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Untreated hearing loss is now recognised as a significant modifiable risk factor for cognitive decline and dementia.
The current understanding between hearing loss and cognitive decline emphasises on the importance of early detection and treatment of hearing loss to not only improve hearing, but to also protect brain health and slow down cognitive deterioration.
In this respect, audiologists play a crucial role in this form of preventive care by identifying hearing loss early and offering interventions such as hearing aids, which can make a measurable difference in maintaining cognitive function.
LINK BETWEEN HEARING LOSS AND COGNITIVE DECLINE
Recent research has established a clear link between untreated hearing loss and cognitive decline, highlighting hearing loss as a significant risk factor for conditions such as dementia.
One key explanation is the increased cognitive load. When hearing is impaired, the brain must work harder to process sounds, diverting resources away from other cognitive functions like memory and thinking. This may potentially accelerate cognitive decline.
When hearing is impaired, the brain must work harder to process sounds, diverting resources away from other cognitive functions like memory and thinking. This may potentially accelerate cognitive decline.
Additionally, untreated hearing loss often leads to social isolation,whichhasbeenshowntoincreasetheriskofdementia by 50%. Studies using brain imaging also reveal that hearing loss may cause faster brain atrophy, particularly in areas responsible for processing sound and memory.
Longitudinal studies confirm this, with individuals experiencing mild hearing loss having twice the risk of developing dementia, while those with moderate and severe hearing loss face three and five times the risk respectively. This association is most pronounced when hearing loss occurs in mid-life (age 45-65) – a critical period for brain health.
On a positive note, using hearing aids has been found to mitigate these risks by reducing cognitive load and fostering social engagement, highlighting the essential role of early intervention in maintaining cognitive health.
This growing body of evidence underscores the importance of addressing hearing loss not only to improve hearing, but also to protect brain health and slow cognitive decline.
EARLY DETECTION
The earlier you detect hearing loss, the sooner you can treat it. It is recommended that adults in the age range of 40-65 should go for at least an annual hearing test. Unfortunately, these tests are usually not part of regular screening done at most places. This is something that needs to change.
Hearing loss in adults can often go unnoticed because it tends to develop gradually. Some common signs include frequently asking others to repeat themselves, difficulty following conversations in noisy environments, or perceiving that people are mumbling.
Older adults may also turn up the volume on the TV or radio to uncomfortably high levels, or struggle with phone conversations. Social withdrawal can also be a subtle sign, as individuals may avoid social situations due to frustration with their inability to hear clearly.
If an individual or their caregiver suspects hearing loss, the first step should be to schedule a hearing evaluation with a healthcare provider, typically an audiologist. The approach should be supportive and encouraging, as some may be reluctant or unaware of the impact hearing loss has on their daily lives.
An audiologist can conduct a series of tests, starting with a detailed medical history and ear examination. This is followed by tests such as pure-tone audiometry, which measures hearing sensitivity at different frequencies, and speech audiometry, which evaluates how well a person can hear and understand speech.
Another common test is tympanometry, which assesses the condition of the middle ear and eardrum.
Together, these tests help determine the type and degree of hearing loss, guiding appropriate treatment or intervention.
Exciting advancements in hearing aids are further transforming the way we manage hearing loss and cognitive health. There are now AI- driven hearing aids that adapt intuitively to different listening environments, reducing cognitive strain by enhancing sound clarity and focus, especially in noisy settings. This reduces the mental fatigue that often accompanies hearing loss, keeping users more engaged and cognitively sharp.
BARRIERS TO SEEKING HELP
In Singapore, several barriers prevent people from seeking help for hearing loss. One of the most significant is the lack of awareness among General Practitioners (GPs) regarding the importance of hearing care.
As the first point of contact for many patients, GPs often overlook or fail to inquire about hearing issues, even when patients raise concerns. These concerns are frequently downplayed in comparison to other health issues, without considering the long-term impact untreated hearing loss can have on cognitive decline, social isolation, and overall well-being.
Another challenge is the unregulated nature of the hearing care industry in Singapore, which causes confusion about whom to consult for hearing-related problems. While an ENT (Ear, Nose and Throat) specialist is the right choice for ear infections, individuals with hearing loss should seek guidance from an audiologist. This distinction is not always clear to patients, resulting in delays in getting appropriate care.
Additionally, long waiting lists in public hospitals further exacerbate the problem, leaving many without timely access to hearing assessments or treatment.
ROLE OF HEARING AIDS AND OTHER ASSISTIVE TECHNOLOGIES
Studies have shown that individuals who use hearing aids experience slower rates of cognitive decline compared to those who leave their hearing loss untreated. Furthermore, assistive technologies like cochlear implants or personal amplifiers can also significantly improve communication, reducing feelings of isolation, and fostering better cognitive and emotional well-being.
By improving hearing, these devices help to reduce the strain on the brain to process sound, allowing cognitive resources to be allocated more effectively to functions such as memory and problem-solving. Hearing aids also enhance social interaction, which is vital for cognitive health. Social engagement keeps the brain active and stimulated, helping to delay or prevent cognitive decline.
Exciting advancements in hearing aids are further transforming the way we manage hearing loss and cognitive health.
There are now AI-driven hearing aids that adapt intuitively to different listening environments, reducing cognitive strain by enhancing sound clarity and focus, especially in noisy settings. This reduces the mental fatigue that often accompanies hearing loss, keeping users more engaged and cognitively sharp.
Another breakthrough is the integration of biometric monitoring capabilities into hearing aids. These devices may soon track not only hearing health, but also analyse voice quality, measure blood flow through the ear, detect falls, and even use large data models to predict cognitive function. This will enable both clinicians and patients to detect early signs of cognitive decline, allowing for timely intervention.
Amazing Hearing
Amazing Hearing is currently the only Audiology & Hearing Clinic in Singapore offering cognitive testing for patients with hearing loss.
Most of our patients are between the ages of 55-85, and we have consistently observed that those who seek treatment while their hearing loss is still mild to moderate experience significantly better cognitive outcomes. In contrast, patients who delay treatment for 8-10 years often face a longer and more difficult journey in slowing cognitive decline.
Patient A, a 55-year-old professional, came to us when he first noticed mild hearing loss. After conducting a cognitive assessment, we discovered early signs of memory and attention challenges. With timely intervention using hearing aids and ongoing cognitive exercises, he experienced a notable improvement in both his hearing and cognitive performance. His working memory and attention span improved dramatically.
In contrast, Patient B, an 82-year-old, waited nearly a decade before seeking help for her hearing loss, which had progressed to a more severe stage. By that stage, her cognitive decline in areas like immediate memory and attention was more pronounced. While we managed to slow further decline with hearing aids and cognitive rehabilitation, recovery took longer, and the improvements, though meaningful, were less pronounced compared to patients who sought earlier intervention.
