Aural Rehab, MCI, Dementia, and Aging
Kricos (2009) reports that audiologists need to be aware of age-related cognitive decline. Weinstein and Amsel (1986) reported that more than 20 years ago people with hearing loss may present similarly to people with dementia. Additionally, mild cognitive impairment (MCI) needs to be considered as a possible confounding factor. Multiple studies confirm the majority of people with cognitive impairment have significant hearing loss. Gold et al (1996) found 49 of 52 individuals with Alzheimer's Disease (AD) and other cognitive impairments also had significant hearing impairments.
Screenings for MCI and dementia vary considerably. Nonetheless, a common screening tool is the Mini-Mental State Exam (MMSE). The MMSE has high sensitivity and specificity and is normed for educational level and age. Multiple conditions may be associated with MCI including Alzheimer's Disease (AD), stroke, brain injury, brain tumors, central nervous system infections, alcohol and other drug abuse etc. People with MCI experience greater problems than would be expected based on age alone. However, people with MCI do not exhibit impaired judgment or impaired reasoning associated with dementia. Kricos notes that MCI is considered a "transitional syndrome" between normal cognitive function and dementia and more than half the people diagnosed with MCI progress to dementia within five years.
Treatments and interventions for people with cognitive impairment and hearing loss (in tandem) continue to be assessed and developed. Nonetheless, after appropriate amplification (hearing aids, assistive listening devices, alerting devices, cochlear implants, FM, connectivity tools etc) has been applied, cognitive engagement, social interaction and physical exercise may slow down cognitive decline, and may help maintain and potentially expand cognitive function.
Kricos notes that signs and symptoms of hearing loss and cognitive disorders overlap in the elderly, and therefore, professionals need to use caution when identifying either or both problems. Specifically, hearing loss may masquerade as cognitive decline and vice versa. Kricos reports failing to address the hearing problem may accelerate cognitive decline.
For More Information, References and Recommendations:
Kricos PB. (2009) Providing Hearing Rehabilitation to People with Dementia Presents Unique Challenges. Hearing Journal. 62(11):39-43