Don’t ignore hearing loss: it could be linked to dementia

Just six per cent of us have had a hearing test in the past year, yet new research reveals tackling hearing loss could reduce our risk of dementia.

Are you always turning up the TV or asking people to repeat themselves? You’re not alone. The NHS says four in ten of us over the age of 50 and 71% of the over-70s have hearing loss.

The figures also reveal that 12 million people in the UK are affected, and that figure is expected to rise to 14.2 million by 2035. Yet, whether it’s pride, ignorance or a worry that hearing aids make us look older, many people still don’t get their hearing tested.

TV presenter Jeremy Clarkson recently revealed he’s been struggling with sounds for 12 years, but only got aids after learning that hearing loss can be linked to dementia.

We find out what the research says and whether getting your hearing tested could help you reduce your risk of dementia.

Older man hard of hearingCredit: Shutterstock/ A
There’s an estimated 12 million of us in the UK affected by hearing loss

There have been numerous studies all suggesting links between hearing loss and dementia.

Alzheimers Research UK says that people with unaddressed midlife hearing loss may be up to five times more likely to have dementia than those without.

But does wearing a hearing aid make a difference?  Research from the US, published in July, seems to suggest that it does.

Scientists found that improving hearing – including wearing hearing aids – slowed cognitive decline by 48% over three years among certain people in the study.

It’s an astonishingly high figure, but participants already had a three-times greater risk of dementia because they had multiple risk factors, including high cholesterol, high blood pressure and Type 2 diabetes.

However even if you don’t have ongoing medical issues, these findings add weight to other research suggesting that tackling hearing problems may contribute to a reduced dementia risk. A 2020 Lancet Commission report identified hearing loss as a risk factor for dementia, linked to 8.2% of cases.

Do hearing aids make a difference?

Co-author Professor Gill Livingston says, “Even if you don’t realise you’re losing hearing, or imagine it’s not affecting you, there is an excess risk of developing dementia. And the worse the hearing loss, the higher your risk.”

She cites a study published in April comparing the risks of developing dementia among three groups of people: the first without hearing loss, the second with hearing loss who wore hearing aids, and the third with hearing loss who didn’t use hearing aids. While the first two groups had the same risk of dementia, over time the third group had a 40% increased risk.

This study, too, comes with caveats. There was no objective measure of hearing ability among volunteers, and it only points to a correlation between hearing loss and dementia, which isn’t the same as a cause.

“It suggests that wearing hearing aids is highly protective but doesn’t prove it, as we don’t know why the third group weren’t using hearing aids,” says Tom Dening, professor of dementia research at Nottingham University, who is a hearing aid wearer himself.

“Perhaps they had other issues or types of hearing loss that don’t benefit from wearing aids.”

How does loss of hearing affect the brain?

How hearing loss affects your brain

1. Sensory deprivation

It used to be thought that social isolation was the main factor, but experts are now looking at other explanations, such as sensory deprivation.

“Hearing stimulates the brain so if you go to the shops and can’t hear what’s going on, you cut out an easy way of exercising your brain,” says Prof Livingston.

If the hearing parts of the brain aren’t receiving normal levels of input from the ears they shrink because they’re not being used.

2. Increases cognitive load

Research suggests that hearing loss may increase cognitive load; if the brain must focus more of its finite cognitive capacity on hearing, it leaves less bandwidth for other thinking tasks.

This may trigger changes in the brain that ultimately lead to dementia.

3. Inflammation

Another suggestion is that there is a common underlying cause of dementia and hearing loss, such as cardiovascular disease or inflammation.

It’s also argued that difficulties processing sounds in the brain may be an early manifestation of dementia; in other words, an effect not a cause.

A reluctance to wear hearing aids

Only 6% of people without a diagnosis of hearing loss have had a hearing test in the past year, in contrast to 53% who have visited the dentist, 46% who have had an eye test and 44% who have had their blood pressure checked, according to the RNID.

How to get your hearing tested

Take the first step to better hearing

The first step is to arrange a hearing test, which is free on the NHS, either via your GP or at certain high street audiologists, including Specsavers and Boots. When it comes to choosing hearing aids, private is not always better than NHS, according to Franki Oliver, audiology manager at the RNID.

“There is a perception that NHS hearing aids are beige, clunky, ugly and don’t work, but this isn’t true nowadays,” she says.

“They are the same as the mid- to high-range hearing aids in terms of sound quality. The same manufacturers supplying the private market also supply the NHS and many features previously available only privately, such as Bluetooth connectivity, are now available to NHS patients.”

What you’re likely to get by going private is a greater choice of styles and add-ons; and most are also rechargeable.

You can now check your hearing online, using headphones. Try the RNID test, which uses spoken numbers against a white noise background or Boots hearing test that uses different pitches of sound.

How much will a hearing aid cost?

It all depends on the model you go for

On the high street, Specsavers came out cheapest with an average price of £1,993 per pair, followed by Boots (£2,652), Amplifon (£2,675) and Hidden Hearing (£3,464).

It’s hard to be definitive on price as it will depend on the sophistication of the technology and what add-ons you choose.

Options include sound-filtering, rechargeability, Bluetooth connectivity and the ability to link to mobile apps, a smart watch or a TV/computer. Some providers bundle up the price of aids with the cost of appointments, aftercare and batteries, so always check the small print.

With any aid, you do need to be patient at first as your brain adjusts to hearing in this new way. And your hearing may continue changing as you get older so your aids may need modification or replacement.

“Most hearing aids have a useful life of a maximum of five years and on the NHS you would usually be due to have your hearing retested in three to four years and get an upgrade,” says Oliver.

A useful guide to hearing aids

A speaker in a case behind the ear channels sound into the ear via a thin, clear, flexible tube. It may be connected to a customised mould inside the ear (ear mould) or to a soft tip or dome (open-fit), which doesn’t block the ear, allowing you to hear certain sounds, such as low pitch noises, naturally.

Best for: Open fit, mild to moderate hearing loss. Ear mould is good for mild, moderate, severe and profound hearing loss. Open fits allow air to flow to and from the ear, so won’t give that ‘blocked’ sensation.

Available: On the NHS and privately.

Expect to pay: Privately, from £495 to £2,000+ for a pair from high street audiologists.

The most popular style on the market, these are similar to open-fit BTE aids but smaller. The main part of the aid (microphone and amplifier) sits behind the ear and is connected via a thin wire to a discreet receiver inside the ear canal.

Best for: Mild to severe (profound) hearing loss. Small size can be fiddly for arthritic fingers. May require more maintenance than others.

Available: Privately, and in some areas on the NHS.

Expect to pay: Privately, £995 per pair for the cheapest, but most £1,700+.

The microphone is within an ear mould created from an impression of your ear so the whole aid fits into the ear’s outer cavity. ITC versions are custom-made to fit into the opening of the ear canal and are only partially visible; ITEs are slightly more visible from the side.

Best for: Mild to severe hearing loss. May be unsuitable if you have frequent ear infections or particularly small ear canals. Volume controls can sometimes be fiddly.

Available: Privately, and occasionally NHS (for example, cancer treatment or congenital abnormality).

Expect to pay: Privately, the cheapest are around £1,000 per pair, but most £1,500-£3,000.

Visible if you look directly at the person’s ear canal opening but otherwise not. IICs are the smallest aids and the most discreet. They fit deeply in the ear canal and are often dark coloured so they are not easily seen.

Best for: Mild to moderate hearing loss. Their size may make them unsuitable for people with severe hearing loss. A good option for people looking for a discreet aid, although they can be fiddly and some can only be put in and taken out by a hearing aid specialist.

Available: Privately

Expect to pay: The cheapest around £1,000 per pair, but most £1,500-£4,000.

Written by Patsy Westcott