic system, which was wireless and easy to use, I was able to return to the workforce after years of ‘forced retirement’, brought on by progressive bilateral, adult onset hearing loss. It worked extremely well with the telecoils in my hearing aids. It’s unfortunate that, that very basic system, used with a receiver boot that fit on hearing aids and a small easy to hold microphone transmitter, is no longer manufactured. Later models of this device became more complex, so ease of use was compromised. (My opinion.) While the younger set is eager to learn how to use all the bells and whistles that come with the later models, including BlueTooth devices, many in the older population would do better keeping it simple. It’s a much easier place to start. I miss that basic personal device, at times, even with my cochlear implant. Not only did it keep me in the workforce, it kept me in social and intellectual circles too. I doubt It allowed me to complete a master’s degree n my 50s. I encourage the manufacturers of these ‘add on devices’ to recognize the value of keeping them easy to use, and continue to make the base products available. Fine to become more complex for those who are tech savvy, but don’t throw the baby out with the bath water! Thanks for the great article on the dementia/HL relationship. It’s a scary concept, but I believe strongly that isolation brought on by hearing loss withdrawal is a huge factor in the correlation. I vow to do everything possible (and affordable), that I can do to openly use devices and share information on technology with anyone who will listen. Whew…guess I got that out of my system! Thanks for the opportunity.

    1. Apologizing for typos. NOTE: cochlear not cochlea AND, that MicroLink did make it possible for me to continue my education :). Julie Olson

  3. I want to learn ASL, lip reading, and other strategies, but nothing seems to be available here in Central MA. Any online options? Not the best, but what to do? Any ideas? thanks, (I am not a CI candidate….) Margaret

    1. Margaret, hi. I don’t know what’s valuable in central MA, so please contact HLAA and they provide you with resources.

  4. Hearing loss for seniors is very difficult and what happens is they lose social contacts. People get tired of repeating themselves and sign language is not an option when you are involved with hearing people with your hearing loss. Sign language must be first learned and used every day with people who are also fluent in sign language.

    1. Someone once said “it’s good to learn the Croatian language if you plan to live in Croatia”. ASL is a beautiful, useful language, but if you live, work and play in the hearing mainstream there won’t be many people to talk to.

  5. Dr. Lin is also studying cochlear implant recipients as the CI’s are far more robust with better outcomes especially with older users. CI users do better in social settings. Stay tuned!

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