Hearing loss and cognition: a discussion for audiologists and hearing healthcare professionals

Abstract

Among researchers, clinicians and patients, there is widespread and growing interest in the relationship between hearing and cognition. The Cognition in Hearing Special Interest Group (SIG) is part of the British Society of Audiology (BSA) and is uniquely positioned to explore the relationship between hearing loss, amplification and cognitive ability and cognitive decline. The multiplicity of emerging reports concerning hearing loss and cognition is increasing rapidly. In light of this vast growth, there is a risk that clinicians may be left uncertain regarding the nature and extent of the emerging evidence linking hearing and cognition. The trickle-down corollary of such uncertainty can negatively impact patient care. Answering challenging questions and disseminating complex information about the latest evidence-based hearing science are a daily part of any clinician’s role and those in audiology services may be asked “How does my hearing loss affect my chance of getting dementia?” or “can hearing aids help people with dementia?” This discussion is therefore, based on articles and information our committee members selected to represent the status quo. The Cognition in Hearing SIG aims, through this discussion article, to provide clinicians a contemporary understanding of research on this topic. We will discuss evidence concerning hearing loss and cognition and how it relates to people living with hearing loss and cognitive decline or dementia, and we shall pose some challenges and opportunities for future research and clinical practice evidence. Therefore, to address these aims in an accessible manner for clinicians, the Cognition in Hearing SIG shall address the following broad questions: What is the relationship between hearing loss and cognition? What do we know about hearing loss and cognitive performance? Is there a link between hearing loss, cognitive decline, and dementia? Can we intervene on the relationship between hearing loss and cognition?

Impact of Wearing Hearing Aids on Cognitive Abilities and Subjective Tinnitus in Patients with Sensorineural Hearing Loss: A Pilot Study

“…This systematic review aims to investigate (a. There is no consensus on the role and impact of hearing loss on the deterioration of cognitive functioning 18 . The results of a study by Wong et al showed a significant decline in cognitive abilities in orientation in time and space, registration, complex commands, and repetition.…”

“…Nevertheless, such results indicate the complexity of the relationship between hearing and cognitive processes. The most common complaint among people with hearing impairment difficulty in understanding words in the presence of tinnitus 6,15,18 cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770. According to the research by Loughrey et al, hearing loss was less associated with the decline in executive functions and recall compared with long-term and semantic memory.…”

“…Additionally, semantic memory showed a decline similar to a decline in episodic memory 7 . Research has shown that a reduced signal-to-noise ratio can reduce the ability to remember spoken words even in people with good hearing 18,19 . Redistribution of neuronal resources is required due to the poorer information input signal as a result of hearing impairment.…”

Vision, audition, cognition and sensory-based clinics

“…Regarding the impact of hearing loss on dementia, it has been well-documented that the most significant potentially modifiable risk factor for dementia is hearing loss (see Lin, Metter & O'Brien et al, 12 see Livingston et al, 7 see Beck, Bant & Clarke, 13 , see Beck, 14 and see Beck & Grisel 15 ) When hearing loss is diagnosed and managed early (through amplification, FM transmitters, digital remote microphones, telecoils and loop systems, assistive listening devices and more) long-term outcomes appear significantly improved, as compared to untreated hearing loss see Amieva et al, 16 Glick & Sharma, 17 and Jiang, Mishra, Shrestha et al 8 Older adults with dual sensory impairment (DSI; hearing and vision impairment) perceive even greater difficulty and worse outcomes than those with only vision or hearing loss. Across the USA, some 12% of the population has vision-only loss, approximately 13% have hearingonly loss, and about 8% have DSI Shakarchi, Assi, Ehrlich et al, 18 Nonetheless, a recent Scoping Review 19 reports despite a clear need, only limited outcomes-based information, regarding how and when optometrists work with dementia patients, is available.…”

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“…Regarding the impact of hearing loss on dementia, it has been well-documented that the most significant potentially modifiable risk factor for dementia is hearing loss (see Lin, Metter & O'Brien et al, 12 see Livingston et al, 7 see Beck, Bant & Clarke, 13 , see Beck, 14 and see Beck & Grisel 15 ) When hearing loss is diagnosed and managed early (through amplification, FM transmitters, digital remote microphones, telecoils and loop systems, assistive listening devices and more) long-term outcomes appear significantly improved, as compared to untreated hearing loss see Amieva et al, 16 Glick & Sharma, 17 and Jiang, Mishra, Shrestha et al 8 Older adults with dual sensory impairment (DSI; hearing and vision impairment) perceive even greater difficulty and worse outcomes than those with only vision or hearing loss. Across the USA, some 12% of the population has vision-only loss, approximately 13% have hearingonly loss, and about 8% have DSI Shakarchi, Assi, Ehrlich et al, 18 Nonetheless, a recent Scoping Review 19 reports despite a clear need, only limited outcomes-based information, regarding how and when optometrists work with dementia patients, is available.…”