How best do we confront potential cognitive loss associated with hearing problems? The simplest response is to fit affected patients with a hearing aid, which can eliminate or reduce what Hope College professor David Myers described to psychologists attending the American Psychological Association (APA) Annual Convention this past August as the “anger, frustration, depression and anxiety (that) are all common among people who find themselves hard of hearing.”
Determining the best response to the cognitive decline associated with hearing loss, however, requires additional study. How does adding extraneous noise to a conversation affect our cognition? What stressors emerge in a person with hearing loss when he or she is trying to hear a conversation in such environments? How does the divided attention resulting from hearing loss affect a person’s ability to accomplish complex tasks?
One approach involves studying ease of listening: Researchers measure how difficult it is for a person to follow a target voice—a conversation with another person, for example—while different types and volumes of extraneous noise get added to a listening environment.
Larry E. Humes, chair of Indiana University’s Department of Speech and Hearing Sciences, along with audiologist Sridhar Kalluri from Starkey Hearing Research Center, conducted a study focused on how assistive hearing technology might improve cognitive function. The data showed a near-immediate improvement in ease of listening and a parallel increase in cognitive ability among patients fitted with conventional hearing aids. However, the study also states that “limited evidence is available following long-term usage, and evidence that is available does not support an effect of hearing aids on cognitive function.”
More research is needed, obviously, including rigorous studies of older adults following longer periods of hearing aid use. And although the study offers encouraging results, reducing background noise often leads to a reduction in the volume of things we want to hear, such as conversation or the dialog in a movie.
This study complemented earlier research, which led to a new generation of hearing aids that can discriminate between speech and background noise, and then attenuate the noise while preserving the clarity of a conversation or other target sounds.
Hearing loss manifests in many ways beyond simply asking people to repeat themselves. Because many people don’t understand hearing loss outside the obvious signs of being hard of hearing, there is no sense of urgency in treating it. Yet new research is continually identifying new risks to health that transcend our common perception of hearing loss.
Depression and dementia—two critically important health issues—can both manifest as symptoms of cognitive loss suffered by people who don’t hear well. By addressing this decline in cognition among patients with hearing loss, we can combat an array of medical problems while bringing needed attention to the broader risks of hearing loss and how to treat it.
More on dementia and hearing loss from The Leader:
Frank Lin’s research ties hearing loss to dementia, and he believes audiology services can help battle some kinds of cognitive decline among seniors.
The research that Myers presented to the APA brought some of that needed attention to hearing loss. According to Myers, people experiencing hearing loss wait about six years before seeking medical help, and people between the ages of 29 and 69 are about half as likely to seek help for hearing loss as those who are 70 or older.
Myers isn’t alone in his assessment. The National Committee to Preserve Social Security and Medicare Foundation reported in July that, “Hearing loss is the third most prevalent chronic health condition facing older adults. Unfortunately, only 20 percent of those individuals who might benefit from treatment actually seek help.”
With such a large swath of the population unable or unwilling to recognize and treat their hearing loss, this issue becomes a significant public health problem. If we can improve cognition among patients with hearing loss, for example, we might reduce the risk of developing dementia.
David Fabry, PhD, is vice president of audiology for Starkey Hearing Technologies. He previously practiced at the Mayo Clinic and Walter Reed Army Medical Center. David_fabry@starkey.com.