Hearing loss now strongly linked to cognitive decline


Research by John Hopkins University has confirmed what many audiologists and physicians have long suspected: that there is an irrefutable link between hearing loss and cognitive decline. Initial problems like memory loss can worsen over time and, left untreated, may eventually lead to dementia and other forms of cognitive impairment. In fact, studies have shown that individuals with moderate hearing loss were three times more likely to develop dementia.

“Losing one’s cognitive ability is the No. 1 fear of people of all ages,” said Dr. Aaron Liebman, board certified audiologist and owner of Aaron’s Hearing Care in Vero Beach. “Since cognitive decline goes hand in hand with hearing loss, the best thing you can do to prevent that decline is to get your hearing tested and get properly fitted hearing aids if necessary. Even if you don’t need them right away, a test will give the audiologist a baseline reference for future reference.”

It’s now scientifically proven that the slow onset of hearing loss can have a significant impact on several key brain functions, including the memory, hearing, speech and language portions of cognition. It may be that the brain experiences an increased cognitive load when trying to hear properly and it taxes the resources that would otherwise be available for memory and concentration. The proactive management of hearing loss may delay or slow down the progression of cognitive decline.

“Hearing loss is the third most common health problem in the United States, following heart and arthritis issues,” said Dr. Liebman. “Yet according to the Centers for Disease Control and Prevention and Better Hearing Institute, the statistics for screening are alarming. While 74 percent of adults have their eyes examined every two years and 63 percent will visit a dentist each year, only 23 percent of adults receive any form of hearing screening during a physical exam. This is a shame because early detection of hearing loss can effectively slow down the mental decline.”

Aaron’s Hearing Care offers the latest FDA-approved computer-based screening test for cognitive function in relation to hearing loss, a program called ‘Cognivue.’ According to Dr. Liebman, Cognivue objectively, quantitatively and reliably identifies changes in cognitive function that could be indicative of an impairment that may be optimally treated or managed.

The screening addresses the auditory system from ear to brain and the software algorithm uniquely calibrates each individual’s motor and visual abilities. Cognivue evaluates memory, visuospatial (risk of falling) and executive (ability to hear in noisy situations) functions as well as reaction time and speed processing. These parameters are the key to performance at any age. While it’s not a stand-alone diagnostic tool, it is an important adjunctive tool for evaluating cognitive function.

“First and foremost, my goal as an audiologist is to perform a proper diagnostic hearing test so I can decide whether a patient needs to be referred to an ear, nose and throat physician for a medical evaluation, or if this is strictly a permanent hearing loss that needs help with hearing aids,” Dr. Liebman said.

“That is what really differentiates me from a traditional hearing aid salesman. I’ve got a Doctorate in Audiology and my diagnosis is based on years of education, not a few months of hearing aid salesmanship. I will take the time to screen and assess all the data prior to making a recommendation for hearing aids. Even AARP says that you are more likely to be successful with a hearing aid fitting by seeing an audiologist than a hearing aid salesman.

Now, with this new cognitive screening equipment I can actually verify if even a minute hearing loss is affecting your cognitive function. It’s really a game-changer.

Only about 20 percent of the population who actually need hearing aids will get them,” Dr. Liebman continued. “There are two reasons for this. The first is vanity denial when the patient doesn’t really believe they need them, and the second is the negative stories they’ve heard from family and friends. Up until all these recent revelations that hearing loss actually affects mental function, all they were losing out on was conversation. Now, however, we realize that they are also losing out on cognitive function as well, making it more important than ever to address the issue.”

A hearing screening is simple. The patient is first asked a series of questions ranging from if they have noises in the head, called tinnitus; if they experience dizziness or balance issues; if they had noise exposure in the workplace or military; and if the loss was sudden or gradual.

After a thorough examination of the ears, the patient is seated in a sound booth for tone testing with headphones that measure the frequency that the patient can comfortably hear. Then a bone test is performed by placing a device just above the bone behind the ear so it bypasses the outer and middle ear and detects loss coming from the inner ear. These tests allow the audiologist to qualify where the hearing loss is and what might be causing it.

A speech discrimination test is also performed. Single syllable words are presented and then scored on the percentage that the patient was able to respond to correctly. This audibility index percentage represents the percentage of speech information they are receiving and retaining at their regular conversational level. After all the tests are reviewed, an individualized plan can be implemented by the audiologist to maximize a patient’s hearing potential.

With the advent of Cognivue technology, an additional test can be administered to correlate how the hearing loss is affecting the patient’s cognitive ability. According to The Lancet, one of the most respected medical journals in the world, of everything you can control concerning future potential dementia, 25 percent is related to hearing. The test isn’t required with a hearing screening but can absolutely provide insight into future cognitive health.

“If after this simple screening I see cognitive impairment, I will refer the patient to a medical doctor for further evaluation. The Cognivue test is simply a preliminary cognitive screening that can be done in conjunction with the hearing test for a minimal cost and give a preview of future cognitive health.

“Many patients don’t want to accept that they have a hearing loss, but when I show them results on a computer screen and demonstrate to them that they can hear better by just changing the frequency and not the volume, they understand.

“If you are a candidate for hearing aids, you should get them fitted properly and wear them consistently to stimulate the brain. It’s now a known fact that simply depriving the brain of sound is contributing to cognitive decline. Early detection is the key, so as soon as you notice that you might be missing words on the TV or asking associates to speak louder, get tested. There’s more at stake than just your hearing. It’s all about your quality of life and your future mental capacity.”

Dr. Aaron Liebman followed in his father’s footsteps to become a Doctor of Audiology, and now has more than 35 years of experience. He attended the State University of New York at Albany for his bachelor’s degree, Brooklyn College for his master’s and A.T. Still University of Health Sciences for his Doctor of Audiology. He specializes in diagnostic hearing testing, aural rehabilitation, and hearing aid evaluation and dispensing. His office is located at 925 37th Place, Vero Beach. Call 772-562-5100 to schedule a free hearing screening and introductory priced cognitive screening.

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