In the same way you care for the rest of your health including getting your eyesight tested and heart and blood pressure levels monitored regularly, it is important to take care of your hearing health. Because there is a lot more riding on it than just your hearing. Hearing loss is the second most common health condition experienced by Australians – more prevalent than asthma, heart disease, cancer, or diabetes – and is projected to increase to 1 in every 4 Australians by 2050. The number of Australians who are hearing impaired or deaf is increasing because of long-term exposure to excessive noise in the workplace, the environment, and a result of an ageing population. Hearing Awareness Week (which commenced Sunday 25th February) and World Hearing Day (set for this Saturday March 3rd) are two global initiatives which aim to increase awareness of and educate people about the issues relating to hearing loss, which are many and varied.

Untreated Hearing Loss: The Health Risks

Untreated hearing loss has been documented to result in a range of negative physiological effects including increased speech comprehension difficulties, auditory deprivation, and brain atrophy (linked to cognitive decline). Hearing loss can also increase risk factors for a number of acute health conditions including diabetes, stroke, elevated blood pressure, heart attack, psychiatric disorder (particularly for those who rate their hearing as “poor”) and affective mood disorders. Numerous studies have linked untreated hearing loss to:

• Diminished psychological and overall health
• Dementia and Alzheimer’s
• Fatigue
• Stress
• Depression
• Irritability, negativism and anger
• Headaches and tension
• Reduced alertness
• Inability to focus and retain information
• Impaired memory
• Impaired ability to learn new tasks

Untreated Hearing Loss: The Impact on Mental Health & Quality of Life People with hearing loss experience greater impacts on mental health and overall quality of life than the general population. This includes lower self-esteem, and increased incidence of sadness, depression, anxiety, insecurity, irritability, and loneliness, as well as increased stress and fatigue. The negative effect on mental health may arise through the negative impact of hearing loss on interpersonal communication (which is central to a person’s health and well‐being), and through increased social isolation.

For children with hearing loss, even a mild or moderate case of hearing loss could cause learning difficulties, issues with speech development, and problems building the important interpersonal skills necessary to foster self-esteem and succeed in school and life.

Hearing loss can increase risk factors for a number of acute health conditions including diabetes, stroke, heart attack, psychiatric disorder, and affective mood disorders.

Untreated Hearing Loss: The Social Effects Untreated hearing loss can result in harmful social impacts that go far beyond the hearing impairment itself. These include issues with work performance and relations, and difficulties with family relationships and friendships that could potentially lead to social withdrawal, avoidance of social events, and eventually social rejection and loneliness. In light of these negative associations, it is clear that taking care of your hearing health is something that should be taken very seriously indeed. The good news is that new and more effective treatments for hearing loss are now available, thanks to advances in health care and medicine. Treating a hearing loss has been associated with improvements in self-confidence, relationships, social life, and physical and mental health.

Untreated hearing loss can result in issues with work performance and relations, and difficulties with family relationships and friendships.

Types of Hearing Loss

Hearing loss can occur as a result of problems at any stage of the hearing pathway, and at any age. A comprehensive audiological evaluation should be undertaken in order to determine the type and severity of hearing loss, and to make appropriate recommendations for treatment. There are four types of hearing loss: conductive hearing loss, sensorineural hearing loss, mixed hearing loss and central hearing impairment.

Conductive Hearing Loss Conductive hearing loss occurs when sound is not conducted efficiently through the outer and middle ears, including the ear canal, eardrum, and the small bones, or ossicles, of the middle ear. Conductive hearing loss usually involves a reduction in sound level, or the ability to hear soft sounds. Presence of fluid in the ear associated with colds, allergies, and ear infections (i.e., otitis media), or a poorly functioning Eustachian tube are common causes of conductive hearing loss. Other causes include excessive earwax in the ear canal, perforation of the eardrum, or damaged or defective ossicles. Approximately 10% of all hearing losses are conductive, which can range from mild to moderate in severity. Conductive hearing loss can often be medically or surgically treated, and in many cases, hearing can be restored.

Sensorineural Hearing Loss Hearing loss that originates in the inner ear is referred to as sensorineural hearing loss. Sensorineural hearing loss not only involves a reduction in sound level, or ability to hear soft sounds, but also affects the ability to hear and understand speech clearly. This type of hearing loss can occur in one of two ways: firstly, when the delicate hair cells in the inner ear are damaged and become unable to convert sound vibrations into the electrical signals required by the auditory nerve, and secondly, when nerve pathways in the auditory nerve itself become damaged, preventing the signals from reaching the brain. A sensorineural hearing loss can be of any degree – mild, moderate, severe, or profound, and most often occurs from genetic factors (i.e., hearing loss can run in families), excessive noise exposure, or presbycusis (i.e., hearing loss caused by changes in the inner ear due to aging). Other causes of sensorineural hearing loss include:

• Ear-toxic medications
• Auditory nerve tumours
• Congenital or acquired infections such as meningitis and mumps
• Kidney disease
• Vascular disease

Approximately 90% of all hearing losses are sensorineural, which is a permanent loss that cannot be corrected medically or surgically. In more than 95% of cases of sensorineural hearing loss, hearing aids or cochlear implants are the recommended course of treatment.

Mixed Hearing Loss Sometimes a sensorineural hearing loss may occur in combination with a conductive hearing loss. In other words, there may be damage in the outer or middle ear, as well as the inner ear or auditory nerve. If this happens, the hearing loss is referred to as a mixed hearing loss. An example of a mixed hearing loss may be someone with inner ear hair cell damage due to aging who at the same time has infected fluid in the middle ear due to an upper respiratory infection.

Central Hearing Impairment Central hearing impairment occurs when the auditory centres of the brain are affected by injury, tumour, disease, heredity, or other unknown causes. Central hearing impairment does not necessarily involve hearing loss, although it may. Central hearing impairment involves issues with auditory discrimination, sound localisation, auditory pattern recognition, the temporal aspects of sounds, and the ability to deal with degraded and competing acoustic signals.

Sensorineural hearing loss most often occurs from genetic factors, excessive noise exposure, or presbycusis (i.e., hearing loss caused by changes in the inner ear due to ageing).

How to tell if you have a hearing loss

Most cases of hearing loss develop slowly over time, as a natural part of ageing or the product of a long period of exposure to loud noise. Because of the gradual nature of the problem many people with mild to moderate hearing loss are actually unaware they have an issue, believing that certain lifestyle choices or behavioural adjustments are ‘the norm’ for them, for example avoiding social situations. People can become so used to having hearing loss that they forget how things sound and start living in a quieter world, without even realising what they are missing out on or how their quality of life is being affected. Often family or friends are the first to recognise the problem. If you suspect that you or a loved one may be experiencing hearing loss, early detection is important. TYPICAL SYMPTOMS OF HEARING LOSS:

• A perception that people mumble a lot and don’t speak clearly.
• Hearing someone speak but difficulty understanding some of the words.
• Frequently asking people to speak up or repeat themselves.
• Having to watch a speaker’s lips closely to follow the conversation.
• Difficulty understanding women and children’s voices (or other high frequency sounds).
• Difficulty hearing someone call from behind or from another room.
• Difficulty hearing clearly on the telephone.
• Difficulty hearing at the theatre or other entertainment venues.
• Difficulty hearing in noisy environments, for example in a restaurant or in a car.
• Difficulty following a conversation when in a group of people, in a meeting, at church, or during lectures.
• Difficulty understanding words or voices in a crowd.
• Turning the TV or radio up to an uncomfortably high level.
• Favouring one ear over the other.
• Limiting social activities due to difficulty hearing and communicating.
• Acting withdrawn, isolated, depressed or irritable.

SYMPTOMS THAT INDICATE A LARGER AUDIOLOGICAL PROBLEM:

• A sudden hearing loss in one or both ears.
• Acute or chronic vertigo, dizziness, or imbalance.
• A ringing or buzzing in the ears (i.e., tinnitus).
• A fullness or pressure in the ears.
• A speech/language delay in children.

To get ahead of the game, the best course of action is to take a baseline hearing test and annual follow-up hearing tests to help identify and treat any hearing issues early.

A comprehensive hearing evaluation is a painless, non-invasive, quick and inexpensive process, typically taking 30 – 45 minutes for most adults.

Free Hearing Screening Promotion

The purpose of a hearing assessment is to determine not only if you have a hearing loss, but how mild or severe it is. A thorough hearing evaluation can also help define the type of hearing loss you have (i.e., conductive, sensorineural or mixed) and whether it will respond best to medical treatment (i.e., a Cochlear implant), or hearing aids. A comprehensive hearing evaluation is a painless, non-invasive, quick and inexpensive process, typically taking 30 – 45 minutes for most adults. During your visit the audiologist will run a series of tests and examinations using professional equipment.

Once you have completed the series of hearing tests your audiologist will present you with a thorough explanation of your test results, including your audiogram. If a hearing loss has been identified, your options will be discussed including whether you require further testing, any medical or surgical referrals or treatments, and if hearing aids are recommended, the type and style that would be suitable to your individual circumstances. In addition, you may be given more information regarding your specific needs; whether it’s how to protect your hearing if you’re exposed to noise on a regular basis, or strategies for improved understanding in difficult listening environments.

You’ll be referred to a physician for evaluation and treatment if an underlying medical condition is suspected. In most cases of hearing loss, (including more than 95% of sensorineural hearing losses), hearing aids or cochlear implants are the treatment of choice. As part of Hearing Awareness Week 2018, Ear & Hearing Australia are offering free hearing screenings for pensioners, veterans and seniors.* If you or your loved one would benefit from this offer please book an appointment now. We provide hearing tests at all of our conveniently located clinics and our dedicated team of qualified audiologists has amassed years of experience, guaranteeing a professional, friendly and dependable service you can trust. *Fees may apply if proceed to audiological assessments.

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Hearing Loss and Dementia: The Link Between Them & 10 Common Warning Signs

According to several major studies, older adults with hearing loss are more likely to develop Alzheimer’s disease and dementia compared to those with normal hearing. Further, the risk escalates as a person’s hearing loss grows worse. Those with mild hearing impairment are nearly twice as likely to develop dementia compared to those with normal hearing. The risk increases three-fold for those with moderate hearing loss, and five-fold for those with severe impairment. One study led by Dr Frank Lin, Professor of Geriatric Medicine at Johns Hopkins University in the US, shows auditory impairment is associated with a 30-40 per cent rate of accelerated cognitive decline. His team is now trying to identify if better treatment of hearing loss could reduce dementia rates.

People with severe hearing loss are five times more likely to develop a form of dementia compared to those with normal hearing.

Dementia is NOT a normal part of ageing. The World Health Organization defines Dementia as a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses that affect memory, thinking, behavior and ability to perform everyday activities. As of December 2017 there are more than 413,106 Australians living with dementia, a figure that is predicted to increase to 536,164 by the year 2025.

Alzheimer’s disease is the most common cause, accounting for up to 70 per cent of people with dementia. Some forms of Alzheimer’s and frontotemporal dementia (which usually affects behaviour before memory) can be genetic. But most dementias are not inherited. The most common dementias – Alzheimer’s and cerebrovascular disease (damage to the brain’s blood supply) – have no cure. The disease progression varies but people usually live four to eight years after an Alzheimer diagnosis but can survive 20 more years. So improving communication between doctors and audiologists and finding better ways to support and test people for hearing loss and dementia is becoming increasingly urgent.

There are more than 413,106 Australians living with dementia, a figure that is predicted to increase to 536,164 by the year 2025.

How are hearing loss and dementia connected?
Although the reason for the link between hearing loss and dementia is not conclusive, study investigators suggest that a common pathology may underlie both, or that the strain of decoding sounds over time may overwhelm the brains of people with hearing loss, leaving them more vulnerable to dementia. They also speculate that hearing loss could lead to dementia by making individuals more socially isolated—a known risk factor for dementia and other cognitive disorders.
In addition to being an important risk factor for Alzheimer’s and dementia, multiple studies have shown that hearing loss worsens the symptoms of these diseases when they are already present. These symptoms include impaired memory, the inability to learn new tasks, reduced alertness, compromised personal safety, irritability, anger, fatigue, stress, depression, and diminished overall health.

Can hearing aids help?
So what can be done to identify and assist those at risk? Consulting a doctor and an audiologist is the obvious first move. But more research is needed to analyse the overlap between the two conditions. It is important to note that typical hearing loss does not cause dementia and not everyone with hearing loss will develop a dementia. But if a hearing loss is identified wearing hearing aids – earlier rather than later – can help. Dr Anil Lalwani and his team at Columbia University Medical Center in the US published a study in the American Journal of Geriatric Psychiatry last year. “Our study suggests that using hearing aids may offer a simple, yet important way to prevent or slow the development of dementia by keeping adults with hearing loss engaged in conversation and communication,” explains Dr Lalwani.

Using hearing aids may offer a simple, yet important way to prevent or slow the development of dementia by keeping adults with hearing loss engaged in conversation and communication.

How to help loved ones with hearing loss and dementia
Having a supportive family is critical in improving communication and wellbeing for people with hearing loss and dementia. Maintaining empathy and composure, ensuring you are facing the person when talking to them in a well-lit area and speaking up can make a big difference, says Scanlan. Greg Savage, Professor of Clinical Neuropsychology at Macquarie University, says research backs up the importance of familial support. “We have found that when a family member is helping in cuing, the overall performance is much better than when a partner is not helping in that way,” explains Professor Savage.

If a relative suspects hearing loss or the early signs of dementia, suggesting a hearing test is a sensitive way of addressing the topic. “Sometimes a hearing test can be a good first step to make, rather than admitting you think someone is developing dementia because they are becoming forgetful,” says Scanlan. She adds that feeling cross or frustrated with the person will only increase their fear of social interaction.

Having a supportive family is critical in improving communication and wellbeing for people with hearing loss and dementia.

Encouraging a healthy, low fat, low sugar diet is also sensible as diabetes has been linked to hearing loss and Alzheimer’s disease, and high blood pressure and raised cholesterol increase the risks of vascular dementia. But having ways that allow for early diagnosis and intervention are key to improving outcomes.

“Most people wait seven to 10 years before they do anything about it. During that time psychological and social impacts of hearing loss can be far-reaching,” says Scanlan. “One thing we do know is that it’s not so much the hearing loss itself but hearing loss that hasn’t had any intervention that seems to cause the most impact on the affected individuals, their partners and families,” she says.

The 10 Warning Signs of Dementia

Although the early signs vary, common early symptoms of dementia include:

• 1. Recent memory loss that affects daily life. It’s normal to forget meetings, names or telephone numbers occasionally and then remember them later. A person with dementia might have trouble remembering conversations or may repeatedly ask questions.
• 2. Difficulty performing regular tasks. It’s normal to make a wrong turn occasionally while driving. Someone with dementia might have regular difficulty driving a familiar route.
• 3. Problems with language. Many people have trouble occasionally finding the right words. Someone with dementia might have difficulty following or starting a conversation, or may use the wrong words.
• 4. Disorientation of time and place. It’s normal to forget for a moment what day it is or why you went into a room. A person with dementia may be confused abut the time of day and what it’s appropriate to do at that time (for example eating breakfast at dinner time).
• 5. Decreased or poor judgement. Making a poorly thought through decision once in a while is normal. A person with dementia might make bad decisions frequently and may start paying less attention to their physical appearance.
• 6. Problems with complex tasks. It’s normal to have some degree of difficulty with complex tasks, for example balancing a budget. A person with dementia may be unable to keep track of finances or manage to plan or cook meals.
• 7. Misplacing things. Anyone can misplace their wallet or keys. A person with dementia may repeatedly put things in inappropriate places.
• 8. Changes in mood and behaviour. Everyone becomes sad or moody from time to time. A person with dementia can have rapid mood swings, from calmness to tears to anger, for no apparent reason or because they are having difficulty coping.
• 9. Relating to others. People’s personalities can change a little with age. A person with dementia may suddenly become more outspoken and seem less considerate, or become more socially withdrawn and unconfident.
• 10. Loss of initiative. It’s normal for people to tire of work, interests, or social responsibilities. A person with dementia may lose interest in or be unable to get started on things that they used to enjoy doing.

The 10 common warning signs of dementia.