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.

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As parents, it’s easy to sometimes think our children are ignoring us. But it’s a real possibility they could have a hearing problem.

According to the World Health Organization, about 95.1 million children age 5-19 live with hearing loss. And more than 1 billion young adults are at risk of permanent, avoidable hearing loss due to unsafe listening practices. May is national Speech-Language-Hearing month and is a good time to raise the importance of staying on top of our children’s hearing.

Krista Irmeger, AuD, an audiologist with OSF HealthCare, says congenital hearing loss starts at birth. 

“It can be genetic. It can be a factor in pregnancy with the mom; it can be acquired later with different viruses and illnesses,” says Irmeger.

There are plenty of signs to look out for, Irmeger adds. In babies, it starts when they don’t get startled at loud noises. They don’t use signal words by the time they turn 1. Signal words are basic words and gestures toddlers use to communicate basic needs, regulate their emotions or express preferences before they develop full sentences. In older children, speech and language development is delayed. They don’t follow directions or often turn the TV volume up.

As children age, there are several contributing factors that could lead to hearing loss. The biggest one is noise exposure. That can include repeated exposure to loud music or attending concerts or fireworks displays. Another potentially bad habit is overusing ear buds and headphones.

“Kids nowadays are using earbuds and headphones like crazy,” says Irmeger. “So, monitoring the volume of that; the rule that we go with is 60% or less of the max volume, never greater than that. And then monitor how much time they're using headphones and earbuds. Wearing hearing protection when you're around loud noises, concerts, sporting events, fireworks...”

Children should be receiving hearing exams in school through middle school. But if parents have any concerns or notice any issues such as speech and language delays or frequent ear infections, Irmeger encourages parents to make an appointment to see an audiologist to set up a hearing exam. Ear tubes are an effective way at treating hearing loss caused by chronic fluid buildup or repeated infections in the middle ear.

“If there's an underlying medical condition like an ear infection or a structural abnormality, first we would get that treated,” Irmeger says. “And if the hearing loss is still there, then it would be a hearing aid, and if it's more severe, it'd be a surgical treatment, like a Bone Anchored Hearing aid (BAHA) or a cochlear implant.” BAHA is a surgically implanted device that uses bone conduction to transfer sound directly to the inner ear, bypassing the outer and middle ear. A cochlear implant is a small electronic device that can provide a sense of sound to a person who is deaf or severely hard-of-hearing. 

Getting the news that hearing aids are needed can be unsettling to anyone. Irmeger says children typically react in one of two ways. “Some children are excited to have hearing aids because the kids in their classroom are like, ‘Whoa, that's really cool that you have that.’ And others are more reserved and they're hesitant to get them. I think the big factor that really helps is how the parents respond. If they're super excited and they make it seem like a cool thing that they get to do.”

Preserving your child’s hearing starts with good habits developed in the home. “If you're in a situation and it's loud for you, it's going to be loud for your kids too,” says Irmeger. 

For more information on children and hearing, visit the OSF HealthCare website. 

 

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The OSF Audiologist says since it's his profession, he knows the dangers of loud noise and the lasting impact it can have on his hearing. 

Our listening habits could be doing more harm than good. Especially for younger people.

A recent published study cautions that between 670 million and more than 1.3 billion teens and young adults could face hearing loss due to unsafe habits. 

Researchers concentrated on two main sources of loud music exposure: live music events and personal listening devices like headphones. 

Listening to sounds at a decibel level of 85 or higher for long or a repeated amount of time can cause hearing loss.

“A lot of us feel invincible at that age, so we tend not to take that message to heart," Dr. Workman says. "Hopefully they understand the potential damage they could do.”

Dr. Workman offers a few helpful tips like wearing protection at concerts and sitting in the back of the venue, if possible. 

He also says to wear ear plus and turn the music down on your headphones. 

If you're concerned you may be experiencing hearing loss, Dr. Workman recommends scheduling a hearing test.

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Chris Workman, an audiologist with OSF HealthCare, loves to crank up his music from time to time. But since it’s his profession, he knows the dangers of loud noise and the lasting impact it can have on his hearing.

“It stirs some emotion. It gets you pumped up,” says Dr. Workman. “It gets you if you're working out, you might crank some music. Some folks will listen to music for other emotions. Maybe they're feeling a different way, and cranking a song will bring them out of that depression or whatever they're going through.”

But our listening habits could be doing more harm than good. Especially for younger people. A recent study published in the BMJ Global Health Journal cautions that between 670 million and 1.35 billion teens and young adults could face hearing loss due to unsafe habits.

The study analyzed data from 33 studies covering more than 19,000 people between the ages of 12 to 34. Researchers concentrated on two main sources of loud music exposure: Live music events and personal listening devices, like headphones and earbuds.

Listening to sounds at a decibel level of 85 or higher for long or a repeated amount of time can cause hearing loss.

Researchers found that 24% of young people listen to their devices at volumes high enough to harm their hearing. And 48% are exposed to unsafe sound levels at concert venues. Listening at high volumes can lead to noise-induced hearing loss as well as lifelong hearing problems like tinnitus, which is a constant ringing noise in your ear.

“Most of our kids are walking around with headphones in their ears. Athletes are walking around with headphones in their ears,” says Dr. Workman. “They're listening to something multiple hours a day, some of which is at loud levels, which, over time, is going to do some damage to their hearing.” 

Dr. Workman doesn’t see many young adults in his practice. But when he does, he makes sure to give them a reminder about taking care of their hearing. Ongoing bad listening habits can lead to problems within 10 years.

“I'm all for listening to some loud music. I like it myself, but I know to do it in short durations, crank a couple songs, turn it down, or take them off. Give your ears a break,” he says. “That way you're letting those hairs in the inner ear come back and protect them from any permanent damage.”

Dr. Workman offers a few helpful tips. “Encourage them to wear hearing protection around loud noise. If they’re going to a concert don’t sit up front. Back away a little bit. If you do sit close, wear some hearing protection. You can get an inexpensive pair online for $20. That will help make the music sound normal at a reduced level.” 

The best place to start is getting a hearing test to establish a baseline. Dr. Workman recommends testing for people as young as 20-25. In addition to loud noises, there are other reasons for hearing loss such as aging, genetics, certain medications and diseases like diabetes.

Dr. Workman says the bottom line is to use common sense when it comes to your hearing. Afterall, the last thing you want as a young person is to be fitted for hearing aids. 

“A lot of us feel invincible at that age, so we tend not to take that message to heart,” he adds. “Hopefully they understand the potential damage they could do.”

For more information on audiology services, visit OSF HealthCare.

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There are many health complications for people living with diabetes including heart and kidney disease, oral health and vision problems. You can add hearing loss to the list.

According to Chris Workman, AuD, an audiologist with OSF HealthCare, people with diabetes are twice as likely to suffer from hearing loss compared to those who don’t. Even people with prediabetes have a 30% higher rate of hearing loss than people with normal blood sugar levels.

“There's about 28 million people in the United States with hearing loss,” Dr. Workman says. “There's 37 million people with diabetes. So, we can surmise that there's a good portion of that 28 million who have diabetes that also have hearing loss.”

The link appears to be nerve damage. All senses rely on good blood flow and nerve function. Dr. Workman says blood vessels feed the nerves, which are crucial to good hearing. According to the Centers for Disease Control and Prevention (CDC), the average person is born with about 16,000 hair cells within their inner ear, which allow your brain to detect sounds. By the time most people notice a change in their hearing, 30% to 50% of hair cells have already been damaged or destroyed. And they do not grow back.

“I believe high blood sugar could potentially affect the blood flow to the inner ear and some of the hair cells which could affect and cause some hearing loss,” Dr. Workman says. “Low blood sugar could cause some damage to the nerve and transmission of the hearing.”

Dr. Workman adds that for the past 10-15 years the audiology field has seen a rise in patients who also have diabetes – including in his own practice. For those patients, especially those who have other comorbidities such as hypertension, screening tests are especially important.

“For those patients, we would recommend following up with an annual hearing test to keep an eye on things,” he says, “We encourage them to diet, exercise and take their medication as needed to get better control of diabetes. Otherwise, they’re prone to potential hearing loss and more severe loss.”

There are many signs of hearing loss.

·         Ringing in the ears

·         A tendency to assume everyone is mumbling

·         Difficulty understanding what people are saying

·         Needing to turn the TV volume up high

·         Struggling to hear in group settings

Dr. Workman encourages patients to talk with their primary care physician to establish a hearing baseline. He also recommends stopping smoking and avoiding frequent exposure to loud noises. In addition to physical changes, hearing loss can also lead to depression or feeling secluded, which can impact your social life and mental health. 

The month of May is National Speech-Language-Hearing Month. It’s a time which raises the importance of taking care of your hearing.

Dr. Workman says the key to better outcomes is early treatment. “I think raising awareness of hearing loss not only impacts the individual with the hearing loss, but impacts family, friends, coworkers. If we can raise that awareness and get them help sooner, we're going to continue their quality of life and transition easier to any type of treatment.”

For more information on hearing loss, visit OSF HealthCare.

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Hearing loss can affect anyone. According to some studies, about 23% of Americans ages 12 and older experience hearing loss. While it can be mild or severe, hearing loss can also increase the odds of developing dementia later in life.

That’s according to a study published in JAMA that focused on people ages 70 and older.

While the reasons aren’t clearly understood, it’s important to note that there is a causal effect between hearing loss and dementia, according to Christopher Workman, Au. D., an audiologist with OSF HealthCare.

“There's enough research out there that shows some link to it," says Dr. Workman. "Some of that may be related to the hearing loss itself. Some of it may be related to the effects of hearing loss, which could include loneliness, depression, or lack of social interaction. There may be a direct and indirect cause to dementia, Alzheimer’s, and those type of things.”

In the past 30 years Dr. Workman has seen several patients with cognitive issues including dementia, and that number is growing. Some of their symptoms are significant, which he says raises concerns about their cognitive capabilities.

He adds that one way to prevent feelings of loneliness, depression and to stay socially active is by wearing hearing aids.

“I've read a number of these studies over the past several years and there's some debate as to exactly what's happening or what's causing it," he says. "But I think that hearing aids can play a role in minimizing the potential for dementia occurring. Obviously, you could still have dementia without and have good hearing. You could also have dementia and have hearing aids early on and still have dementia. It's not a cure, but it can help minimize some of the factors that may lead to dementia.”

But getting someone to wear hearing aids isn’t always easy. Some people cite the cost of the devices, while others have issues with sound quality. Other reasons are more of a social stigma – hearing aids are associated with becoming older, and some people have a difficult time with that reality.

A new Illinois law was signed in August, which requires all insurers to provide coverage to Illinois residents if their doctor prescribes a hearing instrument. This expands on a bill in 2018 that required insurers to cover hearing aids for children under the age of 18.

“When we see a patient, I try to kind of screen where they're at mentally, as far as the acceptance of the idea of hearing aids and sometimes I'll recommend they wait if they're not mentally ready, because the last thing we want as people buying hearing aids and they sit in a drawer, so the key is mental acceptance," says Dr. Workman. "And then the second key is committing to the idea of wearing them and wearing them all day. Because if you only wear them for an hour a day, they're not providing the benefit that they need. We want to keep stimulating the auditory pathway to prevent any atrophy from occurring.”

The goal is to treat the patient’s hearing loss as soon as possible before they experience any signs of dementia or cognitive decline. Many times, if an audiologist does suspect some cognitive decline, he or she will refer the patient back to their primary care provider for further evaluation.

Dr. Workman stresses that not everyone who experiences hearing loss is going to get dementia. But he encourages patients and family members to pay close attention to potential warning signs such as asking people to repeat themselves, accusing people of mumbling or turning up the volume on the TV, for example.

“When you start realizing you're withdrawing or the spouse or children recognize that they're withdrawing, then it's time to have something done," he adds. "Get it checked out, find out what's going on and then address it before it continues to lead to further isolation, depression and loneliness.”

Dr. Workman is optimistic that the medical community will have a better understanding of the connection between hearing and dementia in the next several years as more data is compiled and further research is conducted.
 

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