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!
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
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