Working Memory and Hearing Aids: Does Rehab Work?

Hearing Health & Technology Matters
October 30, 2012

This past week I went to a workshop about Cognitive Health and how it affects the fitting of Hearing Aids.  It started out showing connections to a person’s Working Memory and how well they did with hearing aids.  The better the working memory the better the person could hear in noise and in more complicated situations.

What is working memory?  It is that part of your cognitive functioning that helps your short-term memory and attention. It enables you to remember something when you are performing an action.  One example is being able to remember a phone number while you are dialing.

For the younger generation, I have to come up with a different example, as with our cell phones we hardly need to know a phone number anymore!  This example remembering all the passwords we need to establish (and not write down!) for the multitude of web sites we have to create accounts for.

How do we test for this?  There is a 20-minute test called the Reading Span Test that is used in research. It’s not quite tweaked enough to use in our clinics, but it can be found in several studies. {{1}}[[1]] Hallgren, M., Larsby, B., Lyxell, B., & Arlinger, S. (2001). Evaluation of a cognitive test battery in young and elderly normal-hearing and hearing-impaired persons. Journal of the American Academy of Audiology, 12, 357-370. [[1]] {{2}}[[2]] Ronnberg, J., Arlinger, S., Lyxell, B., & Kinnefors, C. (1989). Visual evoked potentials: Relation to adult speechreading and cognitive function. Journal of Speech and Hearing Research, 32, 725-735. [[2]]  {{3}}[[3]] Lunner, T. (2003). Cognitive function in relation to hearing aid use. International Journal of Audiology, 42, S49-S58. [[3]]

One of the connections that is emerging from Pamela Souza’s research is how we fit those with better or poorer working memories.  Since there is not a clinical version of the test, we have to rely on our interaction with the patient and their families to determine how difficult it is for them to recall certain information. That means using our intuition, which is something we have to do  all the time in fitting instruments.  The connection that Dr. Souza found is the type of attack and release time the hearing aid delivers.  For those of us who fit, fast acting seems to work better with better working memories and slow acting seems to work better with poorer working memories.  For the hearing aid wearer, the more information you can give to the professional fitting your instruments the better, even if you do not think it has anything to do with your “hearing.”

After the presentation of the working memory and hearing in noise topic concluded, it was clear that they are still looking for ways to help those who hear poorly in noisy situations as it relates to their cognitive function.  The bottom line is that we don’t know why some people develop the way they do and specific aural rehabilitation is not showing the improvements that we would like.  I do, however, give information to patients to keep working their brain (see below), but the one option that seems to work the best right now is physical exercise.

Keeping sharp is a lifelong activity, and it’s not just about the mental hoops you put yourself through.  Researchers are discovering brain health benefits from mental and physical exercise.   Find new, challenging activities you find stimulating and interesting to exercise your brain and body, and it’s even better if you find them fun.  A combination of activities is best.

  • Take a walk: Light aerobic exercise like walking increases blood flow, keeping up a healthy supply of oxygen to your brain.  This shows the strongest advantage to better cognitive function.
  • Engage in Music:  Learn an instrument, or pick up an instrument you haven’t played in a long time.
  • Mental Math: Do basic arithmetic in your head without the aid of pencil, paper or calculator.  Try to keep a running tally of the total cost of your grocery items as you go around the store.
  • Map It: When you travel to a new place, draw a map of the area and how you got there.  This helps spatial awareness and memory.
  • Learn a New Language:  Your brain is stimulated by listening and hearing the new language.  You can even revive interest in a language you’ve studied before and haven’t used in years.
  • Refine Motor Skills:  Learn a new skill that involves fine-motor skills, such as knitting, drawing, painting, assembling a puzzle, etc.
  • Test Your Recall:  Make your usual grocery list, and try to memorize it before going to the store.  Do your shopping without looking at the list, and see how many you could remember before check-out.
  • Crossword Puzzles and Sudoku:  Exercising your brain is all about novelty. If these games are new to you, try them in your morning newspaper.
  • Bingo:  This classic game requires careful listening as well as fine-motor skills to mark the card.  A bonus is the social interaction!
  • Switch Hands:  Try completing everyday tasks with your opposite hand, like brushing your teeth and hair, using the computer mouse, and even stirring your morning coffee.
  • Learn a new sport:  Take advantage of this two-for-one opportunity. Pick up an athletic exercise that utilizes the mind and body, like golf or tennis.
  • For those who like computer games, check out these free websites for challenging games to work your mind.

Compiled by Doctoral Candidate Christine Bartelt, MS


This area is one of huge interest to our clinics here and several of our audiologists are scouring the internet for cognitive connections. We hope to be bringing more information soon to the blog on what we find.


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