25 April 2024

Leading academics call for more positive messaging on hearing loss and cognition

by Hannah Williams

Two audiology professors have called for a more considered response to the evidence linking hearing loss and dementia.

Kevin Munro and Piers Dawes, from the Manchester Centre for Audiology and Deafness, make the case for more positive messaging on hearing loss and dementia, in the Ear and Hearing journal.

On reviewing the literature, they say that, while there is growing evidence that hearing loss is a marker for dementia, there remain many unanswered questions about whether hearing loss causes dementia.

They also report that, given the robust evidence that hearing aids help reduce the impact of hearing loss and improve quality of life, it is difficult to conduct ethical and robust randomised controlled trials (RCTs) to prove that hearing aids can help stave off cognitive decline because this requires a control group being denied hearing aids.

Munro and Dawes caution that focusing on dementia might have other unintended consequences, setting out how "advocating the need to address hearing loss as a way of mitigating dementia may reduce the importance of addressing hearing loss in its own right" and that "linking hearing loss to dementia may exacerbate the stigma of hearing loss and discourage people from seeking help".

The review leads to the recommend that audiologists keep raising awareness about the prevalence of hearing loss and its impact on communication and quality of life. They conclude that the focus should be on "the proven benefits of hearing interventions rather than negative messaging about associations between hearing loss and dementia risk".

NCHA, the association for primary care audiology providers, also notes that sensory function has long been associated with better cognition and, if left unaddressed, reduced hearing can have a real impact on general health and wellbeing. For example, someone may begin by finding background noise difficult and start avoiding such situations, which might reduce their opportunities to socialise with family, friends and colleagues. This increases the risk of depression, social isolation and loneliness, which in turn may increase the risk of cognitive decline.

Harjit Sandhu, the NCHA's managing director, said "Professors Munro and Dawes are spot on about the evidence and how it will be difficult to prove for certain that hearing aids reduce the risk of dementia. The most important thing is that NICE has already reviewed the clinical and economic evidence for hearing aids."

Evidence shows that hearing aids are already one of the most cost-effective interventions on the NHS, which is why NICE recommends early diagnosis and support for all adults with hearing loss. Sandhu added: "It makes sense to address hearing loss as a key part of helping people to live and age well. We join the call for acting now and not waiting until we have more evidence on any causal relationship with dementia."