Welcome to Week 2 of our Hearing and Brain Health Webinar Series

In this second video learn the latest research on the connection between hearing loss and dementia.

Week 2 Hearing and Brain Health Transcript

Part 1 - Dementia Research

So welcome to week two of the hearing and brain health webinars. Thank you for sticking with us. There’s a whole lot of really interesting material we gotta get through, and I’m sure you’re gonna find it all really worthwhile.

So this week, we’re going to continue on with some of the dementia and hearing loss links, some of the really important research around this area, a continuation of what we started off in week one.

The headline numbers that we were talking about in week one was associated with the increased risk of dementia when we’ve got a hearing loss that we’ve done absolutely nothing about.

So even at mild levels, just to recap, even mild levels like a 25% hearing loss, there’s a doubling in the risk factor of developing dementia, if you’ve got a hearing loss that you’ve done nothing about relative to someone that has normal hearing at that same age.

At moderate levels, so 25 to 40% hearing loss, most of my patients have a 25%, 40% hearing loss. If they’ve done nothing about it, they are three times more likely to develop dementia relative to the same age people with normal hearing.


Those with the severe hearing loss, so a severe meaning, about a 50% or more hearing loss. Those people are five times more likely to develop dementia if they’ve got a hearing loss of they’ve done absolutely nothing about relative to their same age peers with normal hearing. Five times more likely, this is a really serious topic.

Part 2 - Dr Frank Lin

I had the pleasure of meeting Professor Frank Lin, who was the pioneer behind this really important research at the Johns Hopkins University in the United States. He was over in Sydney last year just in a couple of capacities.

First of all, he was visiting Australia in a public health capacity.

  • Trying to bring more to the forefront these really clear links between untreated hearing loss and dementia.
  • How can we get this more into the medical community and into the public health treatment of this really important topic.
  • Also he was here to give some intensive training on the research that he’s been conducting and the mechanisms behind these clear links between untreated hearing loss and dementia.

I had the privilege of attending that training. And I got to say, I got a whole load out of that. Some of the other points that he discussed in his training was that what we see with untreated hearing loss is an acceleration in the decline of cognitive abilities.

So our cognitive abilities include but are not limited to our memory, processing speed, reaction time, the kind of functions that we need to operate independently.

Right, so what we see, when we’ve got a hearing loss that we’ve done absolutely nothing about is a 30% to 40% increase in the acceleration, in the decline of these abilities.

And essentially what that means is that for every 25% of hearing loss, the researchers have consistently found, and this isn’t just in one study, that is can lead to 6.8 years of premature ageing.

It’s a really robust finding.

So what we find when we’ve got a hearing loss that we’ve done nothing about is a premature aging in those really important cognitive abilities by on average 6.8 years.

Quite astounding.

Part 3 - The Astounding Findings of this Hearing Loss and Dementia Research.

And so essentially what that research means is that someone, at 60 years of age that has a 50% hearing loss that they’ve done nothing about, they’re potentially going to have the brain age of a 74 year-old.

And what we see it’s quite common for people to be misdiagnosed as having dementia or Alzheimer’s disease. The most common form of dementia. Because the symptoms of having a hearing loss and having dementia can be quite similar.

Unfortunately a lot of people do get diagnosed as having dementia or Alzheimer’s disease where it’s really the hearing loss.

Part 4 - How does the treatment of hearing loss fit in?

And we see a reversal, a rather rapid reversal, in the kind of those cognitive abilities. And when we treat hearing loss and we treat it correctly, and we’re gonna talk about the correct treatment of hearing loss in a moment. But we can see improvements in those cognitive abilities when we treat hearing loss in as little as two weeks.

What studies have also shown is that treating hearing loss,  usually with hearing devices, can be twice as effective as the most effective cognitive-enhancing drugs out there.

Unfortunately at this point, there’s no magic pill, there’s no really effective medication for the treatment of dementia or even cognitive decline.

It’s a really tricky subject.

There’s been billions of dollars spent into research into the slowing and reversal of cognitive decline, leading to dementia. But unfortunately, they really haven’t got all that far.

Also, a number of the major drug companies, Merck, Pfizer, Johnson and Johnson and so on, have actually halted research into drugs that address cognitive decline.

So, at least hopefully there will be a magic pill at some point, but really at this point in time what the experts like Professor Lin, are telling us is that it really is lifestyle modification over the long term.

That is our best bet against, in the fight against dementia and Alzheimer’s.

Part 4 - The Brain and Treatment

So just to recap, pre and post-hearing device fitting, we see improvement.

Prior to being fitted with hearing devices, we see an under-stimulation in these parts of the brain. These ones that I’m just highlighting here, the parts of the brain associated with speech, hearing, language and memory.

And when we treat hearing loss, and this is what this particular study was showing is that what happens in the brain when we treat hearing loss correctly over a 12-month period, is that we see reversal of that trend.

  • We actually see re-growth back into these parts of the brain.
  • We can see physical volume changes at those parts.
  • They literally get bigger and have functional improvements. They start to actually work better.

But I just want make a really important point here.

And it’s quite possibly the most important point that I’m going to make in this whole program.

Part 5 - A Crucial Point to Understand

What is the correct treatment of hearing loss?

So, for the most common forms of hearing loss, and we’re going to talk about those in a moment.

For the most common forms of hearing loss the correct treatment is fitting of hearing devices.

But the most important point that I really want to make is that those devices actually need to be worn.

We know that in Australia, most people that own hearing devices do not wear them. There’s a major study done looking at about 14,000 hearing device owners in Australia, that was published a couple of years ago.

And what they found was that: one third of hearing aid owners in Australia don’t wear the devices at all.

If they did wear them, they’d wear them for a maximum of two hours a day.

Completely inadequate.

We know how often people are wearing their hearing devices, because all of them have these little databases on them, that allow us to easily check how often on average, they’re wearing them each day.

So most people really don’t wear them at all. They’re just sitting there in the top drawer.

Another third of hearing device owners in Australia, they only wear them inadequately, like between about two to 12 hours a day.

They’re what I call my ‘reading glass wearers’ and so they kind of treat their hearing aids like their reading glasses and they only put them on when, for conversation or if they’re going out or something like that.

Completely inadequate.

In order to get the brain health benefits that I’m talking about here, it’s really important that those devices be worn on a full time basis.

Full time, meaning at least 12 hours a day.

If we’re wearing them for less than 12 hours a day, we’re really not getting the value and we’ve missed an opportunity to really catch hearing loss in time and treat it effectively.

In my experience and in all the clinics that I’ve worked in, what I’ve found is that those people that wear their devices on a full-time basis, hear well for the rest of their life.

They’re able to maintain speech clarity over the long term, provided they keep their devices in. So this is a point that, I’ll probably come back to a number of times later in this webinar series.

And my patients will tell you that I’m a bit of a broken record when it comes to this particular point!

I think that in my role as an audiologist, it is the most important thing that I do is the hopping on, the checking, the educating, the reinforcing of the importance of full time hearing device use.

So really, really important.

  • if you need hearing devices
  • if you already have them,
  • if you know someone that needs hearing devices or has them
  • or at some stage in future you get them,

It’s really important that they worn full-time.

I just can’t stress that enough.

We’ll come back to that a little bit, I’m sure later on in this series.

Part 6 - The Dementia Link

So I’m going to dive into the topic of dementia now.

Dementia has been described as a horrible disease. And it’s been described as a situation where the mind can leave the body about 10 years prematurely.

And that’s it, that really is as awful as it sounds. How we can categorize whether someone has dementia or not.

One of the more common ways in which this can be done is by the significant presence of at least two of the following.

Here are Five Factors we’re going to Step Through.

So the first thing memory loss, and these are in order of importance and relevance.  Right, so the first thing memory loss and you could almost predict that that would be one of the more important factors that are considered when working out whether someone has dementia or not.

Well, we know that there’s acres of research pointing to the clear links between untreated hearing loss and memory loss. Just one example is that, there’s acres of research showing that the harder it is to follow a conversation, the less of that conversation you’re going to remember.

So really clear links between untreated hearing loss and memory loss.

Communication difficulties is the next most important thing. So we’re just, we’re kind of working down the list here, communication difficulties. Clearly related to our ability to hear well, is are our communication difficulties.

And attention deficits is the next one here.

So attention deficits, and specifically how that relates to our ability to hear well. What having a hearing loss does is it really does put strain on the brain.

We’ve got limited resources, limited attention resources, particularly thinking about our short term memory. We’ve got finite resources that we’re able to employ to get through life on a day-to-day basis.

And so for example, with an untreated hearing loss, for most people their hearing loss is uneven. Meaning that they’re only hearing parts of words.

They need to supplement what they can hear with what they can see.

And sometimes that’s really not enough and they’ve got to guess, rely on their memory. Often they make a bit of a judgment as to the context and what the person is likely to be talking about.

We’ll go into all of this a little bit later.

But rather than just being able to hear the conversation on its own, when we’ve got a hearing loss that’s untreated, we’re needing to supplement what we can hear with what we can see. Quite often also needing to rely on their memory, to make a bit of a judgment as to what the person is talking about.

And so if you’re listening to me give a presentation, there’s a good chance I’m gonna be talking about hearing. And that might give you some clues as to what I’m talking about if you haven’t quite captured the whole conversation.

It’s quite hard work.

Anyone that has a hearing loss will tell you that and particularly when socializing, or there’s a lot of background noise or they’re having to listen a lot during a day. They tend to be far more exhausted at the end of that day.

Part 7  Did you know? Hearing Loss and Falls

Also to those attentional deficits, they do also relate to balance and steadiness.

So we know that people, even at mild levels of hearing loss and remember mild hearing loss is a serious issue. At mild levels of hearing loss, people are three times more likely to have a fall then their normal hearing peers.

So why is falls risk associated with even hearing loss even at mild levels?

Well, there’s two reasons why people with hearing loss are more likely to have a fall.

One is, the less aware you are of your environment, you’re less able to respond to it.

So if you:

  • miss a step
  • or you tread on a twig or a toy,
  • or you’re out having a walk, and there’s bikes whizzing by and things like that,

The less well you can hear those things, the less you’re going to be able to respond to them.

But the main reason that researchers know there is a heightened falls risk, and there’s acres of research on this stuff.

The main reason they put this heightened falls risk down to   having hearing loss is the attentional deficits that occur, when we’ve got a hearing loss, that we’ve done nothing about.

The extra effort it takes to hear in your environment and the extra effort that needs to be put into conversation, the less of your brain’s resources you have for balance and steadiness.

One example:

I had a patient that came in and he wasn’t wearing his hearing devices full time. He’d come to me from another audiologist and he was hoping I could get him better on track.

And anyway, a warning sign that I always look for is how well, particularly if things aren’t going well, is how often are those hearing devices being worn?

And he said, oh, just a couple of hours a day, most of the time I’m not talking to people and so on.

I talked to him about falls, and I said does he know anyone that’s had a fall. He says, “Well, I’ve had a fall. I had one just about a year ago. I was at my son’s house and he was downstairs. I was upstairs and I couldn’t quite understand what he was saying.”

“He’s trying to talk to me, and I start walking down the stairs, so I could be in the same room. I was kind of leaning down and end up tripping, falling down the stairs. I broke my hip, and I was in hospital for three weeks.”

This is one example of how that extra effort really does put strain on the brain. And we’ve got limited attentional resources to be able to operate in the world. So lets address the third factor that we look at when we consider whether someone has dementia.

So these top three; memory loss, communication difficulties, attention deficit, they’re all related to our ability to hear well.

So hopefully you’re starting to get a bit of a sense as to what are some of the links between untreated hearing loss and dementia.

The next couple retention, reasoning and judgment issues, visual perception challenges, they’re not so related to our ability to hear well, but there are a couple of factors that are also considered.

Thank you for joining us for Week Two of the Hearing and Brain Health Webinar.

If you have any questions that you’d like answered in our Q&A sessions, please email them to andrew@neuaudio.com.au Our Q&A sessions are on our website. Look forward to seeing you next week!