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Hearing loss, even when mild, associated with mental retardation in the elderly

By Linda Carroll

(Reuters Health) – A slight decrease in hearing, less than the usual interruption of the diagnosis of hearing loss, is associated with a measurable mental decline in the elderly, according to a new study.

When researchers used a stricter threshold to include mild hearing loss, they found evidence that a well-established relationship between age-related hearing loss and cognitive decline could begin earlier than acknowledged, according to the report in JAMA Otolaryngology-Head & Neck Surgery

elderly people who had hearing problems at a more sensitive threshold would be considered to have normal hearing according to the current standard of hearing loss diagnosis: 25 decibels, the researchers note. But when the threshold was set at a hearing loss of just 1

5 decibels, comparable to the volume of whispers or rustling of leaves, some of the elderly had hearing problems.

These people also had a "clinically significant" cognitive decline, i.e.

Some scientists suspect that hearing problems can lead to thinking problems because the brain has to redirect so much attention to hearing that it cannot exercise other psychic functions.

"People with worse hearing use so much more brain power to decode spoken words; they cannot process the meaning of what is said, which is an intellectually stimulating part," says study lead author Dr. Justin Golub. Assistant Professor at the Department of Otolaryngology-Head and Neck Surgery at New York Presbyterian / Columbia University Irving Medical Center in New York.

Dove compares brain fitness to physical fitness. If runners had to think about how to take each step, it would not be very fast, he explained. Similarly, parts of the brain involved in complex thinking do not receive as much "exercise" when more resources are devoted to decoding words in conversation.

Beyond this, it has been shown that "hearing impaired people socialize less – because it is difficult – and thus have less intellectually stimulating conversations," said Golub. "The brain is like a tool that needs to be maintained."

For the new study, Golub and his colleagues analyzed information from the Spanish Community Health Study (HCHS) and the National Health Survey. health and nutrition (NHANES), both containing data on participants who were given both auditory and cognitive tests.

Researchers focus on participants in HCHS who were 50 or older and who did not develop early-onset hearing loss and those in NHANES who were between 60 and 69 years of age. This gives them a total of 6,451 people in the analysis, with an average age of just over 59 years.

After considering demographic and cardiovascular risk factors – both of which could affect the likelihood of developing cognitive problems – researchers have found that decreased hearing ability is associated with poorer cognitive performance.

"People who have a hard time hearing whispers (but technically I still had normal hearing) scored 6 points worse on the speed and attention test than people who had absolutely perfect hearing," Golub says in an email. "This took into account other factors, such as age. Researchers say a 6-point change can make a significant difference in daily function. "

The study is not intended to examine how hearing loss can directly affect cognitive decline, researchers admit.

Still, Golub suspects that people may be more psychologically sharp if they start wearing hearing aids as soon as they even have mild hearing problems.

In fact, he said, "we are currently conducting a randomized controlled trial treating one group of hearing impaired people and comparing them with a group without treatment. We will see if in a few years the people with hearing aids will be cognitively more severe."

Golub and his colleagues looked at something other researchers had not considered: the possible impact of mild hearing loss on knowledge, said Dr. Maura Cosetti, an assistant professor at Icahn Medical School and director of Cochlear Impl

. said Cosette, researchers are increasingly wondering "whether to cure hearing loss can we improve our knowledge or at least stabilize the rate of decline. The answer seems to be yes, but it is too early to say. "

Unfortunately, many people who have developed hearing problems do not want to use a hearing aid," Cosetti said. "It's something innate in our culture," she added.

SOURCE: https://bit.ly/33ZACA4 and https://bit.ly/2OpIy7x JAMA Otolaryngology-Head & Neck Surgery, online November 14, 2019

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