Dementia is not just about memory loss. It impacts many different brain functions including the sense of hearing. The Better Hearing Institute advises us: “Listen to your ears. They might be telling you something.” Hearing loss should be the number one red flag, a sign of developing dementia or Alzheimer’s disease.
The ear was considered the seat of memory in antiquity, particularly in Latin literature. This was an era when books were scarce. The ear was thought to be the natural avenue of information. The ancients understood that a person who does not listen attentively does not remember well. Hence, we have the adage, “In one ear and out the other.” (The Classical Weekly, vol. XII, No. 4, p. 28.)
My husband and I recently attended a presentation on the effects of hearing loss sponsored by a local hearing aid company. I came to realize the close association of hearing loss with dementia. It also shocked me enough to schedule a hearing test. What I learned about our incredible sense of hearing was enlightening. Here’s a synopsis of that presentation, along with further research I did in this regard.
Our Amazing Sense of Hearing
Hearing is one of our most extraordinary processes. Our auditory system is completely intact in the womb by twenty weeks gestation. At twenty-three weeks a fetus can respond to loud noises, and may jerk or even hiccup after hearing a loud sound. (babysense.com)
The auditory system is comprised of two subsystems: the peripheral system (the outer ear, middle ear, and inner ear), and the central auditory system, (from the cochlear nucleus up to the auditory cortex of the brain). When these parts all work together, we can hear and process sounds. We rely on our hearing for many things:
• understanding speech which educates, informs, and entertains us;
• recognizing sounds that can warn and alert us to danger;
• recognizing background noises of nature and the world around us;
• appreciating pleasurable, beautiful sounds.
It is the cochlear, a spiral shaped tube filled with fluid and hair cells, which creates the electrical signals that pass through the auditory nerve to the brain. Sound is processed in different regions of the auditory cortex, part of the temporal lobes located on both sides of the brain. Here these electrical signals are interpreted as music, speech, or other sounds such as laughter, thunder, etc. The meaning of words is also processed in the temporal lobes.
The Brain and Hearing Loss
Studies at Johns Hopkins University, the University of Utah Health Care, and the National Institute on Aging show a link between hearing loss and mental decline. “Making sense of sound is one of the most computationally complex tasks we ask our brains to do: process information in microseconds,” says Nina Kraus, Ph.D., neuroscientist and director of Northwestern University’s Auditory Neuroscience Lab. The strain of decoding sounds over time may begin to overwhelm the brains of people with hearing loss. This forces the brain to devote too much energy to processing sound, and leaves the person more vulnerable to dementia. “Adults with hearing loss are more likely to develop problems thinking and remembering than adults with normal hearing.” (Starkey.com)
Statistics by the National Institute of Deafness and Other Communicative Disorders (NIDCD) reveal that one out of three persons between the ages of 65 and 74 have some degree of hearing loss. This number increases to almost 50% for those who are over 75. However, less than 25% of those who need hearing aids actually get them.
Dementia and Hearing Loss
Hearing impairment can make cognitive dysfunction worse. If a person can’t hear the words, their brain won’t remember the words, and those words start to become confusing. Hearing loss can bring on anxiety, social isolation, reduced alertness, and compromised personal safety. These are factors for developing dementia.
Research shows the following:
1. Adults with mild hearing loss (greater than 25 decibels) are two times more likely to develop dementia.
2. Adults with moderate hearing loss are three times more likely to develop dementia.
3. Adults with severe hearing loss are five times more likely to develop dementia.
Hearing and Quality of Life
It is recommended that every person over fifty years of age get their hearing tested every three years. A hearing evaluation should also be part of any assessment of cognitive function. Persons with Alzheimer’s and hearing loss can use and benefit from hearing aids. Improved sensory perception won’t stop the progression of Alzheimer’s disease, but increasing their ability to hear can help reduce the person’s confusion.
Making Adjustments for Communicating with a Person with Hearing Loss and Dementia
1. Get their attention. Always face the person when speaking. Get to their level. Gain attention by speaking their name or gently tapping them on the shoulder or arm.
2. Provide good lighting. Take care that bright light is not shining directly in the person’s eyes.
3. Reduce sudden unexpected or loud background noises as this may cause sensory overload. Avoid having too many people speak at the same time.
4. Slow down. Speak slower, more distinctly, but don’t let your speech become too exaggerated.
5. Speak in a normal tone. Don’t shout, as shouting can distort your voice and make it more difficult to understand. Don’t chew gum or have candy or food in your mouth while talking.
6. Simplify the message or write it down. Rephrase if needed. Give visual cues and gestures, such as moving your hands to your mouth to show eating food, brushing teeth, etc.
7. Give them time to hear what you are saying. Allow time for their brains to process and think of the answer.
8. If you are out in a restaurant, choose a table or booth away from a lot of noise. Have the person sit at the end of the table or lean with their back against the wall. These things reduce noise levels.
There is still much that we don’t know about the connection of hearing loss with dementia. But researchers are working diligently to find the answers. In the meantime, we can be more mindful of our incredible sense of hearing. Take time to listen and appreciate the wonderful sounds of nature, music, and the human voice.
I wish you joy, peace, patience, and love in your caregiving journey today and every day!
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Hearing loss is not a joke. But try this forty second hearing loss simulation featuring the Flintstones and Barney: https://youtu.be/ar1Dq-M2ok4
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Here is a ten-question hearing quiz to take: https://www.nidcd.nih.gov/health/do-you-need-hearing-test-quiz
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Hearing aids are expensive. Read about two cheaper but effective “hearing amplifiers” recommended by an audiologist at Johns Hopkins University: http://dailycaring.com/affordable-hearing-aid-alternatives-for-seniors-hearing-amplifiers
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Bird lover, Lang Elliott, has a lovely website filled with the “Music of Nature.” Check it out by going to: http://musicofnature.com/listening-room/.
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