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Listen to Your Mind

by Prof. Suzanne Timmons, Consultant Geriatrician and Clinical Lead, HSE’s National Dementia Office

Many of us worry about developing dementia in later years. We may know someone close to us who has a type of dementia, whether that causes memory trouble, or difficulty making decisions, or understanding the world around them, or communicating with others.

The same good lifestyle habits that reduce our risk of heart disease and stroke can reduce our risk of dementia. Not smoking, or quitting smoking, is crucial. Taking steps to avoid high blood pressure and diabetes, and regular physical exercise are essential. A healthy diet, such as the Mediterranean diet with its emphasis on fresh fruit and vegetables, and oily fish like salmon and mackerel, is key. Reducing alcohol levels, which can damage or kill brain cells, and keeping within the low-risk weekly guidelines of less than 11 standard drinks for women and 17 standard drinks for men, is important too. But there is one other way to reduce our dementia risk – by protecting our hearing.

Increased Risk

Hearing loss can be caused by different things. It can occur from birth. It can be the result of head or ear trauma. It can arise from a viral infection or as a side effect of certain medications. It can be due to loud noise exposure, such as from power tools or music gigs. It may be due to family history.

However, the biggest risk factor is getting older. Half of people over 70 will have problems hearing. Hearing loss can cause difficulty in understanding words, especially when there is background noise or a group talking. Over time, even one-to-one conversation can be challenging. This can obviously have a major impact on how we live our lives.

However, in recent years, there is increasing evidence that hearing loss can also increase dementia risk. In fact, people with even mild hearing loss are almost twice as likely to develop dementia. With severe hearing loss, the risk of dementia is five times higher.

Brain Workout

Hearing loss is related to shrinkage of parts of the brain that are linked with memory. Some researchers think that this may relate to the increased work for the brain in having to figure out muffled sounds and words. Others think it relates more to not hearing information properly, as hearing new information and remembering it later is an important workout for the brain.

We know that keeping socially active and learning new things keeps the brain exercised and reduces the risk of dementia, so it makes sense that withdrawing from these activities due to hearing loss could increase dementia risk. The good news is that wearing a hearing aid, if prescribed, can reduce this risk.

Wired for Sound

It’s important that people already diagnosed with dementia have their hearing checked at least every two years, as hearing loss added to dementia can affect the ability to stay independent. A hearing problem could be something as simple as having too much ear wax, which is very treatable.

Hearing loss can present as possible dementia when someone actually has normal brain function. They just can’t hear the questions. Anyone having a memory or brain assessment should let the tester know if they have hearing problems, so that they can make sure the room is especially quiet, and that they can hear everything. They might also have a hearing amplifier – headphones connected to a microphone – which can help.

If prescribed a hearing aid, it is important to wear it to all clinic and hospital appointments. For a person admitted to hospital, not being able to hear what is going on makes it more likely that the person will get confused – called delirium – which can have serious health effects.

As a person’s brain becomes impaired, it can be harder to remember to wear or to turn on a hearing aid, or how to use it, and they may need support. In future we may see more “smart” hearing aids which will reduce the need for fine-tuning. Chime, the national charity for deafness and hearing loss, has useful information about hearing loss and hearing aids at www.chime.ie.

Three Actions

Here are three ways to protect your hearing:

  1. Avoid excessive noise exposure and, if not possible, wear good quality ear protection
  2. Have your hearing checked immediately if you are concerned
  3. Use a hearing aid if you need one

Hearing loss is the most common factor that we can change when it comes to dementia, even ahead of smoking and high blood pressure. Worth keeping a listening ear!

The Dementia: Understand Together campaign is led by the HSE in partnership with The Alzheimer Society of Ireland, Age Friendly Ireland, Age and Opportunity, and the Dementia Services Information and Development Centre. It aims to create communities that actively embrace and include those living with dementia and their families. For information about dementia, visit www.understandtogether.ie or contact The Alzheimer Society of Ireland Helpline for support on Freefone 1800 341 341 (Monday to Friday 10am to 5pm, Saturday 10am to 4pm). For information about HSE audiology services, visit www2.hse.ie/services/audiology

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