When an aging patient develops dementia, his or her world begins to make less and less sense.
As seniors’ cognitive abilities decline in the form of memory loss, emotional issues and problems with language production and comprehension, so, too, does their understanding of what’s happening around them.
For decades, researchers have questioned how the aging process affects these issues. Do disabilities such as hearing impairment, associated with aging, make a patient’s dementia worse? If so, what can be done to help alleviate the effects?
For help approaching the issue, “I tend to liken the brain to a processor,” says Dr. Jeffrey Milks, an independent physician whose specialty is geriatric medicine. “We hear most of what people say, and then our brain fills in the rest.”
The question is what happens when an older patient’s ability to hear is impaired or lost.
Milks’ 35 years of practicing medicine, including serving as director of the Geriatric Fellowship at OhioHealth Riverside Methodist Hospital, has brought him extensive professional experience to understand dementia.
“We definitely know that people with significantly impaired hearing have more likelihood of having dementia,” Milks says, “and they also tend to experience a more rapid decline. The literature supports that.”
The difficulty arises, however, when we consider out second question: Can we prevent that decline by treating the hearing problem?
The short answer: We don’t know.
“No study supports that treating hearing impairment definitely affects the decline,” Milks says. “There was a (U.S. Department of) Veterans Affairs study about 15 years ago, but its results weren’t conclusive.”
Still, Milks is confident that the possible correlation is being looked at and, one day, we’ll be able to understand more about delaying a disorder that often feels like a spiral for patients and family members.
In the meantime, we can take cautionary steps while managing our expectations.
“I doubt that treating hearing loss will stop dementia,” Milks says. “But not treating it causes dementia’s acceleration.”
“I would advise my patients to get a hearing aid earlier, when they first notice signs of hearing difficulties. My feeling is that if they’re able to hear everything, they’re more aware and they have a better shot.”
Going further, it’s wise to be evaluated for dementia at the first sign of hearing loss over the age of 50. Tests will determine whether a person’s memory or thinking skills are weakening as a result of a type of dementia.
Early diagnosis is important to understand the type and extent of the disease. The term “dementia” is simply “an overall term that describes a wide range of symptoms,” according to the Alzheimer’s Association. True, Alzheimer’s disease accounts for 60 to 80 percent of dementia cases, but many cases are the result of preventable causes, and are sometimes reversible. Thyroid problems and vitamin deficiencies, for example, can contribute to conditions that cause symptoms of dementia.
For friends and family members of patients who suffer from both severe hearing loss and dementia, vigilance and special care are key.
“With my patients, I speak in what I like to call my ‘big boy voice,’” Milks says. In other words, speak significantly louder.
It also helps a great deal to make sure your mouth is clearly visible when speaking to someone with dementia. People tend to be better lip-readers than they think. Letting the brain catch onto several stimuli leads to better engagement and better comprehension.
“Watch and make sure that people understand,” Milks adds. “Sometimes they’ll nod, but that doesn’t necessarily mean that they’re comprehending what you're saying.
Dr. Douglas Scharre, director of the Division of Cognitive Neurology at The Ohio State University Wexner Medical Center, recommends also using visual picture books to help stimulate brain activity in dementia patients who can’t hear well.
Per Scharre, awareness is key.
“Get cognitive screening if at risk for cognitive impairment,” he says. Knowing that the battle has begun is the first step to preventing rapid decline.
With the help of modern hearing aid technology, and with further research, the hope of another way to fight dementia could be on the horizon.
Zach Maiorana is a contributing writer. Feedback welcome at gbishop@cityscenemediagroup.com.
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