“What did you say?” she asks across the table. “Did you say cheese and muffins?”
“What?” I laugh. “Cheese and muffins? No, I didn’t say that. I was talking about the car and its muffler.”
“Oh, I thought you said cheese and muffins,” Mom says, and then she laughs too.
Mom often mishears what we say then demands to understand what we are talking about. She wants to be included in our conversations, though they are mostly over her head. Her misinterpretations generate laughs and remind me of Telephone, that long-ago game we played where players line up to repeat a whispered phrase that always becomes garbled by the time it reaches the last player.
Is hearing loss associated with dementia? What does it mean to hear normally?
Research as early as 1986 studied hearing loss in 30 institutionalized patients who were diagnosed as having senile dementia and found that 83% had hearing loss that exceeded 25 dB HL, a significantly higher percentage than a comparable random sample of patients without dementia.*
Clinicians measure sound intensity in dB HL (decibels Hearing Level), meaning decibels relative to the quietest sounds that a young healthy individual ought to be able to hear. Normal hearing ranges from 0 to 20 dB in all frequencies.
What was unusual about this study is that 10 of the subjects, or 33%, were reclassified to a less severe category of dementia when their scores on the standardized mental health exam improved through the use of hearing aids and other amplifications.
Hearing loss, it seems, was responsible for misdiagnosis, and when their hearing improved, their dementia diagnosis was downgraded.
A number of recent studies out of Johns Hopkins University found that hearing loss is associated with accelerated cognitive decline in older adults and that seniors with hearing loss are significantly more likely to develop dementia over time than those who retain their hearing. A third study revealed a link between hearing loss and accelerated brain tissue loss. Researchers found that for older adults with hearing loss, brain tissue loss happens faster than it does for those with normal hearing.**
Meaning, it’s not dementia that is causing hearing loss, but hearing loss may cause dementia. The tail, in effect, is wagging the dog.
Scientists are still sketchy as to why hearing loss may bring on dementia, but the evidence that it does happen is documented.
We don’t actually hear with our ears, we hear with our brains. And even with mild hearing loss, the brain will reorganize its pathways to compensate, possibly impacting synapses to memory and cognitive function. The strains of decoding sound may leave us vulnerable to dementia.
According to current statistics, hearing loss affects 14% of people aged 45-64; 33% of people over the age of 65; and 67% of people over the age of 75.*** It may be possible that interventions like professionally fitted hearing aids could delay or prevent dementia. While that is anecdotal, I advise you to check your hearing! Be proactive about using hearing aids if you have even mild hearing loss.
As for Mom, her Alzheimer’s is bringing about a general decline in all her functions. It may be too late to prevent hearing loss, but there are still things we can do to help her. If we can get her to sit and participate in a hearing test, we could determine the extent of her hearing loss. We might even be able to introduce hearing aids if she’ll accept them. If she won’t, there are a few basic ideas that may work.
Talk facing her so that she can see our lips move so as to better understand us.
Eliminate background noise as much as possible.
Speak slowly and enunciate.
Use hand gestures and other signs that may convey what we mean.
And when all else fails, we’ll laugh as much as possible over misheard words.
There are funny homonyms in Hebrew that are sure to mess you up in general conversation. For example, the word for womb, rechem, sounds an awful lot like the word for car, rechev. I was once on a bus with another new immigrant who asked me why the radio ad for a specific mechanic was talking about women’s body parts. Yes, it happens to the best of us. For me, one of the hardest word-pairs to remember is lentils, adashim, versus contact lenses, adashot. I can assure you that when I made these lentils, I had my glasses on.
Lentil Spinach Dish
Lentils are a good source of fiber, iron and protein. And a healthy alternative to meat and chicken.
1 cup brown lentils
2 cups water
1 large onion, chopped
2 Tbsp olive oil
2-3 cloves garlic
1 200 gr bag spinach
1 tsp cumin
Salt and pepper to taste
Warm lentils in 1 Tbsp olive oil, add water and cook until water evaporates. Set aside. In another pot, sauté garlic and onion in remaining oil. When onions are browned, add spinach and spices. Cook for about five minutes. Add cooked spinach to lentils. Serve on a bed of rice.
*Weinstein, BE, Amsel, L (1986). Hearing loss and senile dementia in the institutionalized elderly. Clinical Gerontologist, 4: 3-15.
**http://www.hearingreview.com/2016/09/world-alzheimers-month-hearing-loss-linked-impaired-memory/ and https://www.webmd.com/healthy-aging/news/20110214/hearing-loss-may-be-linked-to-alzheimers#1