About 15 years ago, I was working at a seaside town when a wealthy American yacht owner came into the clinic, dragged in by his attractive partner who was less than half his age. He’d lost around half of his hearing and, much to his partner’s frustration, had refused any kind of assessment or treatment. “She can just speak up!” he insisted.
The couple were planning a trip to Polynesia however a few months later, the gentleman came back into the clinic. The trip never happened. The young lady had left him and he was finally motivated to address one of the root causes of his relationship breakdown… his hearing loss.
For me, one of the most frustrating things about working in hearing health care is the depth of avoidance and denial people face when dealing with the challenges of their hearing loss for the first time. A big part of the problem is that the profession has failed to shift the outdated stereotype of the ‘big beige banana’ hearing aids. In Audiology, we see one of the lowest treatment rates I can find of any medical profession. If only more people knew that today’s devices are smaller and smarter than ever before. If only more people knew that the benefits of treating hearing loss are relatively immediate, often profound and may reduce the risk of cognitive decline in later life.
What makes hearing loss uniquely different to just about every other health condition is the impact it has on other people. When you have hearing loss, it doesn’t just affect you; it affects anyone wanting to have a conversation with you and in particular, your closest loved ones.
In 2012, researchers at The University of Queensland investigated the extent to which spouses of people affected by hearing loss acquired a ‘third party disability’ as a result of their partner’s hearing impairment. Third party disability is defined as the disability and functioning of family members as a result of the health condition of their significant other. The study included 100 couples and the criteria for taking part was that one spouse had hearing impairment and the other had normal hearing. What emerged was that 98% of the normal-hearing spouses were found to have at least some degree of third party disability as a result of their partner’s hearing loss. In severe cases, this commonly resulted in lower relationship satisfaction as reported by the spouse. I find that the results of this study are echoed in my audiology practice. Spouses are often the much more motivated individual to have their partner’s hearing loss treated.
When conversation becomes challenging and it becomes necessary to repeat ourselves often, the tendency is to just stick to the basics. Nuances and subtleties are often diminished; we do away with verbal affection and we avoid talking because it’s difficult and tiresome. We don’t bother telling little jokes or funny stories anymore because timing and suspense are so important to the effect. The richness of communication disappears and we end up sticking with the mundane. Inevitably, this leads to a weakening of the human connection and there is a real danger of isolation setting in, even within a long-term relationship such as a decades-long marriage.
The impact of untreated hearing loss on cognitive health has gained significant research attention in recent years. If you’ve read my book, you’ll know that the globally-recognised Lancet Journal cited hearing loss as the number one risk factor for the development of dementia. It also revealed that hearing loss is associated with a 30-40% acceleration in cognitive decline. The good news is, studies have shown that treating hearing loss increases cognitive function. After just two weeks, there are significant increases in selective attention, memory recall and processing speed. I can only speculate as to how much harmony these kinds of improvements would restore in a relationship dealing with hearing loss in one of the partners.
The graph below illustrates ten areas of life improvement that are experienced by wearers of hearing devices and their family members, when hearing loss is treated. Almost all the factors show that family members are more satisfied than the person receiving the treatment!
For many, the idea of treating hearing loss can feel daunting. If you suffer from hearing loss, I’d encourage you to consider the wider implications of letting it go untreated. But if you do seek treatment, and wear your devices which I promise, are not the ugly old hearing aids of days gone by, you will experience a fuller participation in life. Plus, you’ll be enabling those around you to better share it with you.
#Audiologist#Audiologist #HearingLoss#HearingLoss #HearingAid#HearingAid #NeuAudio#NeuAudio
Recently, I had the pleasure of attending a keynote presentation in Sydney by Professor Frank Lin of John Hopkins University. He led the research team that published ground-breaking research in 2011 which, for the first time, showed the clear links between untreated hearing loss and dementia.
If you’ve been to one of my seminars or read my book Catching the Mind Robber – A Summary, you may be familiar with some of his work. It was really helpful to learn more of the background to his research including some of the nuances of what has been published and what new research is in the pipeline. I also found fascinating his findings in related areas such as untreated hearing loss and depression.
According to Professor Lin, projections estimate that the prevalence of dementia is expected to double every 20 years, to the point that one in every thirty Americans will have dementia by 2050. That’s one in thirty of the total population. What sparked much of the work and focused interest on dementia and untreated hearing loss was discovering that hearing impairment is independently associated with a 30-40% rate of accelerated cognitive decline.
Two major independent studies found that a 25dB (roughly 25%) shift in hearing levels was equivalent to nearly seven years of ageing on cognitive scores in older adults. Hence, a 50dB shift would, on average according to the studies, result in an increase in cognitive age of around 14 years. This would give a 59-year-old person the cognitive abilities of a 73-year-old. This is quite significant and very concerning. The two studies repeated independently yielded, essentially, identical results.
Between 1990-1994, 639 participants (aged 39-90 years) entered an intensive study on ageing. None had dementia at the start of the 12-year longitudinal study. Using a rigid definition of dementia, following annual checks over a 12-year period, subjects had a 200%, 300% or 500% increased risk for dementia depending on whether their hearing loss was mild, moderate, or severe, respectively. In cases of hearing loss, they also found up to a 40% loss of matter in the areas of the brain associated with speech, language, memory and attention. Similar results have been observed elsewhere which is further evidence to suggest that taking action early on hearing loss is advisable.
Professor Lin’s current work is focused on the impact that consistent hearing aid use has on the slowing and/or reversal of cognitive decline. This major study won’t be published until 2022/2023.
A recent study using functional MRI showed structural and functional changes in the brain following 12 months’ full-time hearing aid use. Another showed that hearing aid owners experienced a 75% reduction in dementia risk. It is anticipated that Professor Lin’s research will support this growing body of evidence linking hearing and brain health.
Whilst it could be easy to feel discouraged about hearing loss and its link with dementia, I would urge readers to feel particularly encouraged about the positivity of treating hearing loss early.
#BrainHealth #HearingLoss #CognitiveDecline #Audiologist #hearingaid#hearingaid #tinnitus#tinnitus #brisbane#brisbane #melbourne#melbourne #dementia#dementia
Ringing in the ears affects approximately 10-15% of people on a regular basis
Tinnitus, commonly known as ‘ringing in the ears’ is more common than you may think. Most people think they’re alone in experiencing it because it’s not something we typically discuss. No one goes out for coffee and says to their friends: “Hey, do you hear that? That high-pitched squeal?” Mostly it’s because tinnitus tends to be more noticeable in a quiet environment, like when you’re lying in bed at night, trying to go to sleep. But also, people often think tinnitus is ‘all in their mind’ so they tend not to bring it up in general conversation. The truth is, tinnitus is absolutely not all in the mind.
It’s believed that around 18% of Australians are affected by tinnitus. Studies have shown that as much as 98% of the population will experience tinnitus in a room that is quiet enough, such as an acoustics laboratory. For some, it comes and goes without rhyme or reason. For others, it’s constantly there. How much it disturbs your quality of life depends on a variety of factors. But first, let’s explore what tinnitus is.
Tinnitus is the medical term for ‘ringing in the ears’. The sounds don’t exist in the environment and only the sufferer can hear them, which is why it seems to be an imaginary condition. It generally sounds like a high-pitched ringing but for some people, it can sound like whistling, hissing, blowing, buzzing, humming, sizzling or roaring. The noises can be barely detectable, or they can be debilitatingly loud.
You may have heard of ‘phantom pain’ which is when a person who has lost a hand reports that they can still feel pain as if the hand was still there. Neuroscientists believe that since the brain is used to receiving sensory signals from that part of the body, when the signals cease, the brain steps in and generates its own signals around what the hand is doing. In tinnitus caused by hearing loss – however mild or significant the loss – the phantom pain theory suggests a similar mechanism is in play. The brain is used to receiving audio signals from the ear and when they are no longer detected, or are greatly reduced, the brain generates its own signals or sounds to compensate. This is a dysfunction and it’s undesirable but you really have to hand it to the brain for being so clever!
Frankly, tinnitus can affect people of all ages, genders, races and hearing abilities. Here are the most common risk factors:
Ageing – The older you get, the nerve fibres in your ears deteriorate, leading to gradual hearing loss and quite often, tinnitus.
Smoking – You have a higher risk of experiencing tinnitus if you smoke.
Gender – Though men and women get tinnitus, the number of men is higher.
Cardiovascular issues – Those with high blood pressure or atherosclerosis (narrowed arteries) have an increased risk of tinnitus.
Exposure to loud noise – People who work in noisy places such as factories and airport tarmacs are more susceptible. Of course, those who subject their ears to loud music such as at concerts or through headphones up too loud are prime candidates for tinnitus.
Just when you thought your tinnitus was mildly annoying, you find it gets worse sometimes. There are the three main factors that can cause it to worsen:
1. Silence – The quieter the environment, the louder the tinnitus. Unfortunately, as mentioned previously, your brain is going to try to compensate for those missing sounds, and in a quiet room such as your bedroom at night, you’ll notice them even more.
2. Sleep deprivation – Scientists the world over have documented that a lack of sleep worsens tinnitus.
3. Stress – To date, the exact link between tinnitus and stress isn’t known but they are undoubtedly related. When we are under stress, our bodies can experience a ‘fight or flight’ response. The body is on ‘high alert’ to deal with this unwelcome situation and one of the ways it responds is by heightening our sense of hearing. Of course, that makes even low-level tinnitus more noticeable. Most sufferers report that their tinnitus is worse when they are stressed and for many, their first experience of tinnitus was during a period of great stress.
It is important to note that there is no ‘one-size-fits-all’ approach to tinnitus management and recent research recommends a personalised approach under the guidance of an Audiologist. Here are some broad strategies that will help you in your quest to deal with your tinnitus.
Have your hearing checked – One of the most common causes of tinnitus is hearing loss. Even mild hearing loss can cause tinnitus and many people are not aware that their hearing has deteriorated because it usually happens so gradually. Make an appointment with an Independent Audiologist who will test your hearing with state-of-the-art medical equipment that will accurately diagnose your hearing, from perfect to however impacted it may be. Aside from providing you with a proper diagnosis which will mean you’ll know how to treat your tinnitus, your Independent Audiologist will be able to reassure you about your specific situation. A word of warning though; consulting ‘Dr Google’ may unearth some misleading claims about tinnitus that could cause you unnecessary concern.
Avoid silence – You would already be aware that silence can make your tinnitus more noticeable. Some sufferers find that having the radio or TV on at a low volume can be helpful. White noise apps and devices designed to put babies to sleep can also be helpful in making the silence less stark to your ears. The volume of the tinnitus sound will be reduced against the background noise that you introduce. If using apps, the radio or TV when going to sleep, check to see if your smartphone or other device has a ‘sleep’ function which turns the sound off after a period of time that you choose. Or, you may prefer to leave it on all night.
Manage your stress – Find ways of reducing your stress. If you can’t avoid the stressful situations in the first place, then work on ways to take the pressure off, such as walking, having a massage, listening to relaxing music or reading a book you enjoy.
Unfortunately, there’s no complete cure for tinnitus but there most definitely are effective treatments. The goal is to take it from being troublesome and intrusive to something you may experience from time to time, and not at the same volume.
If you or someone you care about is bothered by tinnitus, contact us today for a hearing assessment. We’d really love to help.
