A large Danish study confirms growing body of evidence
By Deborah Jeanne Sergeant
A recently released Danish study of 570,000 people over 14 years identified untreated hearing loss as increasing the risk for dementia compared with people with no hearing loss or those with treated hearing loss.
The study doesn’t surprise geriatrician Sharon A. Brangman at Upstate Medical University.
“Alzheimer’s is complex,” said Brangman, who is a distinguished service professor, chairwoman of geriatric medicine and director of the Upstate Center of Excellence for Alzheimer’s Disease and director of the Upstate Center of Excellence for Alzheimer’s Disease.
“It is a neurodegenerative disease. Nerve cells are dying. When you lose hearing, nerve cells are dying. A combination of things is happening that can increase your risk of Alzheimer’s. It’s never just one thing but a combination.”
The correlation between untreated hearing loss and a higher risk of Alzheimer’s has to do with brain changes. Those with untreated hearing loss receive less auditory stimuli than those with good hearing. Brangman said that the center of the brain that helps people interpret sound and connect it to a memory gets less use if the person isn’t hearing as much around them.
“That can increase disassociation with the world around you,” she said. “Research is looking at changes in the retina that may have association with a higher risk of Alzheimer’s. It’s all connected to what’s happening in the brain.”
During the pandemic, many older adults become more isolated as during the quarantine period and following, they stayed away from social gatherings to avoid catching COVID-19. Brangman said that she noted an increase in cases of dementia and cognitive decline as sensory deprivation and lack of regular socialization were commonplace.
“There are many layers to making a diagnosis of Alzheimer’s and talking with people about their risk of developing Alzheimer’s disease,” Brangman said. “There are things we can do to reduce that risk. If someone has hearing loss, we recommend hearing aids and if they have visual problems to get their eyes checked. Sensory input is so important for brain health.”
Introducing hearing aids earlier can also make their use more effective so that the brain becomes accustomed to their input. For those who would develop cognitive decline, earlier adoption of hearing aids to treat hearing issues can delay onset of dementia by seven years.
Clayton Andrews, board-certified hearing instrument specialist at Upstate Hearing Solutions in Oswego, said that the Danish study draws “a very solid correlation. The latest data coming out of John Hopkins that the more severe your untreated hearing loss is and the longer it goes, the more likely you will be diagnosed with dementia. I see a correlation between dementia and untreated hearing loss.”
He said that many people delay treating their hearing loss because they don’t realize they have a hearing loss. Typically, family members notice before the patient himself.
Some people believe that hearing instruments are too costly for them to afford. Andrew related that most insurance companies offer up to 100% coverage, which wasn’t the case 30 years ago.
“I implore people to get help,” Andrews said. “It will change their life. It breaks my heart when they don’t. God gave us eyes and ears for one reason or another. They’re kind of important.”
Unfortunately, many people wait eight to 10 years before treating their hearing problem, according to Doug Brown, audiologist and owner of DB Audiology Associates, PC in Syracuse.
By leaving hearing loss untreated, people “tend to withdraw more socially,” Brown said. “It’s a matter of clarity of speech. People have a tendency to withdraw because they don’t want to be put in that position of not understanding. You may make those changes to withdraw unconsciously. As you’re isolated and not interacting with friends and being challenged to think of different things, the cognition does change.”
Brown thinks that many people choose to delay treating their hearing loss because of stigma of using hearing aids as something for “old people.” However, hearing aids help improve the lives of people of all ages.
“I’d say that fear of dementia shouldn’t be the reason you get a hearing aid,” Brown said. “It should be so you can participate in those important activities of life that you want to participate in. The other side effects of improved cognition and slowing down of dementia are nice side effects. The reason you get a hearing aid is to hear better.”