Dr Hilary Jones, GP and Health Broadcaster, has over 30 years’ experience championing the nation’s health. To coincide with World Alzheimer’s Month (September 2023), he sat down with us to share his thoughts on the link between hearing loss and dementia.
“What?” I hear you say when you read that headline. “Pardon? Hearing can affect your risk of dementia? How does that work?”
Well yes it can. In fact it is the most modifiable risk factor of all when it comes to delaying or preventing dementia.
So listen up and let me explain.
Dementia: the number one health concern
Today, as people generally live longer than ever before, dementia is the health concern the majority of people worry about most. More than heart disease, more than cancer, more than any other condition. Currently there are 850,000 people living with it in the UK and that figure is rising all the time. We all know the symptoms and dread them happening to us, yet 50% of people are unaware of the risk factors. More importantly, even fewer people realise that 40% of these risk factors can be eradicated or reduced by making simple lifestyle changes.
Nobody wants to start losing their memory, repeating themselves endlessly or failing to recognise familiar faces or family, facing the inability to perform everyday tasks and keep track of things, to find the right words and locate household objects. We all know someone who was had to be brought home because they became disorientated and lost, whose mood and behaviour has become unpredictable and difficult, whose safe, independent living is no longer possible.
Regrettably in many cases dementia occurs anyway. A tiny proportion may be inherited, especially if both parents themselves had early-onset dementia diagnosed before the age of 65. But age is by far the greatest risk factor with one in 14 diagnosed after the age of 65 and one in six after the age of 80.
Hearing loss & other modifiable risk factors
Ageing and genetics is something we cannot change but there are things we can change to reduce our risk and the most important of these is managing hearing loss. A recent report by the Lancet Commission entitled “Dementia Prevention Intervention and Care” stated that modifying 12 different risk factors from childhood to later life can delay or prevent 40% of dementia cases. So what are these lifestyle adjustments that decrease our risk and why is looking after our hearing so important?
We now know that even mild hearing loss doubles the risk of dementia. Moderate hearing loss triples it and severe hearing impairment increases the risk up to five times that of those who do not have any hearing impairment. An astonishing fact in itself you might think, but why? What is the association?
What’s the link?
Hearing loss means that people begin to miss out on conversations. They have to turn up the volume on the television or radio, they ask people to repeat what they've just said, they miss out on news and current affairs, they miss out on the fun they used to have with their friends, on jokes, on reminiscences, on calming and pleasant sounds such as birdsong, children at play or waves breaking on the beach. Later they withdraw into themselves. They deliberately avoid going out to socialise or to places where there is too much background noise. Other people then begin to avoid talking to them at all. Unless action is taken, it is the beginning of a downward spiral of isolation, depression and social neglect.
Untreated hearing loss inevitably leads to reduced mental stimulation and cognitive decline. The longer it continues the greater the disconnect becomes between the organs of hearing themselves, the ears, and the organ that processes those sounds, the brain.
Mercifully, hearing aids are proven to protect against cognitive decline by keeping the brain actively engaged in everyday life and maintaining a person’s connection to the outside world. They mean that you can confidently continue to participate in social gatherings and activities with friends and loved ones.
Crosswords, puzzles, sudoku, Scrabble and reading are all important ways of keeping the mind busy and the “brain muscle” exercised but being able to hear clearly and engage actively with other fellow human beings is even more important.
It is worth remembering too that hearing impairment can begin insidiously and at a surprisingly young age. Sixteen percent of teenagers use MP3 players or similar music devices on a daily basis and 9% listen to them at full volume. That means around 104 dB of sound going straight into their ears, almost the equivalent of standing next to a pneumatic drill. Long-term auditory damage can occur at 90 dB. This is why many teenagers already exhibit the same level of hearing loss as their parents’ generation but at a much younger age.
What we also know is that the earlier hearing loss is treated, the better the outcome and the lower the risk of dementia.
So my message to anyone over 50 or anyone who has noticed a problem with their hearing, is to book a hearing test today and have it checked out.
Hidden Hearing carry out a test free of charge and you have nothing to lose. Even finding out that you may just need to have ear wax removed as a result is worthwhile.
What about other modifiable risk factors? What are they?
Since dementia is the gradual loss of nerve cells and their connections to one another within the brain, it makes sense that the greater our level of education throughout our lives the more we can hang onto what we have as we grow older. So always stay curious, take up new hobbies and keep that brain busy. On the subject of brains, research increasingly confirms that traumatic brain injuries, even minor ones such as concussion can contribute to dementia so you may wish to think again about participation in contact sports, particularly ones where the head is more vulnerable.
High blood pressure is another risk factor but one which is eminently treatable. Smoking accounts for around 5% of modifiable risk factors and drinking more than 21 units of alcohol each week a further 1%.
Depression is one of the most common mental health issues and both this and social isolation are significant, and certainly require careful management. Air pollution is an increasing worry but potentially modifiable and careful self-management of diabetes is also important. Finally, the importance of physical exercise should not be underestimated. Yes, there are plenty of people suffering from dementia who have led very physically active lives, it is true, but had they not they may well have been diagnosed earlier or suffered a more severe form of dementia.
The bottom line is that the modifiable risk factors are a combination of all of these things not just one taken in isolation.
What’s the good news?
The good news is that 40% of risk factors for dementia are modifiable. We can do something about them and reduce our risk of developing this cruel and as yet incurable condition.
And the best news of all? The most significant change of all we can make is attending to any hearing loss. And we can do this today.