Study says central hearing loss may affect memory, also signal cognitive decline–an early indicator of possible dementia. Wake up, Medicare (and other insurers).

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The News:

Hearing loss is a common part of aging, but for some people, it may be a sign of far more serious neurological problems.

Researchers in Italy examined two types of age-related hearing loss, peripheral and central. They concluded that people with central hearing loss had a higher risk of mild cognitive impairment (MCI) than those with no hearing loss or peripheral hearing loss. Specifically, the study showed that the central hearing loss group, were twice as likely to have MCI as those with no hearing loss.

The findings mean such hearing loss is a harbinger of dementias, the largest disease component of which is Alzheimer’s.

Central hearing loss is caused by the brain’s impaired ability to process sound. Typically, people with this type of hearing loss can hear sounds, but can’t comprehend their meaning, according to Healthline. Study participants who had lower scores on a speech comprehension test also had lower scores on a test of thinking and memory skills.

“These preliminary results suggest that central hearing loss may share the same progressive loss of functioning in brain cells that occurs in cognitive decline, rather than the sensory deprivation that happens with peripheral hearing loss,” said study lead author Rodolfo Sardone of the National Institute of Health and University of Bari.

“Preventing hearing impairment with hearing aids early on could greatly reduce or delay the onset of cognitive neurodegeneration,” Sardone added. “To do this, we need to improve the assessment of hearing, improve hearing aids fitting, and decrease their costs.”

The study will be presented at the American Academy of Neurology (AAN) 2018 Annual Meeting in Los Angeles.

“The central deficit manifests only in situations of competitive signals like another speaker or background noise,” explained Sardone. “It is a deficit linked to hearing perception rather than to hearing sensation.”

Researchers targeted MCI, said Sardone, because “it’s considered a preclinical phase of dementia, and we’re interested in exploring the onset of neurodegeneration.” All neurologic assessments were carried out by a clinical neuropsychologist and validated by a neurologist, said Sardone.

Of the total study participants, 25.5% had peripheral presbycusis and 12.1% had central presbycusis. This percentage of central hearing loss is “in line with” findings of other studies, including cohorts of the Framingham Heart Study, said Sardone. About a third (33%) of study participants were diagnosed with MCI. (Ref: Medscape)

Steve’s Take:

If you fear you’re going to spend your “golden years” with a hand cupped behind your ear, saying “Eh, pardon me, say again?” you have reason to worry.

And some younger people may be joining you.

According to a study in JAMA Otolaryngology last year, hearing loss is expected to nearly double in coming decades, Healthline reports. Put another way, that means the percentage age of adults who have hearing loss will rise from 15% to 22%. That’s a jump from 44 million in 2020 to 73 million in 2060.

Adele Goman, PhD, a postdoctoral research fellow at the Johns Hopkins Center on Aging and Health in Maryland, is one of several scientists who analyzed audiometric data from the latest National Health and Nutrition Examination Survey. That’s a biannual epidemiologic survey of a representative sample of the US noninstitutionalized population.

“Last year we estimated how common hearing loss is across different age groups and how many adults have hearing loss today,” Goman told Healthline.

The study was supported by grants from the National Institutes of Health and by the Eleanor Schwartz Charitable Foundation.

“We did not know the number of adults that are expected to have hearing loss in the coming decades,” Goman said. “This is important to know in order to appropriately plan for future hearing healthcare needs.”

Since the number of adults with hearing loss is expected to increase in the coming years, demand for audiologic services will increase as well. More than two-thirds of adults 70 years or older in the US will have clinically meaningful hearing loss.

“Audiologic healthcare services encompass a range of options including aural rehabilitation, hearing aid fitting, hearing screenings and referrals, hearing aid testing, and novel approaches to hearing healthcare,” said Goman.

The study JAMA study concludes that hearing loss is a major public health issue independently associated with higher healthcare costs, accelerated cognitive decline, and poorer physical functioning.

That’s not any surprise to Barbara Kelley, whose position as executive director of the Hearing Loss Association of America puts her on the front lines.

“We’ve always known hearing loss is a primary health concern,” Kelley told Healthline. “When you have one health problem, you probably have others.”

She noted that people with hearing loss have more falls than those not affected.

It is thought that some aspects of hearing loss are due to aging, she said.

“But we don’t know if that’s due to exposure to too much noise. It may be a co-morbidity factor. Remember all those warnings about loud rock music that went in one ear and out the other, so to speak?”Kelly said.

If you leave a concert with ringing in your ears, for example, that’s a sign that some cells in your ear have died. And they stay dead forever.

Today, a hearing aid might cost $4,000 and it’s not covered by most insurance carriers. Kelley said the Food and Drug Administration (FDA) has suggested a new category of over-the-counter devices. It would be a first step into amplification devices.

Steve's Take: Now that we have proof of the correlation between #hearingloss and #dementia, #Medicare should be reformed to pay for it Click To Tweet

One new device uses “smart buds” controlled by your smart phone. Kelly said the high-tech format might be popular with aging baby boomers who say, “I don’t need a hearing aid. That’s for old people.”

“The hearing aid market has a low volume, high cost model,” Kelley said. But that could change. “We’d love to see Medicare cover hearing loss,” Kelley said.

When Medicare was established in 1965 its intent was to focus on life-threatening issues. Hearing loss, vision, and dental care were specifically excluded, and it would take an act of Congress to reverse that.

“That’s a hard nut to crack,” Kelley admitted.

She’s right about that, but now we have proof of the correlation between hearing loss and dementia.

One would suppose that with dementia looming for our elected legislative reps as well as the rest of us, isn’t it time to expand coverage for a hearing loss that, when successfully addressed with an aid, can slow or even prevent the onset of dementia?

Naturally, insurers aren’t going to cover a hearing aid if they lose money doing so. But on the other hand, think about all the medical costs hearing loss can lead to.

Here are some sobering facts:

1) According to the Alzheimer’s Association’s Facts and Figures report, an estimated 45% of American seniors 85 and older suffer from Alzheimer’s, and one in eight people aged 65 and over (13%) has Alzheimer’s disease. It is the most common cause of dementia among older adults.

2) One in three seniors dies with Alzheimer’s or another dementia.

3) In 2017, Alzheimer’s and other dementias cost the nation $259 billion. By 2050, these costs could rise as high as $1.1 trillion—with a “t.”

Wake up, Medicare (and other insurers). You do hear us, eh?

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