Hearing loss is the third most common chronic condition reported by elderly people. The estimated prevalence of significant hearing impairment among people over the age of 65 is approximately 40 to 45 percent and among people over the age of 70 exceeds 83 percent. Hearing sensitivity declines gradually and progressively with aging. It may not be noticeable until lost ability to hear in advanced stage. It seems to run in families and may occur because of changes in the inner ear and auditory nerve. Age-related hearing loss, or Presbycusis, usually occurs in both ears, affecting them equally and permanently.
Signs of Hearing Loss
In general, the average hearing thresholds of men are typically poorer than those of women in the high frequencies, with men exhibiting a sharply sloping hearing loss in the moderately severe range in the high frequencies, and the women exhibiting a more gradual sloping hearing loss in the moderate range in the high frequencies. Perhaps the most important consequence of the decline in hearing sensitivity with aging is difficulty understanding speech. Multiple sources are thought to contribute to the communication deficits of elderly people, including hearing loss, cognitive decline, and slowed temporal processing. Processing brief changes in stimulus duration and presentation rate for signals embedded in sequences are notably difficult for elderly people, which suggests that auditory temporal processing deficits may relate to the observed problems in understanding rapid speech and accented English.
Hearing loss and dementia
Dementia has been described as the greatest global challenge for health and social care in the 21st century. Engaging in preventive strategies through reduction of modifiable risk factors can be effective in delaying or preventing the disease, reducing healthcare costs, and stemming the immense burden on relatives and supporters of disease sufferers. A growing body of research has shown that hearing loss confers an independent risk of dementia and the highest population attributable fraction for dementia compared to any other individual modifiable risk factor (e.g., physical inactivity, depression). Given that ARHL is highly prevalent, severely undertreated, easily diagnosed, treatable, and precedes the onset of dementia by 5 to 10 years, it is an ideal modifiable risk factor that can be targeted as a preventative strategy for managing dementia.
A conceptual model outlined 3 kay factors in the causal mechanisms for age-related hearing loss leading to dementia as social isolation, changes in brain structure, and depleted cognitive reserve, based on research findings.
A Johns Hopkins study revealed that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.
Research has shown that hearing difficulties may reduce quality of life through social isolation, feelings of loneliness and depression, and a loss of independence. These factors in turn may increase the risk of developing dementia.
Hearing loss and physical function
As many will lose some of hearing ability when aging, hearing loss may pose a previously overlooked risk, according to recently published research.
Three separate studies found that older adults with hearing loss may be “more sedentary and more likely to experience worsening physical function than those without hearing loss,” according to the National Institute on Aging (NIA), which supported the studies.
In one study, researchers looked at adults between the ages of 60 and 69 and found that people with hearing loss on average were sedentary for about 34 more minutes each day than those with no hearing loss. As hearing loss severity increased, so did lack of activity.
A second study found that people with hearing loss were more likely to have worse scores for physical function, balance and walking speed. These researchers also found that over an eight-year period, those with hearing loss had a faster rate of physical decline than those with normal hearing.
A third study found that people with moderate or greater hearing loss declined faster in terms of physical function over six years than those with normal hearing. These researchers also found that people in their study who wore hearing aids had better walking endurance than those with untreated hearing loss.
All three studies were led by researchers at the NIA and Johns Hopkins University and published in JAMA Network Open or the Journals of Gerontology.
The researchers caution that while there is an association between hearing loss and physical activity, it remains unknown whether hearing loss actually triggers a decline in physical activity or function. The link between hearing loss and more sedentary behavior underscores the importance of treating the condition in aging population.
What to do about Age-Related Hearing Loss
1. Overcome denial of hearing loss
As the hearing loss is gradual with aging, some are not aware or deny hearing impairment, which lead to refusing hearing health care and unmanaged hearing impairment. Hearing loss denial is a common problem among seniors, and can be a major barrier to getting proper treatment. Most common reasons include aging denial, underestimating the impact of hearing loss to overall health, mistrust of hearing aids and of course, the cost.
2. Don’t put off addressing hearing loss
Human brain’s auditory cortex requires hearing input to function. Hearing involves getting the input through ears and the related nerves. The brain must process this sensory input in what’s known as the “auditory cortex.” Hearing loss is associated with negative impacts on cognitive function. Brain’s auditory cortex will get worse at processing sound, with poor quality input and cognitive abilities (e.g. memory and thinking) may decline faster in people with hearing loss. Hearing aids also require a period of adaptation and learning and make it harder for aging brain. It also becomes harder as hearing loss becomes more severe with time. The sooner to improve the hearing input coming into the brain, the better it is for brain health.
Experts explain that even mild untreated hearing loss can have adverse effects on an individual's social, psychological, cognitive, and overall health. In fact, Research studies have linked untreated hearing loss to a litany of undesirable effects on seniors’ quality of life including:
3. Initiate action for hearing loss evaluation
Research shows that hearing loss is commonly overlooked in primary care. Be aware of early hearing loss signs and schedule a hearing screening test. Traditional Medicare, unfortunately, does not cover routine audiology testing. Some Medicare Advantage plans may cover audiology.
Before a person receives a hearing aid, diagnosis of objective hearing loss should be confirmed with a pure-tone audiogram. Fair evidence from studies in highly selected populations shows that hearing aids can improve self reported hearing, communication, and social functioning for some adults with age-related hearing loss.
4. Consider options other than hearing aids, especially for people who aren’t good candidates for hearing aids.
Not everyone is a good candidate for hearing aids. Other approaches to amplification and communication can be effective to help with hearing loss, such as assistive devices for phones, TVs and other devices. Undergoing surgery to implant a small electronic device near the ear is also optional.
Protect your hearing and improve quality of life
Age-related hearing loss is progressive and not reversible. It gets worse over time. You can’t prevent age-related hearing loss; however, you can reduce your chances of experiencing noise-induced hearing loss by limiting prolonged exposure to loud noises and wear ear plugs for protection. Most people with age-related hearing loss can manage their condition with hearing aids or other treatments and continue to live a full and active life.
Disclaimer: This information is for educational and informational purposes only. It is not medical advice. Consult your healthcare professional for personal conditions.
© All rights reserved
References:
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.631.2631&rep=rep1&type=pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749722/
https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults
https://www.healthyhearing.com/report/52904-The-connection-between-hearing-loss-and-cognitive-decline
https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss
https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-OtherInformation04-HearingLoss_english.pdf
https://betterhealthwhileaging.net/hearing-loss-in-aging/
https://www.aafp.org/afp/2013/0115/od1.html#:~:text=Available%20tests%20include%20physical%20diagnostic,for%20identifying%20objective%20hearing%20loss.
https://my.clevelandclinic.org/health/articles/5840-age-related-hearing-loss
https://www.saundershouse.org/article/5/1/2020/how-hearing-loss-affects-seniors-quality-life
Signs of Hearing Loss
- Have trouble hearing over the telephone
- Find it hard to follow conversations when two or more people are talking
- Often ask people to repeat what they are saying
- Need to turn up the TV volume so loud that others complain
- Have a problem hearing because of background noise
- Think that others seem to mumble
- Can’t understand when women and children speak to you
In general, the average hearing thresholds of men are typically poorer than those of women in the high frequencies, with men exhibiting a sharply sloping hearing loss in the moderately severe range in the high frequencies, and the women exhibiting a more gradual sloping hearing loss in the moderate range in the high frequencies. Perhaps the most important consequence of the decline in hearing sensitivity with aging is difficulty understanding speech. Multiple sources are thought to contribute to the communication deficits of elderly people, including hearing loss, cognitive decline, and slowed temporal processing. Processing brief changes in stimulus duration and presentation rate for signals embedded in sequences are notably difficult for elderly people, which suggests that auditory temporal processing deficits may relate to the observed problems in understanding rapid speech and accented English.
Hearing loss and dementia
Dementia has been described as the greatest global challenge for health and social care in the 21st century. Engaging in preventive strategies through reduction of modifiable risk factors can be effective in delaying or preventing the disease, reducing healthcare costs, and stemming the immense burden on relatives and supporters of disease sufferers. A growing body of research has shown that hearing loss confers an independent risk of dementia and the highest population attributable fraction for dementia compared to any other individual modifiable risk factor (e.g., physical inactivity, depression). Given that ARHL is highly prevalent, severely undertreated, easily diagnosed, treatable, and precedes the onset of dementia by 5 to 10 years, it is an ideal modifiable risk factor that can be targeted as a preventative strategy for managing dementia.
A conceptual model outlined 3 kay factors in the causal mechanisms for age-related hearing loss leading to dementia as social isolation, changes in brain structure, and depleted cognitive reserve, based on research findings.
A Johns Hopkins study revealed that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.
Research has shown that hearing difficulties may reduce quality of life through social isolation, feelings of loneliness and depression, and a loss of independence. These factors in turn may increase the risk of developing dementia.
Hearing loss and physical function
As many will lose some of hearing ability when aging, hearing loss may pose a previously overlooked risk, according to recently published research.
Three separate studies found that older adults with hearing loss may be “more sedentary and more likely to experience worsening physical function than those without hearing loss,” according to the National Institute on Aging (NIA), which supported the studies.
In one study, researchers looked at adults between the ages of 60 and 69 and found that people with hearing loss on average were sedentary for about 34 more minutes each day than those with no hearing loss. As hearing loss severity increased, so did lack of activity.
A second study found that people with hearing loss were more likely to have worse scores for physical function, balance and walking speed. These researchers also found that over an eight-year period, those with hearing loss had a faster rate of physical decline than those with normal hearing.
A third study found that people with moderate or greater hearing loss declined faster in terms of physical function over six years than those with normal hearing. These researchers also found that people in their study who wore hearing aids had better walking endurance than those with untreated hearing loss.
All three studies were led by researchers at the NIA and Johns Hopkins University and published in JAMA Network Open or the Journals of Gerontology.
The researchers caution that while there is an association between hearing loss and physical activity, it remains unknown whether hearing loss actually triggers a decline in physical activity or function. The link between hearing loss and more sedentary behavior underscores the importance of treating the condition in aging population.
What to do about Age-Related Hearing Loss
1. Overcome denial of hearing loss
As the hearing loss is gradual with aging, some are not aware or deny hearing impairment, which lead to refusing hearing health care and unmanaged hearing impairment. Hearing loss denial is a common problem among seniors, and can be a major barrier to getting proper treatment. Most common reasons include aging denial, underestimating the impact of hearing loss to overall health, mistrust of hearing aids and of course, the cost.
2. Don’t put off addressing hearing loss
Human brain’s auditory cortex requires hearing input to function. Hearing involves getting the input through ears and the related nerves. The brain must process this sensory input in what’s known as the “auditory cortex.” Hearing loss is associated with negative impacts on cognitive function. Brain’s auditory cortex will get worse at processing sound, with poor quality input and cognitive abilities (e.g. memory and thinking) may decline faster in people with hearing loss. Hearing aids also require a period of adaptation and learning and make it harder for aging brain. It also becomes harder as hearing loss becomes more severe with time. The sooner to improve the hearing input coming into the brain, the better it is for brain health.
Experts explain that even mild untreated hearing loss can have adverse effects on an individual's social, psychological, cognitive, and overall health. In fact, Research studies have linked untreated hearing loss to a litany of undesirable effects on seniors’ quality of life including:
- Irritability, negative attitudes and anger
- Fatigue, tension, stress, and depression
- Avoidance or withdrawal from social situations
- Social rejection and loneliness
- Reduced alertness and increased risk to personal safety
- Increased number of falls and accidents
- Impaired memory and ability to learn new tasks
- Diminished psychological and overall health
- Potential decrease in cognitive skills
- Reduced short-term memory
- Higher incidence of dementia
3. Initiate action for hearing loss evaluation
Research shows that hearing loss is commonly overlooked in primary care. Be aware of early hearing loss signs and schedule a hearing screening test. Traditional Medicare, unfortunately, does not cover routine audiology testing. Some Medicare Advantage plans may cover audiology.
Before a person receives a hearing aid, diagnosis of objective hearing loss should be confirmed with a pure-tone audiogram. Fair evidence from studies in highly selected populations shows that hearing aids can improve self reported hearing, communication, and social functioning for some adults with age-related hearing loss.
4. Consider options other than hearing aids, especially for people who aren’t good candidates for hearing aids.
Not everyone is a good candidate for hearing aids. Other approaches to amplification and communication can be effective to help with hearing loss, such as assistive devices for phones, TVs and other devices. Undergoing surgery to implant a small electronic device near the ear is also optional.
Protect your hearing and improve quality of life
Age-related hearing loss is progressive and not reversible. It gets worse over time. You can’t prevent age-related hearing loss; however, you can reduce your chances of experiencing noise-induced hearing loss by limiting prolonged exposure to loud noises and wear ear plugs for protection. Most people with age-related hearing loss can manage their condition with hearing aids or other treatments and continue to live a full and active life.
Disclaimer: This information is for educational and informational purposes only. It is not medical advice. Consult your healthcare professional for personal conditions.
© All rights reserved
References:
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.631.2631&rep=rep1&type=pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749722/
https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults
https://www.healthyhearing.com/report/52904-The-connection-between-hearing-loss-and-cognitive-decline
https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-hidden-risks-of-hearing-loss
https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-OtherInformation04-HearingLoss_english.pdf
https://betterhealthwhileaging.net/hearing-loss-in-aging/
https://www.aafp.org/afp/2013/0115/od1.html#:~:text=Available%20tests%20include%20physical%20diagnostic,for%20identifying%20objective%20hearing%20loss.
https://my.clevelandclinic.org/health/articles/5840-age-related-hearing-loss
https://www.saundershouse.org/article/5/1/2020/how-hearing-loss-affects-seniors-quality-life
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