Ask people what they do to protect their memory and cognition, and you’ll hear a familiar list:
Eat well. Exercise. Do puzzles. Stay socially connected. Get quality sleep.
Almost nobody says, “Get my hearing checked.”
And yet, when researchers rank risk factors related to developing dementia, hearing loss during midlife lands near the top of the list. In some analyses, hearing loss accounts for a larger share of modifiable risk than smoking, physical inactivity, or excessive alcohol use.
That isn’t a minor footnote. Managing hearing loss could be one of the biggest levers available to people when it comes to the prevention of cognitive decline.
The Size of the Problem
The Lancet Commission on Dementia Prevention has repeatedly identified hearing loss as a leading modifiable risk factor, with the strongest signal appearing when hearing loss develops during midlife (from the mid-40s through the mid-60s).
The correlation also appears to be graded. In other words, the more severe the hearing loss, the higher the associated risk for developing dementia.
A caveat is that these are observational findings. They establish a relationship between hearing loss and dementia risk, but not causality. It’s possible that early, undetected changes in the brain contribute to hearing loss, rather than the reverse. But the timing (i.e. hearing loss that appears years or decades before cognitive decline)—and the consistency of findings across large populations—make this a compelling aspect of dementia research.
Why Would Hearing Affect Cognition?
Several explanations are on the table, and they aren’t mutually exclusive:
- Cognitive load. When sound arrives degraded, your brain has to work harder to decode it. Every conversation becomes an effort, and that effort has to come from somewhere. Resources utilized to decode words could be the same ones that would otherwise be used for memory and comprehension. In other words, you may follow the conversation, but you don’t retain it because your brain spent its budget just deciphering the words.
- Social withdrawal. This one is quietly devastating. When hearing becomes difficult, restaurants are avoided. Invitations to group gatherings are declined. Phone calls are shorter. None of this is because the person doesn’t want connection. It’s because the connection has become exhausting. Meanwhile, social isolation in and of itself is a well-documented risk factor for cognitive decline.
- Reduced input. Your brain (like your muscles) responds to use. The regions of the brain that process sound receive less stimulation when one’s ability to hear declines. And there’s evidence that auditory processing areas undergo structural changes over time as a result.
The Good News
Unlike many risk factors associated with dementia, hearing loss has a straightforward intervention.
The research on hearing aid use and cognitive outcomes is promising, particularly for people at higher risk. Findings haven’t been uniform across every study population, and researchers are still working out exactly who benefits most; but the direction of the evidence is favorable. Best of all, the intervention itself is low risk.
The primary obstacle when it comes to intervention is delay. People often wait several years between noticing problems with their hearing and doing anything about it (often because hearing loss carries a stigma that reading glasses somehow escaped).
Those are years of unnecessary cognitive strain.
Signs Worth Taking Seriously
Hearing loss rarely announces itself. It creeps in. Watch for:
- Difficulty following conversations in noisy places like restaurants.
- Turning the television up while others say it’s already loud.
- Frequently asking people to repeat themselves.
- Feeling drained after social gatherings.
- A sense that people are mumbling.
- Trouble on the phone.
Fatigue deserves special emphasis. If conversations leave you tired, that could be your brain telling you it’s working overtime.
The Hormone Connection
There’s a hormonal dimension here that gets very little attention.
Estrogen receptors are present within the inner ear and in the auditory pathways of the brain, and estrogen appears to play a protective role in auditory function. Some research has observed changes in hearing thresholds among women and men following menopause and andropause. Also, hearing and balance are closely linked systems, which may help to explain why some women report dizziness during menopause.
Blood flow matters too. The inner ear depends on an extremely fine vascular supply, which makes it vulnerable to the same circulatory changes that accompany hormone decline and cardiovascular aging.
None of this means hormone therapy is a treatment for hearing loss. However, hormone therapy could help to prevent hearing loss from happening in the first place. At the very least, hearing should be a part of the healthy aging conversation, rather than being filed away as a separate and discreet problem.
Get It Checked
If you’re over 50 and haven’t had a hearing test, get one. If any of the signs of hearing loss noted above resonate with you, don’t wait years to do something about it.
At Renew Youth, we take a comprehensive view of healthy aging, because the things that protect your brain rarely fit into a single category. To learn more, call us at (800) 859-7511 or use our easy contact form to schedule your complimentary 30-minute consultation.