MemoryWell: Why should people be concerned about hearing loss and memory?
Loavenbruck: From my experience over the last 50 years as an audiologist, it’s clear that hearing loss seriously affects all kinds of abilities in older people, including memory.
Here’s how it works: sounds enter the auditory system and are processed there. Then the brain has to make sense out of the stimulus (sound) that’s coming in. If the stimulus is degraded or incomplete because of hearing loss, people need to use more cognitive skills in order to understand what they are hearing.
MemoryWell: In simple terms, your brain has to work harder when you have hearing loss and that places stress on the brain?
When people have hearing loss, the brain has to work much harder in order to accomplish the same task. That takes a toll.
Loavenbruck: Absolutely! When people have hearing loss, the brain has to work much harder in order to accomplish the same task. That takes a toll. People have a finite amount of energy and ability to concentrate. We think of listening as a passive activity, but it’s not. With hearing loss, they need to use much more energy to focus and to pay attention, and then they have less energy to remember what’s being said or to make sense out of what’s being said. They are spending all their energy on just trying to get a signal that’s clear.
This is compounded by the fact that the ability to process becomes slower as we get older. If a younger person listens to somebody speaking fast, they can still process that information.
MemoryWell: How else does hearing loss affect cognitive function?
Loavenbruck: A very important factor is that hearing loss isolates people. The more isolated people become, the less they are using their cognitive social functions, and they decline. I saw a 102-year-old woman recently who was in a nursing home. She was very mentally sharp, and always participated in social interactions. Her hearing aid, unbeknownst to her family, had stopped functioning, though. The nursing home kept reporting that she had stopped interacting and speaking, and that she was depressed. Once her hearing aid was adjusted she was back to her normal self.
MemoryWell: What are the risk factors for hearing loss in an older person?
Loavenbruck: Certainly “aging” is a key one. The auditory system changes along with everything else as you age. Other risk factors include noise exposure, certain medications taken over long periods of time, and even family history. Researchers are identifying more and more genetic markers for various kinds of patterns of hearing loss.
But the biggest risk factor is avoidable: Because hearing loss occurs gradually, people ignore it for a long time. Even when they notice it, people wait on average six or seven years before they even consider doing something about it. Ignoring the problem makes it worse because of brain changes that occur as hearing loss gets worse.
MemoryWell: What can people do to prevent hearing loss and the eventual effect that may have on memory and cognitive decline?
Loavenbruck: From a very young age and beyond, it’s very important to use ear protection when exposed to really loud noises at home or at public events. Anything over 85 decibels can be harmful, especially over a long time. Listen to music at a safe level, especially with earbuds. Be careful around power tools or loud machines or equipment.
And get your hearing tested! Everyone should start having routine hearing tests after the age of 45 or 50, so that their hearing is being monitored. People don’t do that. We all have our eyes checked because visual changes are more immediately apparent and more immediately affect our ability to function. People tend to ignore the beginning stages of hearing loss, and often blame other factors for it.
MemoryWell: What signs show that someone may have a hearing loss?
Loavenbruck: There are hearing surveys available online that ask things like, “Are you having difficulty hearing on the telephone?” “Do you feel that you hear people but don’t understand?” or “Do you always need to make the TV louder?”
People can take one of those surveys, but it’s also important to go to a licensed audiologist for a professionally administered and interpreted evaluation and recommendations on how to best address the hearing loss. There is no reason not to be evaluated. Virtually every health insurance, including Medicare, covers diagnostic hearing tests.
MemoryWell: What’s the best thing to do if you suspect you have a hearing loss?
Loavenbruck: Unfortunately, there’s still a stigma to admitting to hearing loss and seeking treatment, often because it’s associated with aging. We need to overcome that stigma so people feel comfortable seeking the help they need.
Hearing aids and the services surrounding them are available in a variety of levels and price points. Your audiologist can inform you about all the options, including payment plans. Over-the-counter devices are becoming more prevalent, but it’s important to be careful. Consult an audiologist about how to properly use any device and what it does to help each person’s ability to communicate, think, listen and understand. Those professional services are critical to successfully using the devices.
Linda Kallman is a freelance writer with a special interest in family, health, aging issues and dementia.