Hearing Loss And Cognitive Decline

If you’re over age 50 and you ever catch yourself asking people “What?” or “Huh?” more often than you used to, you’re not alone. Hearing loss becomes much more prevalent as we age. 

Benjamin Copeland, MD, an Indianapolis ear nose and throat specialist with Franciscan Physician Network Otolaryngology Associates, provides details on hearing loss, including age-related hearing loss and how it can factor into cognitive decline. 

Key Takeaways: Hearing Loss And Cognitive Decline 

• Age‑related hearing loss is common and becomes more prevalent with each decade after age 50, often progressing gradually and easily going unnoticed. 
• Untreated hearing loss has been linked to cognitive decline, social isolation and an increased risk of dementia. 
• Hearing difficulties can place extra strain on the brain, forcing it to work harder to interpret sounds and speech. 
• Early evaluation and treatment, including modern hearing aids, may help preserve cognitive health and improve quality of life. 

How Common Is Hearing Loss? 

“The percentage of people with hearing loss increases with age,” explained Dr. Copeland. Here’s how hearing loss risk increases with each decade over age 50: 

What Are The Types Of Hearing Loss? 

There are two main types of hearing loss: 

• Sensorineural hearing loss.“About 95% of hearing loss falls into this category,” said Dr. Copeland. This is the typical, age-related hearing loss or can be caused by noise exposure, certain antibiotics that are toxic to hearing or viruses. This type is permanent and irreversible but can be successfully treated. 
• Conductive hearing loss. This type of hearing loss is less common and is caused by a problem in the outer or middle ear. This hearing loss may be treated medically or surgically and may involve the eardrum or the tiny bones in the ear. 

What Are Early Signs Of Hearing Loss? 

In many cases, family or friends may notice a person’s early hearing loss before the person even notices it. Keep an eye out for these early signs of hearing loss: 

• Asking people to repeat what they’ve said 
• Leaning toward the person who’s speaking and carefully watching their face 
• Ringing in the ears (tinnitus)
• Speaking increasingly louder 
• Turning the television volume louder 
• Withdrawing from social situations – especially in loud environments or group settings 

Treatments For Hearing Loss 

While most hearing loss cannot be reversed, experts can treat it successfully. Depending on your situation, type and severity of hearing loss, treatment options include: 

• Earwax removal
• Hearing aids
• Medication changes to reduce symptoms of tinnitus 
• Steroid treatments to help improve sudden hearing loss 
• Tympanoplasty to correct a hole in the eardrum 
• Placement of bone transmission devices 
• Placement of cochlear implants

Hearing Aid Types 

There is a tremendous amount of hearing aid technology on the market today.  

“Hearing aids are much better today in terms of sound quality than they were even 10 years ago,” Dr. Copeland said.  

There are two main types of hearing aids: 

• Custom in-the-ear hearing aids 
• Over-the-ear hearing aids 

Hearing aid features

• Many of today’s models connect to your smartphone via a mobile app so you can use your smartphone as your hearing aid remote control. 
• Most hearing aids are now rechargeable, so you don’t have to continually buy new batteries. 
• Most hearing aid models function like Apple AirPods, allowing the wearer to make and receive phone calls and listen to music through Bluetooth connections. 
• Directional microphones and improved sound processors can help with hearing in difficult listening situations by helping to focus on what is front and reduce the volume of sounds coming from behind the wearer. 

Sound Processing Challenges 

Hearing aids significantly improve overall hearing and communication for most people. At the same time, Dr. Copeland said, people need to keep in mind that hearing aids do not restorethe hearingloss.We hear and process with our brains – and our ears bring the sound into our brains.

“While a hearing aid can help bring in sounds that a person isn’t hearing, there’s also the processing part,” he said. “With some patients, it’s not just the hearing that’s the issue, they can also have trouble with the brain being able to process what’s being communicated.” 

In severe cases of hearing loss, the patient’s ability to understand words clearly can decline so much that a hearing aid no longer helps with communication.  Fortunately, there are cochlear implants that can restore the hearing clarity in these cases.  

What Is the Connection Between Hearing Loss And Cognitive Decline? 

Many factors play into cognitive decline, which includes dementia and Alzheimer’s disease. The majority of a person’s risk for having cognitive decline has to do with age and genetics – two things that we can’t do anything about. 

However, some modifiable (controllable and changeable) risk factors contribute to cognitive decline. These include: 

• Depression
• Diabetes
• Hearing loss 
Hypertension (high blood pressure)
• Inactivity 
• Obesity
• Smoking

Communication disorders, such as hearing loss, impact social engagement which in turn impacts quality of life.  

“We cannot definitively say hearing loss causes cognitive decline,” explained Dr. Copeland. “But treating hearing loss early and keeping people socially engaged and involved will help keep their cognitive function working better – and possibly change the trajectory of how cognitive decline might happen.” 

When people experience hearing loss as they age, they may tend to withdraw from certain social situations that are especially noisy. That’s because the brain has to work much harder just to hear regular conversations, which can be a major drain on the person. However, missing out on engaging with friends, family members and community groups can quickly lead to social isolation and depression. The more you use your auditory pathway, the better it will be. That’s why seeking help is important if you or a loved one may have hearing loss. 

Don’t Wait – Get Care Now 

Dr. Copeland suggested that people over age 50 should get a baseline hearing test to check their current hearing levels. After that, you should get a hearing test every two-five years or when you notice any hearing loss symptoms such as changes in tinnitus (ringing). Hearing aids come with a trial period of 30 days to give the user time to adjust to the new sounds. If not satisfied, they can be returned.