Warning: approaching elderhood conversation ahead. You’ve been warned.
One of the things I have become… well, not anxious about, exactly, but vigilant about, is my hearing. I know that a certain amount of degradation of my original acuity is to be expected, but I by-god want to know if I’m beginning to lose a meaningful amount of hearing. Because I’m convinced that, while loss of hearing doesn’t cause dementia, it’s a big contributor to the speed with which it can take over. So once a year I get my ears tested, and the minute it’s indicated, I want hearing aids.
Why? Aside from the obvious–I don’t want to be a person who trails around conversations saying “huh? Will you repeat that?” if I can avoid it–sound, and particularly speech, is one of the things that keeps me moored to the world. There are now a budget of studies that indicate that there’s a strong correlation between hearing loss and cognitive decline. Studies of older adults with hearing loss found that they had mental decline 30%-40% faster, on average, than those whose hearing remained intact.
Why? There are a number of theories. 1) Hearing loss increases isolation, which decreases stimulation. 2) When you experience hearing loss, more of your brain is put to work trying to process the sounds you do hear and make sense of it. And 3) there’s a sort of diminishing loop between the ears and the brain: if your ears don’t pick up as much sound, the auditory nerves send fewer signals to the brain, and the brain declines.
I have spent the last eight years or so watching my beloved aunt’s succumb to dementia. Among other things, by the time anyone really noticed the decline in her hearing and hearing aids were acquired, they were not a habit: someone else had to remind her to use them, they annoyed her, so she didn’t use them. As I write (sitting in my aunt’s room while she dozes nearby) I can see the hearing aids in their case–the batteries probably in dire need of recharging. I cannot think of a single time I’ve seen hear use them since they came home with her–it’s just not a thing that became routine (when she was still able to form routines). Whereas she will put on her reading glasses to spend time with the newspaper. Reading–and those glasses–define something for her about who she is, even now. The hearing aids do not.
So if, as seems likely, I will eventually need hearing aids, I want them early enough that putting them in becomes part of my routine. Also–I learned this from watching my father-in-law– once you have hearing aids you can deploy them to manage your surroundings. More than once when there was a family squabble, I saw him, smiling seraphically, reach up and turn his hearing aids off. Family strife? No problem, just tune out. I’d like to think I won’t do that, but having the ability to do it is kind of appealing.
While Medicare doesn’t pay for hearing aids, it does pay for audiology tests to see how good your hearing is. I did one several years back. I’m also now getting my ears cleaned regularly — a wonderful thing that will keep me from stuffed up ears, which I’m prone to and which lead to infections — so I expect my PA will remind me to see the audiologist again when it’s time.
Hearing loss is definitely connected to mental decline for all the reasons you mention. My father used them for years and was pretty used to them, but they were less effective after he got Alzheimer’s because adjusting them is such a personal thing — other people can’t do it for you — and he forgot how to deal with it. However, there is dementia and then there is mental decline has more to do with circumstances and other health issues; I suspect hearing aids will help stave off the latter if you develop the habit early on.
BTW, this isn’t just for us old folks: I know a lot of folks who got hearing aids in their 50s, some even in their 40s. We live in a noisy world and it damages our hearing. And we need it all the time. A year or so ago I was crossing the street in a crosswalk at night. Cars had stopped for me, but all of a sudden I heard a roaring engine and looked to my left. Someone had crossed to the wrong side of the street and was roaring straight toward me. I wouldn’t have looked (or stopped) if I hadn’t heard him.