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Mature man with hearing loss

What happens when hearing loss is mistaken for cognitive decline?

I had a patient several years ago who came to me highly motivated to treat her hearing loss with hearing aids. As we were discussing her case history, she relayed a story about how she had recently been in the hospital. During her stay the hospital staff noted she did not always respond appropriately and that she had trouble following verbal instructions. They made the assumption that she had some form of cognitive decline and ordered testing. After discussions with her family, she immediately became aware that she was just not hearing what was being said. She called and made her hearing test appointment as soon as she got home from the hospital.  

In recent years untreated hearing loss contributing to cognitive decline has been a hot topic and rightfully so. What we don’t talk about often enough however is how hearing loss can be mistaken for cognitive impairment. I recently read some research* that looked at the effect of age-related hearing loss on cognitive test performance. The researchers found that the participants with hearing loss needed additional cognitive resources (more effort) just to take the test therefore there were less cognitive resources for the memory tasks and performance was compromised.  

In addition, Daniel J. Levitin, neuroscientist, cognitive psychologist, and author stated in his book Successful Aging “uncorrected losses to vision and hearing could account for 93 percent of variability in cognitive performance” in reference to “the sometimes poor performance of older adults on memory tests.” 

If you are unsure if a loved one has cognitive impairment or hearing loss, talk to his/her physician. Have both hearing and vision tested prior to administration of cognitive testing so that the results can be interpreted cautiously. If he/she is found to have significant hearing loss, it is advisable that any auditory test stimuli are at suprathreshold levels or that the patient is fitted with appropriate amplification prior to the test. It can also be important that the test environment is quiet. 

Talk to your loved ones about scheduling a hearing test appointment with an audiologist today.  

*On the Possible Overestimation of Cognitive Decline: The Impact of Age-Related Hearing Loss on Cognitive Test Performance by Christian Fullgrabe, School of Sport, Exercise, and Health Sciences, Loughborough, Loughborough, United Kingdom published in Frontiers in Neuroscience 09 June 2020