By Dona MP Jayakody
This article is a part of the November/December 2021, Volume 33, Number 6, Audiology Today issue.
The population is aging and the prevalence of hearing loss and cognitive impairment is increasing. Research suggests that mid-life hearing loss is associated with an increased risk of cognitive decline and dementia and that hearing loss is a modifiable risk factor. Many audiologists see older adults on a regular basis for hearing-loss issues. This article explores the challenges associated with treating older adults who have hearing loss and cognitive impairment/dementia.
Prevalence of Dementia and Hearing Loss
Currently, more than 55 million people live with dementia worldwide and this number is projected to rise to 78 million in 2030 and 139 million in 2050 (World Health Organization (WHO), 2021a). Currently, 430 million people worldwide experience moderate or greater levels of hearing loss and this number is expected to increase to 700 million by 2050 (WHO, 2021b). By 2050, one in every four people will have some degree of hearing loss and one in 14 will require hearing care (WHO, 2021b).
It is difficult to pinpoint how auditory rehabilitation reduces cognitive decline, especially in neurodegenerative diseases. However, there are several documented benefits of hearing interventions.
In 2020, The Lancet Commission on Dementia Prevention, Intervention, and Care specified 12 potentially modifiable risk factors for dementia: early-life education; mid-life factors such as hearing loss, traumatic brain injury, hypertension, alcohol consumption of more than 21 units/week, and obesity (body-mass index ≥30); and late-life risk factors such as smoking, depression, physical inactivity, social isolation, diabetes, and air pollution (Livingston et al, 2020).
If all 12 modifiable risk factors were eliminated, an estimated 40 percent of dementias could theoretically be prevented or delayed globally (Livingston et al, 2020). However, a recent study investigating dementia-risk factors among four ethnic groups in New Zealand concluded that hearing loss contributes to weighted population attributable fraction (PAF) risk factors for dementia by 8 percent in Europeans, 7.3 percent in Asians, 6.6 percent in Pacific peoples, and 6.5 percent in Maori people.
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