Can hearing aids prevent cognitive decline?

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1 9 March 2016 Can hearing aids prevent cognitive decline? Alison Stone Audiologist & Training Manager

2 5 questions

3 5 questions 1. Are hearing and cognition even related? 2. What about listening effort? 3. Is there a link between cognitive decline and hearing loss? 4. Can hearing aids help the brain listen more easily? 5. Can hearing aids prevent cognitive decline? 3

4 4

5 The process of listening

6 5 questions 1. Are hearing and cognition even related? 2. What about listening effort? 3. Is there a link between cognitive decline and hearing loss? 4. Can hearing aids help the brain listen more easily? 5. Can hearing aids prevent cognitive decline? 6

7 Top down vs bottom up

8 Consequences of hearing loss Speech understanding model Modified from Rönnberg et al., 2008

9 Consequences of hearing loss Effortful Immediate

10 10 The effect of bandwidth on listening effort

11 Bruun-Hansen et al, 2010 Keeping speech and spatial cues as natural as possible or cognition friendly! Improved speech understanding Less listening effort Achieving a dual goal: improving the result whilst minimizing the associated cost

12 New techniques for measuring listening effort EEG Pupillometry 12

13 5 questions 1. Are hearing and cognition even related? 2. What about listening effort? 3. Is there a link between cognitive decline and hearing loss? 4. Can hearing aids help the brain listen more easily? 5. Can hearing aids prevent cognitive decline? 13

14 Statements: Hearing loss causes cognitive decline Hearing aids prevent dementia

15 Hearing loss: Correlation with other health issues

16

17 Theories for correlation Genetic predisposition for both Hearing loss causes more stress on the brain Hearing loss causes withdrawal from social situations

18 April 2010

19 Preventing Alzheimer's Disease and Cognitive Decline Greatest Risk Factors Diabetes Genetic Predisposition Protective Factors Cognitive Engagement Physical Activity Smoking Depression

20 5 questions 1. Are hearing and cognition even related? 2. What about listening effort? 3. Is there a link between cognitive decline and hearing loss? 4. Can hearing aids help the brain listen more easily? 5. Can hearing aids prevent cognitive decline? 20

21 The process of listening

22 22 Preserve spatial cues

23 Broad bandwidth High frequency localisation cues Speech cues Hz 23

24 Preserve speech details Fast vs Adaptive Compression Fast Compression Adaptive Compression Fast Adaptive 24

25 Directional Microphones only when they re useful! Free Focus Optimised Omni Speech Omni Split Directionality Full Directionality Full Directionality + Bass Compensation Front Back 25

26 26 Personalisation

27 5 questions 1. Are hearing and cognition even related? 2. What about listening effort? 3. Is there a link between cognitive decline and hearing loss? 4. Can hearing aids help the brain listen more easily? 5. Can hearing aids prevent cognitive decline? 27

28 28 Preventing Cognitive Decline: Hearing Interventions Promising Barbara E. Weinstein, The Hearing Journal, September 2015

29 Self-Reported Hearing Loss: Hearing Aids and Cognitive Decline in Elderly Adults A 25-year Study Published in the Journal of the American Geriatric Society The main conclusion from Hélène Amieva s study is that: Self-reported hearing loss is associated with accelerated cognitive decline in older adults; hearing aid use attenuates such decline. 29

30 Conclusion

31 Take home messages Listening is where hearing meets brain Effort in listening is a useful indicator Hearing loss and cognitive decline are linked Social engagement is key Hearing technology can make listening easier.which means less effort, which means more social engagement! Use of hearing aids may help reduce the rate of cognitive decline (probably because the user is more socially active) 31

32 Thank You!

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