Audiology

Communication Training: Hearing Aids & Brain Health

Welcome to another post providing an overview of our Communication Training Series! Today, we wanted to talk about hearing aids and brain health. As you already know, hearing devices are only a small part of the communication puzzle. So we’re going to learn more about that today. We also wanted to discuss the important connection between your hearing and brain health. New studies are uncovering some remarkable findings.

Hearing Aids: What to expect

Wearing hearing devices isn’t a matter of getting them fitted, and then you have 100% restored hearing. Like with most worthwhile things in life, it takes time to get used to, and practice. Hearing aids need to be accepted by your brain. So it’s important to be kind and compassionate with yourself as you go through this transition period. Here’s what we know to be true:

  • It will take time to adjust to hearing aids and to realize their full potential.
  • Some sounds may be strange initially, including footsteps, birds chirping, and paper rustling.
  • Hearing in quiet will always be easier than hearing in noise.
  • Soft speech should be audible, conversational speech comfortable, and loud speech not uncomfortable.
  • No whistling should occur if the hearing aids are seated properly.
  • Your own voice may sound different when you are wearing hearing aids.
  • Talking on the phone may feel awkward at first as you experiment with proper phone placement and different technology options.
  • It is absolutely necessary to return to your hearing care provider for follow up visits and fine-tuning adjustments to the hearing aids.
  • Treat yourself to easy listening situations (one-on-one conversations in quiet environments) during the first few days or weeks with the hearing aids as your brain adjusts to hearing again.
  • You will experience maximum benefit and success with your hearing aids if you wear them every day and follow the strategies taught in this program!

We hope that these simple tips will help on the road to success with getting comfortable with your hearing aids. Of course, should you have any questions, that’s what we’re here for. Give us a call, and we’ll do all we can to help!

Hearing & Brain Health

Treating hearing loss is more about ensuring you are able to hear. New research is showing a strong link between untreated hearing loss and dementia. Studies are showing that when we leave hearing loss untreated, a part of our brain stops receiving auditory input. With lack of activity in the brain region, it becomes weak, just like other muscles in our body, if we don’t use it, we lose it.

Other research shows that many people with untreated hearing loss tend to isolate themselves in order to avoid the frustration of not being able to hear. Unfortunately, social isolation is also linked to an increase in dementia.

The good news is, if you’re reading this right now, you’re already on the right path by actively treating your hearing loss with auditory rehabilitation. Whether you are wearing hearing aids, have a cochlear implant, or are getting your hearing tested for the first time, you’re on the right track! Pair that with our Communication Training program, and you’re setting yourself up for success while keeping your brain healthy and strong.

Somatic Tinnitus: An Overview

As we know, tinnitus (ringing in the years) is the perception of a sound that has no external source. Somatic (or somatosensory) tinnitus happens when somatosensory (pressure, pain, or warmth) messages from the cervical spine or jaw area causes or changes the way a patient experiences tinnitus. In fact, a study from 2009 found there could be a link between tinnitus and musculoskeletal disorders. It was shown that the presence of joint stiffness, or myofascial trigger points, can cause somatosensory changes to the area around the ear, which may create the perception of a ringing in the ears.

Our friends over at Mend compiled a list of common musculoskeletal impairments that can be associated with tinnitus, they are:

  • Stiffness or hyper-mobility of cervical spine joints
  • Myofascial trigger points to the sub-occipitals, upper trapezius, levator scapulae, or sternocleidomastoid muscles
  • TMJ disorders
  • Presence of forward head posture and forward rounded shoulders

What to do if you think you have tinnitus

If you think you may be experiencing somatic tinnitus, worry not, we’ve got you covered. The best treatment for tinnitus starts with a tinnitus evaluation and consultation with us. At Longmont Hearing and Tinnitus Center, we will conduct a comprehensive evaluation to determine whether or not you are experiencing tinnitus. If we find that you do have tinnitus, we can help! First of all, it’s important to understand that tinnitus is not a disease, but a symptom of a more serious disorder. That’s why it’s important to try to find the medical cause before deciding on treatment. But first, let’s determine whether you have tinnitus in the first place, and we can take it from there.

If you are diagnosed with tinnitus and you are also suffering from one of the musculoskeletal impairments above, physical therapy may help reduce or eliminate the perception of tinnitus. There is strong evidence to support the use of physical therapy to treat somatic tinnitus that is of musculoskeletal origin. The therapists over at Mend are trained in differential diagnosis, which means they can accurately screen you to give you the right referral for treating whatever ails you.

And here at Longmont Hearing a Tinnitus Center, after diagnosis, we can also help you by providing you with tips for how to prevent or minimize tinnitus, like tinnitus retraining therapy, acoustic therapy, music therapy, amplification, and much more! We know that tinnitus can be cumbersome and hard to live with, so don’t delay! Reach out to us today so that we can help get your tinnitus under control!

Could your hip implant be causing your hearing loss?

Over the years, researchers have discovered that metal hip implants can cause hearing loss, tinnitus, and balance issues. Though the presence of any hearing loss may not be immediately apparent, after some wear or corrosion of the chrome or cobalt hip implants, individuals may experience damage in the auditory system.[i]

Let’s break it down

Now, even though the metal is localized in the hip, as time passes, small metal ions can travel into the blood stream from the hip implant and cause problems in other parts of the body, such as, the cardiovascular system, visual system, motor-sensory system, and the auditory system.[ii] As if that’s not enough, some patients have also reported issues with their psychological function and immune system.

At Longmont Hearing and Tinnitus Center, we take your overall health into consideration when you come in for a hearing evaluation. We take the time necessary to get a thorough health history before we even start your hearing evaluation. We believe it’s important to take all aspects of an individual’s lifestyle into consideration so we can get a more complete picture of what is truly going on. Did you know that hearing loss isn’t only caused by aging? It’s also been associated with diabetes, hypertension, cardiovascular disease, and ototoxic medications.

If you have a metal hip replacement, be proactive! It’s a great idea to get a baseline hearing evaluation. That way, if changes occur over time, they can be accurately tracked. Also, if you are experiencing any signs of hearing loss, like trouble hearing in noisy environments, asking for repetition often, or having trouble with the clarity of speech, don’t delay—get a hearing evaluation now! Early detection and intervention for hearing loss is key.

Take Charge

If you have a cobalt-chromium hip implant, educate yourself on the potential long term issues, and be sure to speak to your primary care doctor if you have any concerns. And of course, we’re audiologists who are here to help! If you have any questions about hearing loss or suspect that you may be suffering from hearing loss, do not hesitate to give us a call at 303-651-1178 to schedule an appointment.

Now that you know that hip implants can cause hearing loss, what can you do? While the not all patients with hip implants experience hearing loss, it is a possibility. The important takeaway is that you can be proactive and take steps to keep your hearing health in check. Reach out to us for anything, whether to make an appointment, to set up a hearing evaluation, or for help with your hearing aids.

[i] J. B. Leikin, H. C. Karydes, P. M. Whiteley, B. K. Wills, K. L. Cumpston & J. J. Jacobs (2013) Outpatient toxicology clinic experience of patients with hip implants, Clinical Toxicology, 51:4, 230-236.

[ii] Gessner, Bradford D. MD, MPH*; Steck, Thomas BS†; Woelber, Erik MSc†; Tower, Stephen S. MD‡ A Systematic Review of Systemic Cobaltism After Wear or Corrosion of Chrome-Cobalt Hip Implants, Journal of Patient Safety: June 2019 – Volume 15 – Issue 2 – p 97-104.

COVID-19: No Impact on Hearing Loss

Throughout this pandemic, we’ve seen countless headlines about how COVID-19 impacts individuals differently. From asymptomatic patients, to those who may suffer from long-term effects like the permanent loss of the sense of smell. Early on, one of those speculations had been about whether the COVID-19 virus has any effect on hearing loss, and it was largely debated. Good news: Studies show that COVID-19 has no permanent impact on hearing loss.

Researchers in Israel decided to investigate this question back during the first wave of the pandemic, when the number of patients infected with the virus was relatively small. They were trying to determine if hearing loss while infected with COVID-19 was caused by actual damage to the auditory system, or if it was more like the temporary symptoms of a common cold, with fluid clogging the middle ear. 

In this small study, investigators tested 8 asymptomatic individuals who tested positive for COVID-19 and 8 healthy volunteers who served as a control group. All participants reported no prior hearing loss. The study provided for the first time quantitative measures for hearing quality following exposure to the virus. “Our study explored whether COVID-19 can cause permanent neural or sensory damage to the hearing system. We found no evidence for such damage,” said co-author Dr Amiel Dror of the Galilee Medical Center and the Azrieli Faculty of Medicine at Bar-Ilan University. 

At this stage, according to Dror, their study showed COVID-19 has no impact on hearing loss. This was determined by measuring electrical data from the brainstem to test the route of the soundwaves through the ear until these electric waves were finally received in the brain. They also examined the activity of the inner ear hair cells. Based on their findings, they concluded there was no difference between COVID-19-positive subjects and the control group.

Co-author Dr Eyal Sela of the Galilee Medical Center and the Azrieli Faculty of Medicine at Bar-Ilan University concludes, “This study proposes that the COVID virus does not cause extensive neurological damage but is rather spotty, mostly affecting the sense of smell. Moreover, the hearing impairment among some patients is mostly transient and secondary to fluid buildup in the middle ear, as for the common cold, and therefore likely passes once the acute disease is over.”

It’s important to remember that science and research is ongoing, ever-changing, and always being updated. The researchers are currently conducting a much more comprehensive study with hundreds of patients, including persons who had been severely ill and even ventilated. Let’s hope their results continue to show no permanent hearing loss due to COVID-19—we’ll keep you posted as soon as we hear more!

For now, know that all of us here at Longmont Hearing and Tinnitus Center are here to provide you with the hearing support you need. Whether you need to be fitted with new hearing aids, an earwax cleaning, or have questions, reach out! Give us a call to make an appointment or to ask us any questions. We look forward to hearing from you!

The Link Between Hearing Impairment and Diabetes

As you may know, many health conditions—like hearing impairment—are linked to each other in some way, and knowledge of these connections is vital in helping diagnose, treat, and manage certain conditions, like diabetes. Until recently, hearing loss had not been linked to diabetes in any way. But that has finally changed. The American Diabetes Association (ADA) has recognized hearing loss as being more common in people with diabetes. With this recognition, the ADA has now added audiology to its table on referrals for initial diabetes care management in its recent updated Standards of Medical Care in Diabetes-2021 published in the January 2021 edition of Diabetes Care, the organization’s magazine.

For audiologists everywhere, this is big news. In fact, the inclusion of the link between hearing impairment and diabetes is a significant victory not only for hearing healthcare as a whole, but specifically for the executive director of The Audiology Project, Kathy Dowd AuD. The Audiology Project promotes audiology-based medical management for chronic diseases, and in recent years, they focused much of their effort on educating stakeholders in diabetes about the links between the disease and hearing loss.

The ADA document addresses the link between hearing impairment and diabetes twice in their document, below is an excerpt:

Hearing impairment, both in high-frequency and low- to midfrequency ranges, is more common in people with diabetes than in those without, with stronger associations found in studies of younger people. Proposed pathophysiologic mechanisms include the combined contributions of hyperglycemia and oxidative stress to cochlear microangiopathy and auditory neuropathy. In a National Health and Nutrition Examination Survey (NHANES) analysis, hearing impairment was about twice as prevalent in people with diabetes compared with those without, after adjusting for age and other risk factors for hearing impairment. Low HDL cholesterol, coronary heart disease, peripheral neuropathy, and general poor health have been reported as risk factors for hearing impairment for people with diabetes, but an association of hearing loss with blood glucose levels has not been consistently observed. In the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort, time-weighted mean A1C was associated with increased risk of hearing impairment when tested after long-term (.20 years) follow-up. Impairment in smell, but not taste, has also been reported in individuals with diabetes.

This sort of knowledge is crucial in helping all of us in the health care industry to provide the best in care. If you believe you are suffering from hearing impairment, whether you are diabetic or not, we can help! Reach out to us to ask any questions, book and appointment, or to schedule a time for hearing aid maintenance. As always, our goal is to help you in any way we can.

New Technology Could Measure Tinnitus in Patients

It is estimated that 32% of the U.S. population suffers from tinnitus— the perception of a sound that has no external source. Most patients report they hear a ringing, humming, buzzing, or cricket-like sound that can be constant, intermittent, heard in one ear, both ears, or in the head. Needless to say, it’s uncomfortable, widespread, and difficult to care for because tinnitus is a symptom, not a disease. This means most attempts to address the issue do not cure the actual disease, but rather, alleviates the symptom. However, there may be hope on the horizon.

According to a new study published in November 2020, a technology called functional near-infrared spectroscopy (fNIRS) can be used to objectively measure tinnitus, or ringing in the ears. This is a huge achievement, as to this day there has been no clinically used, objective way to determine the presence or severity of the condition.

How it works

Researchers turned to fNIRS, a non-invasive and non-radioactive imaging method which measures changes in blood oxygen levels within brain tissue.

– By using fNIRS, the study team was able to track different areas of the brain’s cortex known to be linked to the condition.
– Researchers collected data from 25 patients with chronic tinnitus, and 21 people were used as controls (who do not have tinnitus) that matched the 25 patients in terms of age and level of hearing loss.
– Patients were asked to rate the severity of their tinnitus using the Tinnitus Handicap Inventory.

The fNIRS revealed some very interesting findings! Results showed a statistically significant difference in the connectivity between the areas of the brain in people with and without tinnitus. In addition, it was found that the brain’s response to both visual and auditory stimuli was lower among those with tinnitus. Researchers applied machine learning to the data they collected, and the program they used was able to differentiate between patients with mild tinnitus from those with moderate to severe tinnitus with an 87.32% level of accuracy. For a condition that until recently wasn’t even accepted by all audiologists, this is a huge accomplishment!

What this means

We’re so thrilled about these findings, and cannot wait until this technology becomes widespread. But we have to emphasize that that day has yet to come. For now, these are the early stages, and this technology is not available at doctor’s offices. This is but the first step of many, and it is a crucial one! Once this technology is further tested, improved, and approved, we can then hope to see them distributed to hearing care centers, like Longmont Hearing and Tinnitus Center.

Until then, all of us at Longmont Hearing and Tinnitus Center are dedicated to giving you the treatment you need. We are skilled at the screening and treatment of tinnitus, and are here to help. If you or a loved one is suffering from tinnitus, don’t wait, let us help! Make an appointment with us, and let’s see what we can do to provide you with relief.

Toys May lead to Hearing Loss in Children

Wow! It’s almost impossible to believe the holidays are upon, and yet, here we are, it’s December! Many of us celebrate the holidays with gift-giving, and this year shopping may be a little different. With COVID-19 still keeping us primarily at home, many will have to stick to online shopping to get gifts for their loved ones.

Hearing Loss in Children

Though it’s difficult to believe, there are certain toys out there that are too loud, and they run the risk of damaging your child’s hearing. That’s why the Arizona Commission for the Deaf and the Hard of Hearing (ACDHH) recently tested and released a list of 2020’s hottest toys to avoid. These are toys that reach a sound level of 85 decibels (dB) or higher. According to the American Speech-Language-Hearing Association, 85 dB is the maximum volume a child should be exposed to for no more than eight hours a day. Sounds louder than 100 dB can lead to hearing loss in children in less than 15 minutes. With online shopping on the rise, it’ll be harder and harder for parents to test toys out before their purchase, but the ACDHH is here to help. Read on for a list of toys they recommend as well as those to avoid.

Did you know?

Noise is the number one cause of hearing loss in children. Nearly 15 percent of children between the ages of 6-19 have some degree of hearing loss. Loud noises can increase fatigue, decrease a child’s ability to pay attention, and reduce short term memory. It’s not a great combination. That’s why the ACDHH spent time this year examining this season’s most popular toys, chosen at random, to provide parents with guidance this holiday season. Each dB measurement was taken as if the child placed their ear next to the speaker. If your shopping list includes toys for the children in your life, you may want to consider turning down the volume on these toys:

Toys to Avoid listed in highest dB order:
  1. Leap Frog Scrub and Play Smart Sink: 103 dB
  2. Vtech Turn & Learn Driver: 101 dB
  3. Fisher Price Sing & Learn Music Player: 98 dB
  4. Leap Frog 100 Animals Books: 98 dB
  5. Nickelodeon Baby Shark Musical PlayPad: 98 dB
  6. Jada Police Hero Patrol Lights & Sound 95 dB
  7. Leap Frog Fridge Phonics: 94 dB
  8. Vtech Helping Heroes Fire Station: 93 dB
  9. Adventure Force Mighty Dragon: 92 dB
  10. Leap Frog 100 Words Book: 92 dB
  11. Vtech Peppa Pig Learn & Discover Book: 91 dB
  12. Vtech Brilliant Baby Laptop: 90 dB
  13. Vtech Magic Star Learning Table: 89 dB
  14. Fisher Price Leave a Message Smart Phone: 89 dB

The ACDHH also created a list of toys they encourage parents to purchase (the list is not all-inclusive).

List of Safe Toys under 85dB listed by age:
  1. Leap Frog Learn & Groove Caterpillar Drums: 80 dB
  2. Leap Frog Pick Up & Count Vacuum: 78 dB
  3. Vtech Care for Me Learning Carrie: 75 dB
  4. Vtech Drop & Go Dump Truck: 75 dB
  5. Vtech Bright Lights Soccer Ball: 70 dB
  6. B. Toy Critter Clinic: No sound
  7. Melissa & Doug Ice Cream Counter: No sound
  8. Melissa & Doug Dust Sweep Mop: No sound

When buying toys for your children, it’s important to think about how the child will use the toy. More often than not, children may choose to hold the toy close, versus at arm’s length, which can be risky. Another consideration is what other sounds may be present at the time of play. Perhaps there’s a television on, other children they’re playing with who are yelling, or other loud toys they may not be interacting with. All of these sounds can add up, and ultimately lead to hearing loss in children.

If you’d like to conduct your own decibel test, there are a few applications you can download on your smartphone to test sound levels of toys you’re considering purchasing or already bought:

A few suggested dB testing apps from a healthyhearing.com report:
  • Apps for both Android and iOS
    • Decibel X
    • SPL Meter
    • Too Noisy Pro
  • Apps for iOS only
    • NIOSH Sound Level Meter
    • SPLnFFT Noise Meter
  • Apps for Android only
    • Sound Meter Pro
    • Sound Meter and Noise Detector

Simple test methods to ensure toys won’t hurt young ears: 

  • Use ‘try-me’ buttons on the toys when available
  • Hold the toy as close to your ear as your child would and ask yourself if the toy is too loud
  • Hold the toy eight inches away from your ear (approximately the length of your child’s arm), and if you must speak at a higher volume above the sound effects, it’s too loud

How to keep the volume down on loud toys:

  • If the toy has volume control, ensure it’s always set to the lowest level
  • Put waterproof tape or super glue over speaker to mute it
  • Put tape over volume control to prevent your child from increasing the volume to unsafe volume level

As always, our priority is your well-being. If you think your child may be suffering from hearing loss, or perhaps you, be sure to make an appointment with us. We’re practicing all social distancing safety measures, and are here to help with all your auditory needs. Give us a call to set up an appointment, or to ask any questions. We’re here for you!

Surgical Masks and Hearing Loss: COVID-19

Wow! It’s December already, and though we’re past 8 months into the COVID-19 pandemic, we’re still learning something new each day. We wanted to share new data that shows how surgical masks degrade speech quality, affecting those with hearing loss the most. Recent studies show mask use can render speech close to unintelligible for many patients with hearing loss.

What’s Up, masks?

The COVID-19 virus has definitely had an impact on clinician-patient communication, especially fo those with hearing loss. In fact, the trajectory of hearing loss and the infection fatality by age distribution tell a very important story, one we may not have thought of. Many of the people who have fallen victim to the virus and have been hospitalized are older adults, which coincidentally means many of them suffer from hearing loss. These patients tend to be unaccompanied by family members, are frail, have a variety of chronic conditions, and are likely there without any hearing assistance. 

Therefore, their struggle to understand speech is further exacerbated by the use of masks, which of course are a necessity to help minimize the spread of the virus. Surgical mask use presents two challenges for patients with hearing loss when it comes to speech comprehension:

1: The patient can’t facilitate comprehension by lip-reading
2: The healthcare provider’s voice is muffled and distorted

The data we’re referencing comes from a study that focused on how masks distort sound.

How Does a Surgical Mask Impact the Speech Signal?

The study used a GRAS head and torso simulator to play white noise through an artificial mouth, with a mask on, and the output acoustic signal was measured by a microphone 2 meters away. There were 4 different masks used for this study:

The study found that all surgical masks types essentially worked as a low-pass filter. This means the masks ended up reducing high frequencies spoken by the wearer, with the decibel (dB) level of attenuation ranging from 3-4 dB for a simple mask, to close to 12 dB for the N95 masks. Basically, mask use led to speech quality degradation, especially when in combination with room noise/reverberation and the absence of visual cues, and it renders speech close to unintelligible for many.

Addressing the Issue

Because of this, the use of effective communication strategies becomes more important than ever. Here are a few ways that patients with hearing loss and their physicians can bridge the gap to ensure communication is functioning at its best:

  • Speak Slowly
  • Be sure to obtain each other’s attention
  • Reduce any noise when possible
  • Rephrase when not understood
  • Do not shout, over-emphasize, or exaggerate your words

We know surgical masks have an effect on patients with hearing loss when attempting to comprehend speech, and that’s a real challenge. As always, we’re here to help. If you feel you’re experiencing hearing loss, need help with your hearing aids, or have any questions, give us a call and set up and appointment. Here at Longmont Hearing and Tinnitus Center, we’re dedicated to helping our patients every step of the way.

Tinnitus: Exacerbated by COVID-19

New findings indicate that tinnitus is exacerbated by COVID-19. As if the COVID-19 virus hasn’t done enough damage, it now appears to exacerbating the effects of Tinnitus, according to the Angela Ruskin University (ARU) website. As a reminder, Tinnitus is is the perception of a sound that has no external source. Common sounds include ringing, humming, buzzing, or cricket-like. It can be constant or intermittent and is heard in one ear, both ears, or in the head. It’s uncomfortable, a nuisance, and has no cure (yet).

A study led by the ARU, with support from the British Tinnitus Association and the American Tinnitus Association, studied 3,103 people with tinnitus from 48 different countries, with the majority coming from the UK and the US. Research found that 40% of those displaying COVID-19 symptoms simultaneously experience a worsening of their tinnitus. It is important to note, though the study was centered on people with pre-existing tinnitus, it was found that a small number of participants reported their tinnitus was triggered by developing COVID-19 symptoms, which suggests that tinnitus could be a “long COVID-19” symptom, in certain cases.

The study also found that a large number of people believe their tinnitus is worsening due to social distancing measures, as they have led to significant changes in work and lifestyle routines. 46% of respondents in the UK and 29% of respondents in the US say that lifestyle changes have impacted their tinnitus. It was found that internal stressors, like fear of catching COVID-19, financial worries, loneliness, and trouble sleeping has made tinnitus more of a problem for 32% of respondents. External factors like increased video calls, noisier home environments, home-schooling, and increased coffee and alcohol consumption were also cited by respondents as a potential reason for the worsening of their tinnitus.

Worse yet, the COVID-19 pandemic has made it increasingly difficult for people to access healthcare support for tinnitus, which can further increase emotional distress leading to a worsening of tinnitus symptoms. It’s a vicious cycle. It’s clear, tinnitus is exacerbated by COVID-19.

Lead author Dr Eldre Beukes, a Research Fellow at ARU and Lamar University in Texas, said: “The findings of this study highlight the complexities associated with experiencing tinnitus and how both internal factors, such as increased anxiety and feelings of loneliness, and external factors, such as changes to daily routines, can have a significant effect on the condition.

“Some of the changes brought about by COVID-19 appear to have had a negative impact on the lives of people with tinnitus and participants in this study reported that COVID-19 symptoms are worsening or, in some cases, even initiating tinnitus and hearing loss. This is something that needs to be closely examined by both clinical and support services.”

David Stockdale, Chief Executive of the British Tinnitus Association and a co-author of the study, said:“With the second wave of COVID-19 and the resulting national lockdown likely to increase feelings of stress and isolation, it’s vital that we don’t see the same mistakes as before when it comes to community health provision for people with tinnitus.

“Poor treatment of tinnitus in the early stages often leads to much worse cases and severe tinnitus can have a huge impact on mental health. With this in mind, as the COVID-19 second wave takes hold, the healthcare system needs to ensure that anyone who develops tinnitus or experiences a worsening of their condition can access the professional healthcare support they need as quickly as possible.”

Original Paper: Beukes EW, Baguley DM, Jacquemin L, et al. Changes in tinnitus experiences during the COVID-19 pandemic. Frontiers in Public Health. 2020;8. DOI=10.3389/fpubh.2020.592878.

Source: ARU, Frontiers in Public Health

Hearing Health and Cognitive Screenings

All of us at Longmont Hearing and Tinnitus Center are dedicated to improving your hearing health. Did you know? There is a connection between hearing health and cognitive function? That is why we have started incorporating Cognivue Cognitive Screenings as part of our offering. Though it may seem unrelated, there is increasing evidence that age-related hearing loss is linked to a more rapid progression of cognitive decline and incidental dementia.[1]

Hearing Loss: Impact

Studies have shown that long-term hearing deprivation of auditory inputs can impact cognitive performance by decreasing the quality of communication, which leads to social isolation and depression, and can facilitate dementia.[2] In fact, limited cognitive skills from aging may reduce the cognitive resources available for understanding speech, especially when background noise is present. [3]

There are 3 fundamental processes that people need in order to hear well and understand speech.

  1. The ear serves as a connection between the acoustic environment and the brain. It detects, codes, and sends the signal along.
  2. The central auditory system then modifies and analyzes the signal.
  3. Finally, the brain (this is the cognitive process) enhances perception, understands the content received, and stores the information.

Studies have shown that efferent top-down and afferent bottom-up processing is critical to speech perception [4], making the link between audibility and cognition that much more vital. This process works in both directions, both from top-down to bottom-up. Here’s how:

Top-Down Processing—Cognition:

  • The brain emphasizes certain aspects of the incoming signal, allowing for improvements in perception
  • The brain works to compensate for poorly understood bottom-up sensory cues
  • Cognitive Factors help with: attention, listening effort, memory, multi-sensory integration, and prediction in helping code/understand sounds

Bottom-Up Processing—Audibility:

  • The ear engages in additional processing to refine the signal, and extracts important elements that are used for higher level processing
  • Sounds are initially coded by the ear, before it’s sent through the auditory system
  • Neural signal passed up through auditory system

How do we Conduct Cognitive Screenings?

We use the Cognivue® Thrive device. With the Cognivue® Thrive Device, we’re able to provide a 5-minute self-administered test to evaluate cognitive function. It’s a computer-based screening that involves watching a screen and moving a joystick. It’s super easy to take and is not dependent on hearing. The screening tests the following:

  • Memory
  • Visuospatial
  • Executive Function
  • Reaction Time
  • Processing Speed

About Cognivue® Thrive:

  • Based on FDA-cleared technology used by neurologists and other physicians to test for cognitive function
  • 5-minute self-administered computerized screening
  • Proven superior test-retest reliability
  • Evaluates three cognitive domains: memory, visuospatial, and executive function
  • Measures two speed performance parameters: reaction time and speed processing

Once you’ve completed the test, you then receive a report on your cognitive function:

  • Provides brain health score for each domain and performance parameter: Memory, Visuospatial, Executive Function, Reaction Time, and Processing speed
  • Informs on patient’s ability with examples of impact on daily activity

We’re very excited about the improvements in hearing health that we can achieve with the use of this device. If you’re curious about whether you have hearing loss, or if your hearing loss has impacted cognitive function, reach out to us! We’ll set you up with a test, along with tips on how to proceed with whatever results you get.

 

References:

1. Fortunato S, Forli F, Guglielmi V, et al. A review of new insights on the association between hearing loss and cognitive decline in ageing. Ipoacusia e declino cognitivo: revisione della letteratura. Acta Otorhinolaryngol Ital. 2016;36(3):155-166.
2. Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013;173(4):293-299.
3. Loughrey DG, Kelly ME, Kelley GA, Brennan S, Lawlor BA. Association of Age-Related Hearing Loss With Cognitive Function, Cognitive Impairment, and Dementia: A Systematic Review and Meta-analysis [published correction appears in JAMA Otolaryngol Head Neck Surg. 2018 Feb 1;144(2):176]. JAMA Otolaryngol Head Neck Surg. 2018;144(2):115-126.
4. Rönnberg J, Lunner T, Zekveld A, et al. The Ease of Language Understanding (ELU) model: theoretical, empirical, and clinical advances. Front Syst Neurosci. 2013;7:31. Published 2013 Jul 13. doi:10.3389/fnsys.2013.00031