According to the Alzheimer’s Association, dementia is not just one specific disease, but is made up of a combination of symptoms that have many different causes. Although, Alzheimer’s disease is the most common for those over the age of 65, diseases such as Vascular dementia, Lewy Body Disease, Parkinson’s, and Huntington’s disease can cause dementia. Some treatable conditions also cause dementia, such as vitamin deficiencies, abnormal thyroid, and medications.
A newly recognized risk factor for dementia is hearing loss. Recent studies have shown that the prevalence of hearing loss in patients with Alzheimer’s disease is equal to that of the general population and require treatment. The National Institute on Aging, reports that good hearing has been confirmed to produce healthier seniors. This is most likely because hearing allows us to readily perform our activities of daily living and maintain our interpersonal relationships. As important are the daily sound sources and changes that stimulate and train the brain. For these and other reasons all patients suspected of having hearing or memory loss should have a hearing evaluation, especially before tests of memory loss are conducted.
Over the past few decades, research has shown a direct relationship between hearing loss, memory loss, and dementia. In fact, hearing loss results in two to five time more the occurrence of dementia. This is according to a landmark study published in Archives of Neurology by researchers at Johns Hopkins University and the National Institute on Aging. Remarkably, those with normal hearing did not demonstrate the same degree of brain size reduction or cognitive dysfunction as those with hearing loss even when other medical conditions causing dementia were considered. They state that, “The more hearing loss they had, the higher their likelihood of developing the memory-robbing disease.” The mechanism that causes the brain to malfunction is a lack of appropriate electrical activity as the cortex is robbed of available information and the burden of trying to process becomes a strain and isolation ensues.
As misunderstanding and communication failure becomes more frequent, inter-personal relationships become more difficult and stressed. In the clinical setting, Audiologists will frequently see a husband and wife at odds over hearing related complaints. In many of these cases, hearing loss results in personal isolation, arguments, loneliness, and depression. To avoid problems because of hearing loss, family and friends should provide support and encourage the use of hearing aids and other devices.
The fact that a patient has dementia or Alzheimer’s disease is not a sign that hearing aids will not help, but just the opposite. It is not until the patient rejects the use of hearing aids and becomes non-communicative that removing the use of amplification should even be considered, if at all. In these cases, a single hearing aid may be best or the use of a personal amplifier (PLD), such as a Pocket Talker, especially in the later stages of dementia would be appropriate.
Selecting the Correct Hearing Aid/s
The use of hearing aids fitted to one or both ears can be beneficial, especially in the mild and moderate stages of the disease, but also when the patient is homebound. Audiologists help to select the actual amplifier and necessary electronic features to meet individual needs. For example, active individuals will need more sophisticate electronics to automate hearing and reduce noise when in public venues. As activities and response become more limited and the patient is homebound, simpler solutions are more appropriate. In some cases, the Audiologist will recommend the use of a personal listening device (PLD) and television and telephone amplifiers.
When purchasing hearing aids for someone who has dementia or Alzheimer’s disease, the most expensive hearing aids will not dramatically change how the brain functions. As a matter of fact, the simpler the hearing aids are to operate, the more reasonable the treatment. General recommendations would be for larger more visible devices that are easily seen and manipulated because smaller hearing aids are frequently lost. Half-shell or in-the-ear (HS or ITE) sizes or behind-the-ear hearing aids are not too small for the patient and caregivers to handle and store. They are easier to find if lost. The hearing aids do not need a volume control and should be automated and transparent for most listening situations. They may have a push button to reduce noise and switch to other listening programs, such as TV or telephone. They should also have directional microphones and a telephone pick-up coil (T-Coil) in most cases. All hearing aids come with feedback cancellation to reduce or avoid disturbing squealing or whistling sounds from the amplifier that will be uncomfortable and may cause some to stop using the instruments.