According to Emily Cooper, AuD, a clinical audiologist and audiology supervisor with OSF HealthCare Illinois Neurological Institute, researchers continue to learn more about the relationship between hearing loss and dementia.

"Over the last 10 years, there have been more and more studies linking hearing loss with dementia. There's a growing body of research showing that not only is there a link, but that untreated hearing loss is more of a risk for cognitive decline," Dr. Cooper says.

While researchers are still working to understand exactly why hearing loss and dementia appear to be connected, Dr. Cooper emphasizes that hearing loss alone does not cause dementia. Instead, untreated hearing loss may contribute to factors that increase the risk of cognitive decline over time.

One possible reason is the impact hearing loss can have on a person's social life. Individuals who struggle to hear often withdraw from conversations, social gatherings and activities they once enjoyed.

"Your brain needs to be active and used," Dr. Cooper stresses. "Hearing loss also takes a lot of brain power. Your brain is having to do a lot more processing to understand the world." Over time, that increased effort may contribute to cognitive decline.

Recognizing the signs of hearing loss

Hearing loss can develop gradually, making it difficult for people to recognize when their hearing has changed. Dr. Cooper says some common warning signs include:

• Turning up the television louder than usual
• Frequently asking others to repeat themselves
• Saying "what?" or "huh?" more often during conversations
• Having more difficulty hearing in noisy environments, such as restaurants or crowded events
• Experiencing ringing in the ears, known as tinnitus

Because these changes often happen slowly, family members are sometimes the first to notice them.

Dr. Cooper says loved ones can play an important role by encouraging hearing evaluations in a supportive way. Rather than focusing on the hearing loss itself, she recommends emphasizing quality of life and participation in important moments.

For example, family members might say they want their loved one to fully participate in family gatherings or clearly hear conversations during medical appointments.

Don't wait to get your hearing checked

Many people postpone hearing evaluations for years, assuming hearing loss is inevitable or waiting until their golden years.

"Getting treated early is going to be the most beneficial in preventing cognitive decline as it relates to hearing loss," Dr. Cooper says. "That means getting your hearing tested early, not waiting until you're 65 and on Medicare to do so. Even in your 40s and 50s, there's research that shows even mild hearing loss in your 40s and 50s can lead to cognitive decline later in life."

She encourages adults to establish baseline hearing assessments as they age, just as they monitor other aspects of their health.

A good first step is discussing hearing concerns with a primary care provider, who can then provide a referral to an audiologist for a comprehensive hearing evaluation.

A growing concern for an aging population

The importance of hearing health is becoming even more significant as the nation's population ages.

By 2030, all Baby Boomers will be over the age of 65 according to the United States Census Bureau. Dr. Cooper says this creates a larger risk for both hearing loss and dementia.

"We're looking at massive numbers of an aging population and people who could be at a risk for dementia and hearing loss," Dr. Cooper says. "As a field, we are looking at educating people to get their hearing tested early and getting treated early."

Research in Oxford Academic’s Age and Ageing journal suggests that individuals who receive treatment for hearing loss may have a lower risk of cognitive decline than those who leave hearing loss untreated.

Treatment options vary based on the severity of hearing loss and may include hearing aids or cochlear implants. While Medicare does not currently cover hearing aids, cochlear implants are covered by Medicare and many other insurance plans.

For Dr. Cooper, the message is straightforward: hearing loss should not be viewed as something people simply have to accept. Identifying hearing loss early and seeking treatment may help individuals stay engaged, connected and cognitively healthy as they age.

If you have concerns about your hearing, speak with your primary care provider who can help talk through options with you.

Video Interview Clips

We’re taught at an early age the importance of keeping our bodies clean. That includes most body parts. But your ears? That’s a little more complicated.

According to Chris Workman, AuD, an audiologist with OSF HealthCare, cleaning your ears is fine – in moderation.

The real question is what to do about the earwax or cerumen that tends to build up.

“Earwax is a substance that's produced by glands in the ear canal that consists of an oily substance that mixes with dead skin that sluffs off in the ear canal,” says Dr. Workman. “That produces what we know is the brown, orangey substance.”

Dr. Workman adds that earwax serves as a barrier to protect your ear canal. It traps dirt, debris and even bugs who might fly into your ear from reaching the eardrum. It guards against bacterial and fungal infections. It even keeps your ears moist, so they don’t dry out.

Typically, experts recommend doing nothing about earwax. Older earwax tends to fall out naturally over time and your ears make new earwax to replace it.

“The ear canal itself naturally has little hairs that help push it out along with the jaw movement from talking and chewing,” says Dr. Workman. 

However, Dr. Workman says if you have an excessive amount of earwax, the safer route is to visit your primary care or a ear, nose and throat provider for removal. He or she can irrigate the canal, which means pumping warm water into the ear. That may require a visit once or twice a year.

And whatever you do, Dr. Workman says, avoid using a cotton swab. The eardrum is located at the end of your ear canal, about one inch deep from the outside, and it’s shallow, meaning it could easily be harmed by an object.  

“We obviously want to try to avoid sticking something in the ear, as we may impact the wax. Or we may unintentionally rupture the eardrum, which could cause some permanent hearing damage,” he says.

Still, not cleaning your ears can lead to itching, pain and, in some instances, dizziness. So instead of digging inside your ear canal, Dr. Workman recommends cleaning the outer portion of the ear with a damp cloth. That can be done during a shower or bath. There are also some over-the-counter solutions which can help soften and break down earwax, but consult with your provider on those.

For people who wear hearing aids, dealing with earwax can be a little tricky.

“It can plug up a hearing aid. It can block the ear,” says Dr. Workman. “When it blocks the ear, sometimes sound can't go in, so that can impact the effectiveness of the hearing aid. But it also can cause some problems with feedback from hearing aids, where the hearing aid starts to squeal.” Dr. Workman says people with hearing aids should also clean their outer ear with a damp cloth.

If that happens, Dr. Workman says a visit to your audiologist might be in order.

And that’s advice worth listening to. 

 

Interview Clips 

Do you ever get a loud ringing in your ears? What about a hissing or whooshing or clicking sound? Chances could be that you have tinnitus.

And you’re not alone. Many people have a ringing or another sound in their ears from time to time. But tinnitus (tin-NITE-us or TIN-ne-tus) can be both persistent and frustrating for people with a severe case of it.

“Anywhere between 10 to 20% of the population may have tinnitus at one time or another. Estimates of 50 million people in the country which is quite significant," says Chris Workman, AuD, an audiologist with OSF HealthCare. "For most of those people, it's not something that's significantly disabling. However, there is a percentage of population where it can cause significant issues.”

That includes having trouble sleeping or concentrating. Being alone in a quiet room can exasperate the situation. Dealing with tinnitus on a daily basis can make people feel angry, depressed and feeling irrational.

Tinnitus is a symptom, not a disease. It’s been linked to noise exposure, hearing loss, a side effect from taking certain medications at high doses and the aging process. (Hearing loss impacts one in three people over the age of 65.) An injury to the head or neck can damage the structures of the ear, and even ear wax or an ear infection can cause a blockage of the ear and trigger tinnitus.

Tinnitus can occur in one or both ears.

“Most of the time, we see it happen in both ears because it's gradual due to aging, noise exposure or some other health issues," says Dr. Workman. "Sometimes hypertension, cardiovascular health can play a role. So it may come on slowly and gradually and usually both ears. If it's one ear, I would definitely suggest having it checked out.”

There is no cure for tinnitus. But there are therapies and devices called sound generators which may help silence tinnitus, mask the sounds or help the patient get used to the noise or distract them.

“Some patients who have normal hearing may not need a hearing aid, so we might use that device as a tinnitus masker where it has different noises, whether it's a white noise or ocean-like noise, something else to focus on," says Dr. Workman. "We have fit patients with no hearing loss with a mild-gain hearing aid as a means to kind of drown it out. Sometimes just a little amplification is helpful to help the brain focus on the external noises around them.”

Because ongoing noise in your ears is annoying, Dr. Workman says anxiety will play a pivotal role in how a person handles tinnitus. He recommends that people find ways to reduce stress, which may help.

“Part of the key in minimizing the annoyance is reducing anxiety, educating them on the possible causes, and the fact that over time it may reduce the level of intensity," adds Dr. Workman. "It may not be a cure, but exercise and those types of things can help reduce overall stress levels, which will help minimize the annoyance of the ringing. It also may help them get better sleep, which in turn will help lead to less stress.”

Dr. Workman also suggests limiting the intake of caffeine, alcohol and cigarettes, which can increase tinnitus. Lifestyle issues such as exercise and diet are also important to cardiovascular health which also helps overall health, including hearing.

When it comes to your hearing, protection is the key. To minimize any type of damage, Dr. Workman recommends wearing earplugs whether it’s going to a rock concert or mowing the lawn. And if you use earbuds turn down the volume. If someone else can hear your music or podcast, it’s too loud.  

For starters, people age 55 and over should schedule a hearing test to establish a baseline.

For more information, visit OSF HealthCare.

Interview Clips 

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