Hearing Loss and Dementia

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.