The following article appeared on betterhearing.org on October 11, 2013. Read on to get more information on how hearing loss and dementia are related.
Dementia-Hearing Loss Link Warrants Routine Hearing Checks, BHI Stresses for National Alzheimer’s Disease Awareness Month
Washington, DC, October 10, 2013 – As research showing a link between hearing loss and cognitive function mounts, the Better Hearing Institute is urging people to pay close attention to their hearing and take a confidential online hearing check at www.hearingcheck.org in recognition of National Alzheimer’s Disease Awareness Month in November. BHI is raising awareness of the relationship between hearing loss and dementia, and is underscoring the importance of addressing hearing loss for the benefit of overall cognitive function. Today, nearly 40 million people in the United States have some degree of hearing loss.
While the causality requires further investigation, the increasingly evident link between hearing loss and dementia elevates the urgency of diagnosing and treating hearing loss as soon as possible.
A study published earlier this year found that hearing loss is associated with accelerated cognitive decline in older adults. Conducted by Johns Hopkins otologist and epidemiologist Frank Lin, M.D., Ph.D. and other hearing experts, the study found that older adults with hearing loss are more likely to develop problems thinking and remembering than older adults whose hearing is normal. According to a Johns Hopkins press release, volunteers with hearing loss, undergoing repeated cognition tests over six years, had cognitive abilities that declined some 30 to 40 percent faster than in those whose hearing was normal. The researchers also found that the greater the hearing loss, the greater the levels of declining brain function.
In a 2011 study, Lin found that seniors with hearing loss are significantly more likely to develop dementia over time than those who retain their hearing. The study also found that the more hearing loss they had, the higher their likelihood of developing dementia.
Exploring the hearing loss-cognition connection
Other studies have shown related findings, including several involving Brandeis University Professor of Neuroscience, Dr. Arthur Wingfield. For many years, Wingfield has been studying cognitive aging and the relationship between memory and hearing acuity.
Wingfield and his co-investigators have found that older adults with mild-to-moderate hearing loss performed poorer on cognitive tests than those of the same age who had good hearing. These findings have included a significant interaction between hearing acuity and the level of difficulty listeners experience in cognitively processing linguistic information–which is a higher-level brain activity than simply interpreting the sound.
These findings, Wingfield says, suggest that the listener’s hearing ability not only affects their sensory processing of auditory information, but that it also affects higher level linguistic processing.
The study participants with hearing loss expended so much cognitive effort on trying to hear accurately, Wingfield concluded, that it diminished their ability to comprehend rapid speech and remember what had been heard.
More recently, Wingfield, along with colleagues at the University of Pennsylvania and Washington University in St. Louis, used MRI to look at the effect that hearing loss has on both brain activity and structure.
Their study found that people with poorer hearing had less gray matter in the auditory cortex, a region of the brain that is necessary to support speech comprehension. Wingfield believes that the participants’ hearing loss had a causal role. He and his co-investigators hypothesize that when the sensory stimulation is reduced due to hearing loss, corresponding areas of the brain reorganize their activity as a result.
“The sharpness of an individual’s hearing has cascading consequences for various aspects of cognitive function,” said Wingfield. “We are only just beginning to understand how far-reaching these consequences are.”
“Even if you have just a mild hearing loss that is not being treated, you have to put in so much effort just to perceive and understand what is being said that you divert resources away from what you would ordinarily use to store what you have heard in your memory,” Wingfield continued. “Cognitive load increases significantly.”
As people move through middle age and their later years, Wingfield suggested, it is reasonable for them to get their hearing tested annually. If there is a hearing loss, it is best to take it seriously and treat it.
For more information on Alzheimer’s disease and National Alzheimer’s Disease Awareness Month, visit the Alzheimer’s Association at www.alz.org.
Hearing aids can benefit people with Alzheimer’s disease and hearing loss–and their caregivers
BHI reminds people with Alzheimer’s disease and their caregivers that hearing health is an important factor in their quality of life. The ability to communicate with the help of hearing aids can help enhance quality of life for individuals with Alzheimer’s and their caregivers.
BHI advocates that hearing checks, hearing healthcare, and hearing aids when appropriate be included in the regimen of care for people with Alzheimer’s disease. Identification and remediation of hearing loss prior to the evaluation of dementia also can help ensure a more accurate medical evaluation. BHI advocates that a comprehensive hearing examination and hearing healthcare be part of the diagnostic process.
For information about the 10 Early Signs and Symptoms of Alzheimer’s, visit www.alz.org/10signs.
Click here to read the full article at betterhearing.org!
Author: Dr. Alissa Nickerson
We live in a digital age. With a click of a button, you can download your favorite movies. You can order the latest clothing trends. You can even have your groceries delivered right to your door. So what about having your hearing aids delivered to you? Sure, the convenience and relative ease might be convincing. But how do you know you’re really getting the hearing help you need?
The hearing industry has grown tremendously in the last 25 years. We no longer see the “big beige bananas” that plagued those with hearing problems in the past. Now, hearing aids are small, discrete and more technologically advanced than ever. But, it’s not just the hearing aids that help the user. It’s the trained Doctor of Audiology fitting the hearing aids. This is true in not just the hearing industry but many health-related fields. Consider a doctor performing a knee surgery: sure, the prostheses helps the patient, but it will only work well if the doctor performs the surgery appropriately. The same is true for your hearing! Unless your hearing aid is programmed directly for your needs—your physical ear, your lifestyle, your audiometric hearing loss—you won’t be getting the hearing help you need.
In addition to the knowledge the Doctor of Audiology can provide in a professional appointment, there are so many other aspects of hearing health that need to be addressed when you get hearing aids:
- Diagnosis: Before ever discussing hearing aids with you, Doctors of Audiology perform extensive testing to determine the root cause of your hearing problems. In some instances, hearing problems can be easily fixed, such as removing a build-up of earwax from the ear. Without a doctor’s diagnosis, you could be scammed into paying for a hearing aid online that you do not need.
- Programming: Hearing aids are not just volume controls. Hearing aids have to be specifically programmed to help you hear the sounds you are missing. Without a comprehensive test, even the best hearing aids can’t help you because they won’t be programmed to your needs.
- Fit: The fit of the hearing aids has to be customized to you. If you buy online, there is no guarantee that the hearing aids will fit your ears.
- Repairs: Hearing aids can, and do break, just like any piece of technology. When this happens, it’s important to have a professional nearby to help you with issues.
So are you really getting a bargain online? Is it really convenient if you aren’t hearing your best? I’ll let you be the judge. The Doctors of Audiology at the Hearing Health Center are here for you— we look forward to evaluating your hearing and balance problems.
Anyone that has a behind-the-ear hearing aid will use either a dome or a custom mold- this is the piece of rubber or plastic that goes directly into the ear. These pieces of your hearing aid live in a wet, humid environment- so it’s important to know when to change them out! Additionally, sometimes the dome or ear mold just doesn’t fit right, which will not only affect the quality of your hearing, but it will also affect your experience with the hearing aids themselves.
DOMES
The dome is the rubber tip that sits inside the individual’s ear canal. Domes are usually clear or black, and can range in a wide variety of sizes- one for every possible ear canal! As the dome is the first point of contact with your ear canal, it can very easily become blocked with wax or debris, and prevent sound from coming out of the hearing aid. We see a lot of patients whose hearing aids have “stopped working”- when upon closer inspection, they just need a clean dome! When the dome becomes plugged, you can use a cleaning tool with a brush on the end to brush off any debris or wax. So, when should you change your dome with a new one? You should change your dome if it is ripped or yellow. If you see that your dome is ripped or has turned a yellow color, it is time to visit your audiologist and change your dome- or, change it at home!
CUSTOM EAR MOLDS
Many patients with behind-the-ear hearing aids have custom molds that fit into their ear.
You may need to get a new ear mold if:
- Your ear mold is not fitting right or coming out of your ear.
- Your ear mold is ripping or very discolored.
- You are getting feedback or whistling from your hearing aid. If your ear mold is not fitting in your ear correctly, sound may be leaking out of your ear and getting picked up by the microphones of your hearing aid.
In any of these cases, call your audiologist to see if it’s time for a new ear impression!
The Jam’s Danielle Robay sits down with Dr. Ronna Fisher from the Hearing Health Center to get details on a particular hearing loss, and to make people aware of these happenings at an early age.
Watch the video here: http://www.wciu.com/videos/thejam/early-hearing-loss-concerns
Technology requires special care during the summer months, and your hearing aid is no exception. You need to maintain your hearing aids as you normally would, but because of the added humidity in the air and the heat of June, July, and August, you’ll need to take extra care when you’re having summer fun. Take care of your investment and your health with these four tips.
Tip 1: Remove your hearing aids before swimming.
Anytime you’re around water, it’s best to leave your hearing aids behind. You do need to consider your own safety though. If you won’t be able to hear warnings, it might be safer to leave them in. If they do get wet, use a lint-free towel to dry them off, remove the battery, and place the aid itself in a hearing aid dryer or desiccant jar.
Tip 2: Protect them against sweat and humidity.
After a workout, remove your hearing aids and wipe them off. Even water-resistant sets are vulnerable to the bacteria which grows faster when it’s hot and humid. Use disinfectant towelettes and a dry and store solution designed to keep your aids clean and dry. Ask your audiologist about getting your set of hearing aids professionally cleaned more often in the summer.
Tip 3: Keep your hearing aids secure.
Summer activities are often much more risky than those you undertake the rest of the year. Use special clips to keep your hearing aids attached to your clothing or your glasses. If something does come out of place, it won’t go too far.
Tip 4: Get hearing aids suited to your lifestyle.
Talk to your audiologist about the style of hearing aid that fits your needs. Hearing aids that reduce wind noise because they sit completely in the ear canal are ideal for golfers. If you wear a helmet that reduces the effectiveness of your aid, your audiologist has solutions. Take care of your expensive equipment by following proper care and use.
Walter Jacobson sits down with Dr. Ronna Fisher of Hearing Health Center.
Visit our website: hearinghealthcenter.com
Scientific evidence shows that there is a difference between what causes problems with hearing speech while in a noisy area versus the causes of problems hearing sound. Exposure to loud noises effects the brains ability to listen selectively to speech. Click here to read more about why you may have problems hearing someone talking in a noisy area, but still have normal hearing.
OR WHY YOU CANNOT UNDERSTAND WHEN YOUR HEARING IS NORMAL
by Dr. Ronna Fisher Au.D. FAAA
“How is your dad?” Jeremy asked his boss sitting across the table at a recent dinner party. “He died,” said his partner. “That’s great. Tell him I said hello.”
Jeremy knew something was wrong from the stricken look on everyone’s face. When his wife leaned over and whispered, “He said his father died.” Jeremy wanted to crawl under the table and disappear. He thought his boss said, “He’s fine.”
Jeremy called his doctor the next morning to get his hearing checked. He was only 42, but this was not the first time Jeremy had misunderstood. He was having more trouble hearing in court, making out what his wife said from another room and sometimes even when he was in the same room.
He was surprised when the doctor told him the tests were normal and his hearing was fine. “You just need to pay more attention,” his doctor said.
Jeremy’s struggle to understand in everyday listening situations is not uncommon. Studies over the last 10 years show that changes and deterioration of auditory processing in the brain begins at age 40. These changes are not detectable on a hearing test.
SO WHAT HAPPENS WHEN YOU TURN 40?
Hearing vs understanding. They are not the same.
Hearing is about loudness. If your hearing goes down, you just make the sound louder, right?
Wrong!
As any wearer of hearing aids knows, making them louder does not make them clearer. Turning up the volume does not mean you are going to understand any better.
Understanding is about processing. Your brain has to sort out, filter and make sense of all the sounds it receives. How does it do that? What does your brain need so you can understand clearly?
- Temporal Processing – the rate at which we can process auditory information. The ability to follow rapid changes in speech, music and other sounds.
- Have you ever thought that kids talk too fast? They are on their third sentence and you are still processing the first one. Kids do not talk any faster than they always did. Your temporal processing has slowed down.
The slower your temporal processing, the more time you will need to understand what someone is saying.
- Working Memory – the mental sticky note we use to temporarily store and use information. Often used synonymously with short-term memory, working memory is critical for learning, reasoning and decision-making.
- When you have difficulty understanding, your brain has to concentrate more and listen harder. You brain is so intensely focused on trying to understand, that it does not have the resources to transfer the information to your memory. Therefore, even if you “get it” your brain cannot store it.
- Auditory Distraction – irrelevant sounds that break through your attention and focus and impairs your cognitive function.
In order to participate in a conversation, especially in a difficult listening environment, your brain has to separate all of the incoming sounds and focus on one of them.
Beginning at around age 40, the brain cannot filter out distracting information as well as it used to. The ability to encode and retrieve words severely erodes in “background babble.”
WHAT CAN YOU DO?
While you cannot change Mother Nature, there are a few things you can do to help you understand more clearly
- If you can, turn off the TV, Radio, Music and any other distracting sounds
- Eyes help make up for what the ears miss. Try to face and look at the person with whom you are speaking
- In restaurants, try to sit in a booth or a table where you are facing the wall and the noise is behind you.
- Hearing aids and PSAP’s (Personal Sound Amplifying Products). The solution for most people with a hearing problem, attention deficit disorder, or focus issues, is usually to make the signal (speech) louder than the noise or distraction. Amplifying the speech, even when hearing tests are normal, allows for easier listening and less distractions.
Increasingly, hearing aids and the lower cost counterparts, PSAP’s (which are not intended to correct hearing but make sound louder) are being fit and worn to use in those distracting and difficult situations or anytime when understanding clearly is a problem.
Dr. Ronna Fisher, Au.D., FAAA, Founder and President of Hearing Health Center
Dr. Fisher received her doctoral degree in Audiology from the Pennsylvania College of Optometry. She is a fellow of the American Academy of Audiology, has earned the Certificate of Clinical Competence from the American Speech-Language and Hearing Association, and is an active member of the Academy of Dispensing Audiologists, American Tinnitus Association, and the Illinois Academy of Audiology.
- – Beck DL. (2015) Invisible Hearing Loss American Academy of Audiology Web site.
- – Fullgrabe C, Moore BCJ, Stone MA. (2015) Age-group Differences in Speech Identification Despite Matched Audiometrically Normal Hearing: Contributions from Auditory Temporal Processing and Cognition. Frontiers.
- – Grose GH, Mamo SK, Buss E, Hall JW. (2015) Temporal Processing Deficits in Middle Age. American Journal of Audiology 24:91.
- – Helfer KS, Vargo M. (2009) Speech Recognition and Temporal Processing in Middle-Aged Women. Journal of the American Academy of Audiology20(4):264-271.
- – Baycrest Centre for Geriatric Care.
- – bit.ly/bg-babble
Earbuds are tiny, lightweight, inexpensive portable speakers. They are by far the most popular choice for private listening.
Harmless, Right?
Wrong!
Twenty percent of teenagers have a moderate to severe, permanent and irreversible hearing deficit usually seen in 70-year-olds. Why? Earbuds!
How Can Earbuds Damage Hearing?
Any sustained sound that exceeds a certain volume level (measured in decibels, dB) will cause hearing damage. Anything over 85 decibels (traffic noise, vacuum cleaner, noisy restaurants) is harmful. It doesn’t matter if the sound is pleasant (music, sporting events) or irritating and cacophonous (sirens, chain saws, lawn mowers).
Any loud sound for a long time kills the tiny hair cells that respond to auditory stimulation and damages the nerve fibers that send those sounds to your brain.
Earbuds makes the problem worse because:
- They are nestled inside your ear canals very close to your eardrum and inner ear.
- The sound is concentrated. Close proximity in an enclosed environment increases power of the sound about 10 times. And it’s aimed right at the organ of hearing.
- Unlike the old Walkman, whose battery died after a few hours, listening devices today (iPods, MP3 players) can remain powered for 24 hours. You can listen for long periods of time without taking a break. The ears don’t have a chance to recover from the onslaught of harmful sound.
Which are Worse: Earbuds or Headphones?
The short answer is earbuds, because of the deep insertion into the ear canal sending stronger waves that quickly damage the nerve fibers. But headphones today, like Beats by Dre, which are made to fit snugly over the ears and boost the base, can be just as damaging depending on the volume and duration of exposure.
Most MP3 players can produce volumes up to 120 decibels. Listening at that level can cause irreparable hearing loss in less than 15 minutes.
And if you ever have ringing in your ears after loud exposure to sound – it’s too late. Your hearing may recover, but the dead hair cells and nerve damage never will.