Treat Hearing Loss to Help Reduce Risks of Dementia and Depression

Hearing loss can affect everyday life in ways large and small, from having trouble communicating with a store clerk or hearing a favorite television program to missing out on meaningful interactions with friends and family members. But the effects of hearing loss aren’t limited to moments here and there. They can have more serious, long-lasting impacts on mood and cognition.

“Untreated hearing loss has been shown to increase the risk of depression in older adults by 40 percent and the risk of dementia by 50 percent over 10 years,” says Nancy J. Donovan, MD, director of the Division of Geriatric Psychiatry at Massachusetts General Hospital-affiliated Brigham and Women’s Hospital. “Compared to older adults with intact hearing, those with hearing impairment are also more likely to report anxiety and lower levels of positive feelings such as happiness and a personal sense of effectiveness.”

Fortunately, interventions such as hearing aids and cochlear implants may help remove some of the barriers to the rest of the world while also improving mood and delaying the onset of dementia.

Losing Our Hearing

Age-related hearing loss (­presbycusis) occurs gradually in most people as they get older. It’s among the most common conditions affecting older adults. The National Institutes of Health reports that about half of people older than 75 have some difficulty hearing.

Age-related hearing loss usually stems from changes that occur over time in the inner ear, though middle-ear problems or changes in the nerve pathways between the ear and the brain may also lead to worsening hearing.

Hearing loss can also result from long-term exposure to loud sounds, known as noise-induced hearing loss, as well as from high blood pressure, diabetes or other medical conditions, along with medications that injure the sensory cells in your ears, such as chemotherapy drugs.

Hearing Loss and Isolation

The negative effects of hearing loss or hearing impairment include social withdrawal and loneliness, particularly among those who don’t use hearing aids, Dr. Donovan explains. “Individuals with hearing impairment often avoid social contacts and activities where background noise makes communication difficult,” she adds. “They struggle to hear words and phrases, and can also struggle with important nuances of verbal communication, such as the emotional content of speech. Social interactions become more effortful and frustrating and less rewarding.”

Social disengagement, loneliness and depression are all substantial risk factors for cognitive decline and future dementia. Researchers aren’t entirely sure how exactly loneliness or isolation contribute to dementia risk, though one theory is that loneliness may trigger changes in the nervous system that interfere with connections between brain cells. The stress of social isolation can increase levels of inflammation, too. These factors make the brain more vulnerable to changes brought on by conditions such as Alzheimer’s disease.

Healthy brain function requires many things, such as robust blood circulation and sufficient sleep, but it also needs social interaction on a regular basis. “Socially disconnected individuals miss out on the stimulating and stress-relieving benefits of relationships that are important for healthy cognitive and emotional functioning,” Dr. Donovan says.

How Memory Is Affected

The relationship between hearing impairment and cognition is complex, and there may be many explanations for why people with hearing loss tend to experience problems with thinking skills and memory. It has been shown, for example, that chronic hearing loss is associated with atrophy or shrinkage of brain regions normally involved in auditory function. Like a muscle that is not used, this atrophy is believed to result from reduced auditory stimulation, Dr. Donovan says.

Other research in hearing impairment suggests that making sense of poorly heard information requires more brain resources and engages brain networks in less efficient ways, Dr. Donovan explains. This less-efficient network activity can predispose a person to cognitive dysfunction and emotional troubles over time.

Treating Hearing Loss

The right treatment for hearing loss depends on the severity of the problem as well as its cause. An audiologist can usually diagnose the cause of your hearing loss and recommend a treatment plan. An otolaryngologist or ear-nose-throat (ENT) doctor can also diagnose hearing loss causes, but is usually the healthcare provider to see if your hearing loss is related to a disease or injury, or if you have other signs, such as dizziness or ear pain.

Hearing aids, of course, are the most common devices that can help with impaired hearing. Unfortunately, hearing aids aren’t covered by Medicare or by most private insurance companies, though hearing tests are often covered at least in part.

There are several styles of hearing aids available, including those that fit behind the ear and small devices that fit in the ear or the ear canal. You may have to try a couple of different types to find the one that works best for you. The key to success with hearing aids is learning how to adjust them as needed and to work closely with your audiologist to make sure you have the best fit and results.

Other devices include cochlear implants, which are small electronic devices surgically implanted in the inner ear. They are primarily for people who have severe hearing loss. You may also benefit from assistive listening devices, such as cell phone amplifiers and closed-circuit systems that can be used in public places.

It’s sometimes difficult to predict the degree to which treatment improves your hearing and quality of life. Research on the subject is limited.

“Studies, so far, have been mostly observational rather than controlled clinical trials,” Dr. Donovan says. “However, reported studies have found that use of hearing aids was associated with improvements in memory, global cognitive function, social functioning, and in symptoms of loneliness and depression. Cochlear implantation has also been associated with improved cognitive function, decreased loneliness, and increased measures of wellbeing and quality of life.”

Listen Up!

Dr. Donovan emphasizes that anyone with hearing loss should remember that they are not alone and that half of all older adults are experiencing similar challenges. “Lower cost, commercially available devices for restoring hearing are becoming more accessible for those who cannot afford expensive hearing aids,” she says. “In addition, surgical correction of hearing impairment may become a more widely available option in the future.”

It’s also important to understand that hearing loss is often a treatable risk factor for dementia and depression. Many risk factors can’t be managed. “Treating hearing impairment is an important preventative measure to maintain social and emotional wellbeing in aging and to reduce risk of cognitive impairment,” Dr. Donovan says.

The post Treat Hearing Loss to Help Reduce Risks of Dementia and Depression appeared first on University Health News.

Read Original Article: Treat Hearing Loss to Help Reduce Risks of Dementia and Depression »