Dementia and hearing loss: What is the link?

Gradual hearing loss is a normal part of ageing. Around 1 in 6 people in the UK has some degree of hearing loss, with over 70% of people aged over 70 affected.

Exposure to loud noises for a long time, health conditions and presbycusis, commonly known as age-related hearing loss, can all be causes.

For a person living with dementia, communication can already be challenging and hearing loss can exacerbate this. This can lead to the person becoming more socially isolated, have lower self esteem and even aggravate confabulation if they are only catching odd words here and there.

Surprisingly, there are even studies that suggest that people living with impaired hearing are more likely to develop dementia, as there appears to be a causal link.

Signs of hearing loss can overlap with signs of dementia

As with dementia and depression, dementia and hearing loss share some of the same symptoms. This can make it difficult to know which someone is experiencing, and it could be both. 

You may think the person can’t hear what you’re saying, when actually they are struggling to form meaning from your words because of dementia, or vice versa.

Quite a lot of brain work goes into listening – you have to hear each word, understand them individually, take in the order in which they were said and understand the meaning of the sentence, and recall events the sentence references and its context in the conversation, all in a matter of seconds. This can take somebody who lives with dementia much longer and they can forget what you’ve said before they’ve understood it.

Signs of both dementia and of hearing loss include:

• Finding it hard to follow a conversation, especially in busy places or when there’s background noise, like a radio or television
• Asking you to speak more slowly
• Taking a while to respond when you speak to them or often not responding
• Looking at you blankly when you ask a question
• Not remembering things you’ve said to them

If you have a friend or relative who is struggling to communicate, their doctor will be able to assess them further and get to the root of the problem.

Can hearing loss increase the risk of dementia?

A 2021 study by the University of Oxford found a 91% increased risk of dementia in people with hearing issues that affect their ability to hold conversations.

Nobody knows exactly why this is yet but there are various theories. Some suggest that the depression and isolation associated with poor hearing are a causal factor, while one theory suggests that using a hearing aid means the brain doesn’t need to work as hard, so is effectively less fit.

There is an ongoing research project by the University of Manchester to try to ascertain exactly what causes this link.

How to help somebody with dementia and hearing loss

Supporting a friend or loved one who is experiencing hearing loss as well as dementia can improve their confidence in having conversations and help to keep them socially active and independent.

Visit an audiologist

Support your loved one to visit an audiologist. You can get them to ask their GP or simply book one at Boots chemist . These are free, only take 15 minutes and are available in high street Boots shops.

An audiologist can determine what the level of hearing loss is, whether it’s in both ears or just one, and whether they are better at hearing low pitches, which is often the case. 

They can see if the hearing impairment is likely caused by a build up of wax, in which case olive oil drops and sometimes syringing can fix the problem. They might recommend a full hearing assessment which could result in getting a hearing aid.

Leave reminders about their hearing aid

If the person does get a hearing aid, their dementia may cause them to forget to put it in, how to use it, or to frequently misplace it.

Try to set up a place in their home where they keep their hearing aid and easy-to-read instructions on how to use it. You could also add things like what to do if it’s whistling or if the batteries need changing.

Speak clearly

You can help people to hear you by:

• Sitting/standing where they can see your face clearly
• Using body language to accentuate what you’re saying and improve comprehension
• Speaking in short, clear sentences

People who have dementia can find listening more difficult when they are tired or overwhelmed. Choosing times when they are more alert for important conversations can help.

Ask questions

To save the person from having to do too much listening, try to ask open-ended questions that will invite them to talk instead. An open-ended question is one that can’t be answered with ‘yes’ or ‘no’, nor does it need a specific answer, such as if you asked what day something happened or what a particular person said. These invite people living with dementia to tell you what they do remember, rather than worry over what they don’t.

A difficulty for people with dementia is that if questions are too open, they can struggle to find the memories they need to answer. For example, if you ask, ‘What have you been doing this week?’ they may not be able to remember, but if you use prompts, like ‘I hear you went to the seaside with Valerie on Saturday, did you have a good time?’ it can spark memories.

Set up subtitles on their telly

Lots of older people struggle with technology. Setting up subtitles on their TV and any online streaming accounts can really help them.