Understanding the link between hearing loss and dementia

hearing exam

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.