Explore the Helpful Information Provided by Our Hearing Doctor

CBS NEWS 

One-third of cases of dementia worldwide could potentially be prevented through better management of lifestyle factors such as smoking, hypertension, depression, and hearing loss over the course of a lifetime, according to a new report.

Across the globe, about 47 million people were living with Alzheimer's and other forms of dementia in 2015. That number is projected to triple by the year 2050 as the population ages. Health care costs associated with dementia are enormous, with an estimated $818 billion price tag in 2015.

"Dementia is the greatest global challenge for health and social care in the 21st century," lead study author Professor Gill Livingston, of University College London, told CBS News. "The purpose of the commission was therefore to address it by consolidating the huge strides and emerging knowledge as to what we should do to prevent dementia and intervene and care for people with dementia."

To reduce the risk, factors that make a difference include getting an education (staying in school until over the age of 15); reducing high blood pressure, obesity and diabetes; treating hearing loss in mid-life; not smoking; getting physical exercise; and reducing depression and social isolation later in life. About 35 percent of dementia cases are attributable to these factors, the analysis found. Removing them could then theoretically prevent 1 in 3 cases.

For the first time, the researchers also identified hearing loss as a major modifiable risk factor for dementia. They estimated that reducing hearing loss in mid-life could also reduce the number of dementia cases by 9 percent if all people were treated.

 What's behind Americans' hearing loss? Livingston notes that research surrounding hearing loss and dementia is still in early stages and the link likely has something to do with the social isolation that can come with hearing loss.

Help prevent dementia by treating hearing loss

A study published by The Lancet Commission on Dementia Prevention and Care called dementia “the greatest global challenge for health and social care in the 21st century.” The commission noted that 50 million people have dementia worldwide — and the number is expected to triple by 2050.

The commission identified nine modifiable risk factors that could “reduce the incidence of dementia or substantially delay its onset.” One of these factors is treating hearing loss in mid-life.

This study reinforces what we’ve known for a long time; Hearing better means living better!

Many adults are aware that their hearing has deteriorated, but they are reluctant to seek help. Unfortunately, too many adults wait years, even decades, to address their hearing loss before getting treatment. This is unfortunate because mild to moderate hearing loss is easily treated, and the longer the patient deprives themselves auditorally, the more difficult it is to treat. 

STUDIES HAVE LINKED UNTREATED HEARING LOSS   TO:

• Irritability 
  
• Negativism 
  
• Anger
  
• Fatigue 
  
• Tension 
  
• Stress 
  
• Depression 
  

• Avoidance or withdrawal from social situations 
  
• Social rejection and loneliness 
  
• Reduced alertness and increased risk to personal safety 
  
• Impaired memory and ability to learn new tasks 
  
• Reduced job performance and earning power 
  
• Reduced psychological and overall health 
  

• Three in ten people over the age of sixty have hearing loss. 
  
• One in six baby boomers, ages 49-59, have hearing problems. 
  
• One in fourteen young adults, ages 29-40, have hearing loss. 
  
• At least 1.4 million children, 18 years or younger, have hearing problems. 
  
• It is estimated that 3 in 1,000 infants are born with serious hearing loss. 
• Hearing loss is very common. Approximately 48 million Americans report some degree of hearing loss. 
• By age 65, about 1 in 3 adults are affected by hearing loss. 
•  Tinnitus, a ringing or buzzing sound that can be constant or intermittent; tinnitus is one of the most common side effects of damage to the inner ear.

MYTH: If I had a hearing loss, my family doctor would have told me.Although 13% of primary care physicians routinely screen for hearing loss, most people with hearing loss hear relatively well in a quiet doctor’s office. Therefore, it can be virtually impossible for your physician to recognize the extent of your problem. Accurate hearing evaluation really requires the expertise of an audiologist.

With recent advancements, it is now possible to perform comprehensive hearing testing to determine:

• If hearing loss exists, even for our youngest patients. 
  
• The amount and nature of the hearing loss. 
  
• The benefits that are possible through treatment. 

Breakthroughs in identification in audiologic identification techniques include:

• Testing the hearing of babies within the first 48 hours of life; now required in most states. Testing can identify hearing loss in children so that a follow-up evaluation and treatment can be performed as soon as possible. 
  
• Auditory Brainstem Response (ABR) Testing: This assessment technique can be used with difficult-to-test populations and for medical diagnosis of auditory disorders. The ABR test can be performed on individuals of any age, even the youngest infant. 
  
• Immittance testing performs objective and comprehensive evaluation of middle ear function. 
  
• Otoacoustic Emissions testing can provide information regarding the health status of the inner ear. 
  
• Other specialized tests can identify the exact location of the auditory impairment. 
  

• Consult with an audiologist at the first signs of hearing loss. Remember: ringing or buzzing in the ears (tinnitus) is one of the most common indicators of damage to the ears.
• Be aware of recreational sources of hazardous noise like firearms, fire crackers, power tools, music concerts, sporting events, motorcycles, motorboats, snowmobiles, and power boats. We have even seen significant hearing loss and significant tinnitus caused by something as “benign” as a parade when fire engines go by with their sirens wailing. Do not be embarrassed to plug your ears with your fingers when there is unexpected noise. Please purchase soft foam earplugs or ear muffs for any planned event or activity where there is going to be excessive sound or noise. Please also remember that, while it is easy for an adult to plug their ears, children will also be at great risk if they are exposed to loud sounds. It is of course the parents’ responsibility to avoid these situations and protect their children

Hearing loss in an adult has a number of contributing factors... including age, genetics, noise exposure and chronic disease (eg, diabetes, chronic kidney disease, and heart disease). Age related hearing loss, or presbycusis, is generally a slow progressive hearing loss that affects both ears equally. Presbycusis begins in the high frequencies and later affects the mid and lower frequencies. One of the first signs of hearing loss is often the inability to hear and understand speech in noisy environments. Because of this slow progression, adults with presbycusis do not readily acknowledge their hearing loss, considering it to be a normal condition of aging. As audiologists, we are not surprised to hear that the spouse or significant other has been frustrated by the hearing loss long before the individual with the hearing loss even acknowledges it. It is this insidious nature of presbycusis that allows many adults to ignore their hearing loss for years or even decades. 

Several studies have documented the impact of untreated hearing loss. An often cited survey was commissioned by the National Council on Aging in 1999. This national survey of nearly 4,000 adults with hearing loss and their significant others, showed significantly higher rates of depression, anxiety and other psycho-social disorders in individuals with hearing loss who are not wearing hearing aids. This survey looked at the positive benefits of amplification (hearing aids), and showed that hearing aid use positively affected the quality of life for both the hearing aid wearer and his/her family. These findings were consistent with the findings of a large randomized and controlled study that determined that hearing loss was associated with decreased psycho-emotional well-being, decreased social/emotional well-being, decreased communication and decreased cognitive function, in addition to increased depression for subjects who do not use hearing aids (as compared to those who had received hearing aids). These conditions were all improved after hearing aids were fitted. More recently, Dr. Frank Lin and his colleagues at Johns-Hopkins University found a strong link between the degree of hearing loss and the risk for developing dementia. Individuals with mild hearing loss were twice as likely to develop dementia as those with normal hearing; those with moderate hearing loss were three times more likely; and those with severe hearing loss had five times the risk. While this study could not definitively conclude that early treatment with hearing aids would reduce the risk of dementia, there was a strong positive correlation between the degree of hearing loss and the risk of dementia (Lin et.al. 2011).

NEW RESEARCH

Regeneration of 'hair cells' (sensory cells) in the inner ear is something that human babies and mice can only do for a short period after birth. Dr. Ksenia Gnedea and her colleagues at the A. James Hudspeth's Laboratory of Sensory Neurosciences have made some progress in activating sensory regeneration of these hair cells in mature mice. (Proceedings of the National Academy of Sciences. Oct. 2015).

Scientists at the National institue on Deafness and other Communication Disorders have recently had success in treating mice with defective inner ears with gene therapy. A particular mutated gene (whirlin) can cause defects in the inner ears of humans and mice. Although not effective in mature mice, newborn mice with the the defective whirlin gene developed normal inner ear stereocilia (hair cells) when injected with the normal whirlin gene. (Molecular Therapy. October 2015)