Helping Older People with Cognitive Decline Communicate: Hearing Aids as Part of a Broader Rehabilitation Approach

TLDR

Hearing loss and cognitive impairment are common in older adults, often co‑occurring and jointly impairing communication, social participation, and quality of life, yet many with cognitive decline receive inadequate hearing care. The article reviews the continuum from healthy aging to dementia, examines rehabilitation and brain connections, and proposes new research directions and practices for using hearing aids in older adults with dementia. The authors conduct a literature review of rehabilitation strategies, brain–hearing connections, and hearing aid use among older adults with dementia.

Abstract

There is a strong connection between hearing loss and cognitive impairment in old age. Dementia affects ∼10% of persons over the age of 65 years and increases in prevalence to 25 to 30% for persons older than 85 years. Hearing loss is even more prevalent, affecting roughly half of those over the age of 65 years and an increasing majority as age increases. Given these high prevalences, it is reasonable to assume that many older adults will have dual hearing and cognitive loss and that these losses will combine to affect individuals' everyday functioning, communication, social participation, and quality of life. Older adults with cognitive impairment may not receive adequate hearing care. Audiologic rehabilitation may help to optimize communication, which in turn may improve the individual's well-being directly as they engage more fully in activities of daily living. Maintaining communication also may confer indirect benefits to other aspects of the person's health and/or the health of their significant others. In the present article, we examine the continuum from healthy cognitive aging to dementia and review the literature concerning rehabilitation, the commonly overlooked brain connection, and the use of hearing aids by older adults with dementia. Directions for research and new practices are suggested.