Hearing Loss and the risk of developing dementia

A study in the Lancet found that hearing loss is a major risk factor of cognitive decline resulting in dementia. It is estimated that at least £28 million per year could be saved in England by properly managing hearing loss in people with dementia.1

Evidence found that mild hearing loss doubles the risk of developing dementia, with moderate hearing loss leading to three times the risk, and severe hearing loss five times the risk. Hearing loss can be misdiagnosed as dementia or make the symptoms of dementia appear worse. Although dementia is diagnosed in later life, changes in the brain usually start developing many years before. The study looked at the benefits of building a "cognitive reserve", meaning that if the brain’s networks were strengthened, it could continue to function in later life regardless of the damage.2,3

A study by the University of Exeter and King’s College London also found that people who wore hearing aids for age-related hearing problems maintained better cognitive functions than those with similar hearing who did not use them. Those who wore them had brains that performed as if they were, on average, eight years younger. NICE Guidelines state that hearing aids are the primary management option for permanent hearing loss.4

Individuals with memory complaints often present at their GP and assessment of hearing is now recommended as a first step in its investigation. The communication difficulties and misunderstanding caused by hearing loss commonly mimic memory loss. Screening for hearing loss in high-risk populations such as those attending memory clinics or people older in age has been suggested to ensuring hearing loss is identified and managed in a timely manner to facilitate healthy aging. It is accepted that earlier provision of hearing aids leads to better utilisation and concordance. Treating hearing loss in people with dementia also has the potential to reduce the severity of dementia related behaviours such as confusion and simplify communication with families and carers.

At Imperial College London, the Clinical Lead for Adult Audiology has conducted research around the relationship between hearing loss and dementia. A sound clip has been developed (available on the powerpoint on the GPVTS teaching and curriculum section). It demonstrates to clinicians administering cognitive assessments how a common age-related hearing loss can completely distort speech and negatively affect scores on these cognitive assessments. This is particularly in cases that require the patient to repeat back a sentence they have heard.

References:

  1. Hearing Link: Facts about deafness and hearing loss
  2. RNID: 'Why and how are dementia and hearing loss linked? Our Audiologist explains the latest research'
  3. The Hearing Review: Nine Risk Factors Associated with Dementia
  4. NICE, Hearing loss in adults: assessment and management. 2018, National Institute for Health and Care Excellence