The Hidden Risks of Hearing Loss
Becoming hard of hearing, like wrinkles and arthritis, is expected for most of us as we age. It is the most common condition affecting older adults. One-in-three people in the United States between the ages of 65 and 74 has a hearing loss, and nearly half of those older than 75 have difficulty hearing, according to the National Institutes of Health.
Long-term exposure to loud sounds, such as music, lawnmowers and construction equipment; changes in the inner ear as we age; and high blood pressure and diabetes all affect the long-term health of our hearing.
So if hearing loss is an expected age-related condition, we should just live with it, right? Wrong.
Hearing loss has been linked to an increase in cognitive decline, often related to depression, social isolation and reduced activity.
“If you have hearing loss you become more socially isolated,” says Nicholas Reed, an associate professor and audiologist at the Optimal Aging Institute at New York University’s Grossman School of Medicine. “We have evidence now from several studies that the sensory input to your brain really does affect atrophy over time. In a way, your brain’s not exercising if it’s not receiving sensory input so that affects atrophy and network structures.”
The 2024 Lancet Commission on Dementia Prevention, Intervention and Care identified hearing loss as one of the modifiable risk factors for dementia. Treating hearing loss could prevent up to seven percent of dementia cases globally, making it one of the most impactful areas for potential prevention, according to the commission.
Reed said the importance of the “cognitive load piece” can be seen on MRIs.
“We see that those with hearing loss have this prefrontal area lighting up that those with normal hearing do not have. It’s quite literally evidence of your brain trying to compensate and make up for bad cell phone signals, if you will, the bad auditory signals.”
He said social isolation changes inflammation and the immune system.
“It is a physical reaction in our body to be socially isolated, to be truly not engaged. Humans are just not meant to do that.”
EFFECT OF HEARING AIDES
In response to this association between hearing loss and dementia in older adults, The National Institutes of Health funded research that found hearing aids slow cognitive decline in people at high risk. They enrolled adults aged 70 to 84 with substantial hearing loss to compare the rate of cognitive decline over a three-year period between people who did and didn’t receive hearing aids.
Half of the study group members received hearing aids and instructions on how to use them. The other half was assigned to a health education program focused on promoting healthy aging. The people receiving hearing aids had an almost 50 percent reduction in the rate of cognitive decline.
What Hearing Loss Looks Like
The Mayo Clinic advises looking for the following symptoms of hearing loss:
- Muffling of speech and other sounds.
- Trouble understanding words, especially when in a crowd or a noisy place.
- Trouble hearing the letters of the alphabet that aren’t vowels.
- Often asking others to speak more slowly, clearly and loudly.
- Needing to turn up the volume of the television or radio.
- A person staying clear of some social settings.
- Being bothered by background noise.
- Ringing in the ears, known as tinnitus.
Starting the Conversation About Your Concern
Jessica Galatioto, AuD, an audiologist at Columbia University’s Irving Medical Center in New York City, offers the following recommendations to the National Council on Aging.
- Begin a dialogue by using “I” or “we” statements and sticking to facts. You can say something like, “I’ve noticed that when we talk on the phone you don’t always understand what I say.” Ask them if they’ve noticed something similar.
- Focus on specific areas where they have voiced difficulty or frustration. Often wanting to improve specific things (like difficulty hearing grandchildren) can open the door and make people willing to try hearing aids.
- Bring up the idea of a hearing loss quiz, so there is a more objective way to decide if help is needed. You can say something like, “I’ve noticed that you’ve been asking me to repeat myself more often, which can be a sign of hearing loss.” A variety of quizzes are available online to quickly check. Invite them to try one.
- No matter how you start the conversation, be patient and listen actively. Don’t just wait for them to finish their thought so you can make your next point. Really listen to what they have to say.
“Hearing loss is very treatable in later life, which makes it an important public health target to reduce risk of cognitive decline and dementia,” said Dr. Frank Lin, who co-led the research team from Johns Hopkins University. “Until we know more, we recommend for general health and well-being that older adults have their hearing checked regularly and any hearing issues be properly addressed.”