Do hearing aids help improve cognitive abilities?

There is an increased number of people with hearing impairment and decreased cognitive abilities among the elderly population. Due to the fact that the auditory system and central nervous system are connected, pathological changes associated with aging occur on both levels. With the development of hearing aid technology, the quality of life of these patients can be improved. The aim of this study was to determine whether wearing a hearing aid has an impact on cognitive abilities and tinnitus. Current research does not show a clear connection between these factors. This study involved 44 subjects with sensorineural hearing loss. They were divided into two groups of 22 people, depending on whether they had previously used a hearing aid or not. Assessment of cognitive abilities was performed via the MoCA questionnaire, and assessment of the impact of tinnitus on daily activities was evaluated using the Tinnitus Handicap Inventory (THI) and the Iowa Tinnitus Handicap Questionnaire (ITHQ). Hearing aid status was classified as a primary outcome, while cognitive assessment and tinnitus intensity were associated variables. Our study showed an association between longer hearing aid use and poorer naming ability (p = 0.030, OR 4.734), poorer delayed recall (p = 0.033, OR 4.537), and spatial orientation (p = 0.016, OR 5.773) when compared with patients who had not used hearing aids, while tinnitus did not correlate with cognitive impairment. Based on the results, we can emphasize the importance of the auditory system as an input source for the central nervous system. The data direct us to improve the rehabilitation strategies for hearing and cognitive abilities in patients. Such an approach results higher quality of life in patients and prevents further cognitive decline.

BackgroundSensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss.ObjectiveThis study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own.MethodsThis is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction.ResultsData analysis is currently under way and the first results are expected to be submitted for publication in June 2018.ConclusionsResults from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials.Trial RegistrationClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).

Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.

To summarize existing data on the interactions of cognitive function and hearing technology in older adults. A narrative review was used to summarize previous data for the short-term interactions of cognition and hearing technology on measured outcomes. For long-term outcomes, typically for 3-24 months of hearing aid use, a computerized database search was conducted. There is accumulating evidence that cognitive function can impact outcomes following immediate or short-term use of hearing aids and that hearing aids can impact immediate cognitive function. There is limited evidence regarding the long-term impact of hearing aids on cognition, and the most rigorous studies in this area have not observed a positive effect. Although interactions have been observed between cognition and use of hearing aids for measures obtained following immediate or short-term usage of hearing technology, limited evidence is available following long-term usage, and that evidence that is available does not support an effect of hearing aids on cognitive function. More research is needed, however, including rigorous studies of older adults following longer periods of hearing aid usage.

Background and Aim: Cognitive and auditory processing deficits are seen in older individuals with normal hearing sensitivity. Studies on older individuals with hearing impairment have assessed the cognitive function and correlated with hearing devices benefit. Since auditory processing can also affect speech perception abilities, and there is a possible relationship between cognition and some of the auditory processing abilities, it is essential to assess the relationship between auditory processing abilities and hearing aid benefit in naïve and experienced hearing aid users in older adults. Methods: Fifty individuals in the age range of 51 to 70 years with mild to moderate hearing loss participated in the study. There were 30 participants without any hearing aid experience and 20 participants with hearing aid experience for at least six weeks. Their auditory processing abilities were tested using gap detection test, duration pattern test, speech perception in noise, dichotic consonant-vowel test, masking level difference, forward and backward span tests. The hearing aid benefit was assessed using aided speech perception in noise measures and International Outcome Inventory-Hearing Aids questionnaire in Kannada. Results: Spearman’s correlation showed only correlation between auditory closure ability and binaural integration abilities with hearing aid benefit in experienced users. There was no correlation between any other auditory processing abilities and hearing aid benefit. Conclusion: There is a correlation between a few auditory processes and hearing aid use in elderly individuals with mild to moderate hearing loss. Keywords: Auditory processing abilities; hearing aid benefit; hearing aid users; working memory

PurposeTo examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons.MethodsHearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated.ResultsMost of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity – as determined by the fluid intelligence measure – was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered.ConclusionThe present study does not give evidence that hearing aid benefit is critically associated with cognitive function in experienced hearing aid users. However, it was found that lower fluid intelligence scores were related to higher hearing thresholds. Since greater hearing loss was associated with a greater objective benefit, these results strongly support the advice of using hearing aids regardless of age and cognitive function to counter hearing loss and the adverse effects of age-related hearing impairment. Still, individual cognitive capacity might be relevant for hearing aid benefit during an initial phase of hearing aid provision if acclimatization has not yet taken place.

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

Age-related hearing loss is one of the most prevalent health conditions among the elderly. Hearing loss may lead to social isolation, depression, and cognitive decline in older adults. The mechanistic basis for the association between hearing loss and decreased cognitive function remains unknown as does the potential for improving cognition through hearing rehabilitation. To that end, we asked whether the restoration of sensory input through the use of hearing aids would improve cognitive and auditory neural function. We compared a group of first-time hearing aid users with a hearing-matched control group after a period of six months. The use of hearing aids enhanced working memory performance and increased cortical response amplitudes. Neurophysiologic changes correlated with working memory changes, suggesting a mechanism for decreased cognitive function with hearing loss. These results suggest a neural mechanism for the sensory-cognitive connection and underscore the importance of providing auditory rehabilitation for individuals with age-related hearing loss to improve cognitive and neural function. Our findings of improved cognitive function with hearing aid use may lead to increased adoption of hearing loss remedies.

Untreated hearing loss can interfere with an individual’s cognitive abilities and intellectual function. Specifically, hearing loss has been shown to negatively impact working memory function, which is important for speech understanding, especially in difficult or noisy listening conditions. The purpose of the present study was to assess the effect of hearing aid use on auditory working memory function in middle-aged and young-older adults with mild to moderate sensorineural hearing loss. Participants completed two objective measures of auditory working memory in aided and unaided listening conditions. An aged matched control group followed the same experimental protocol except they were not fit with hearing aids. All participants’ aided scores on the auditory working memory tests were significantly improved while wearing hearing aids. Thus, hearing aids worn during the early stages of an age-related hearing loss can improve a person’s performance on auditory working memory tests.

PurposeOur study assessed the efficacy of the simultaneous use of hearing aids and auditory training for improving cognition and psychosocial function in adults with hearing loss, and the relationships between hearing loss, speech perception and cognition.Participants and methodsA 40-person (aged 50–90 years) pilot study in Melbourne, Australia, was conducted. Participants with hearing impairment completed the Geriatric Depression Scale-Short Form, questions about social activity participation, a wide range of cognitive tasks and a speech perception test at baseline, 3 and 6 months. Participants underwent auditory training for 6 months and used hearing aids for 3 months.ResultsCorrelations and structural equation modeling suggested that several cognitive domains were associated with speech perception at baseline, but only the Incongruent Stroop cognition measure was associated with hearing loss. Hearing aid use reduced problems with communication, but there were no significant improvements in speech perception, social interaction or cognition. The effect of hearing aids and auditory training for improving depressive symptoms was significant with a moderate to large effect size (Cohen’s d=0.87).ConclusionThe small sample size and a relatively high rate of attrition meant that this study was underpowered. However, baseline results suggested relationships between hearing loss, speech perception and cognition, and the hearing intervention provided evidence of reduced depressive symptoms. A full-scale, randomized hearing loss intervention and a longer neuroim-aging study with cognitive outcomes measured in the short term as well as after several years of hearing aid use are needed.