Brian Lamb, OBE and Sue Archbold PhD, Hon LLD
A new document from The Ear Foundation, launched at European Association of Cochlear Implant Users (EURO-CIU) annual general meeting in Poland, reviews the latest evidence on the association between hearing loss, cognitive decline and dementia. A number of studies revealed a very strong association between hearing loss and dementia and a number of studies also showed that the use of hearing aids and cochlear implants attenuates the decline in cognitive function and dementia. For example, The Lancet paper of Livingstone et al, 2017 shows that hearing loss may account for up to 9.1% of preventable cases of dementia in middle to older age.
Recent activities including the World Health Assembly resolution (2017) on the prevention of deafness and hearing loss and The Lancet paper recognising the impact of hearing loss (Wilson et al., 2017) have led to increased interest in ear and hearing care.
- Over 466 million adults experience disabling hearing loss and this number is rising, with a cost globally of $750 billion per annum. (WHO)
- Over 50 million people above 65 years of age have been diagnosed with dementia, and that number is expected to triple by 2050 due to the rising number of older people. The cost of caring for those with dementia in 2015 was approximately $820 billion, and 85% of those costs were related to family and social costs.
- Global burden of disease programme shows that hearing loss is the greatest cause of years lived with disability over the age of 70.
Hearing loss impairs communication, has been linked to reduced social support from others and loneliness which, in turn, increases health risks. More specifically, communication and social connectedness are critical to brain health, addressing dementia and maintaining cognition.
The report recommends:
- National action plans on hearing loss, linked to age related strategies
- Public health campaigns on preserving hearing and taking early action to address hearing loss
- National screening programmes for adult hearing loss, improving early access to hearing aids and implants.
- Targeted screening programmes for those receiving home care, living in residential homes or at high risk of hearing loss.
- Training for health and social care professionals in identifying and managing hearing loss for those with or at the risk of dementia.
- An enhanced role for the audiology and hearing professionals in the diagnosis and management of hearing loss, dementia and cognitive decline.
- Supporting the ongoing management of hearing loss for adults living with dementia.
Managing hearing loss well especially in later life improves communication and independence, and reduces loneliness, social isolation and may help to greatly alleviate cognitive decline. The challenge for health systems, commissioners and professionals working in hearing loss is to support healthy aging by ensuring good hearing health. Investments in early intervention and early provision of hearing aids and implants will not only improve quality of life for older people but will also save health systems substantial additional medical and social care costs in the future. Hearing well matters.
Professor Adrian Davis comments: “The Ear Foundation report is an important, highly relevant and practical document that commissioners and providers of hearing health [care] should use to validate the high value of their activity”
Many thanks to a number of reviewers who informed our understanding. The work was supported by an educational grant from Cochlear.
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