Co-existing dementia and hearing conditions: What are the priorities of people with lived experience and clinicians? 

“People with dementia already struggle to engage with the outside world. Hearing loss can make life even more difficult and sadly they may withdraw into themselves if they don’t receive the support they need,” (Carer of person living with dementia and hearing loss). 

“How many people are out there with co-existing hearing loss and dementia, which for one reason or another get neglected, mistaken for each other, or considered as individual situations? We want to know what needs to be understood and researched about this huge population.” (Person living with hearing loss). 

Hearing loss is an extremely common condition that affects approximately 136 million people in Europe (1). It is especially common in older adults, with estimates suggesting that it is present in 70% of those aged over 70 years (1,2). Therefore, hearing loss is thought to be highly prevalent amongst people living with dementia. In addition, it is one of the largest modifiable risk factors for dementia and may even accelerate cognitive decline (3,4). Furthermore, hearing loss and dementia can mask or exacerbate one another due to their overlapping symptoms and consequences (e.g., communication difficulties, concentration problems, social withdrawal, and depressive symptoms), which can impede the diagnosis and management of these conditions (5,6). Consequently, research is currently investigating whether aural rehabilitation interventions (e.g., hearing aids, cochlear implants) benefit people who are at risk of developing dementia, as well as those who already live with co-existing dementia and hearing loss (5-7). Research is also currently examining the best methods for assessing cognition in people living with hearing loss, as well as for assessing hearing thresholds in people living with dementia (6,8,9).  

A team of researchers from the National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre (BRC), Hearing Sciences, and the Centre for Dementia in the University of Nottingham are carrying out a range of studies to understand and address the needs of people living with dementia and hearing conditions (e.g., hearing loss, tinnitus, and hyperacusis). On World Hearing Day (3^rd March 2023), they launched a new James Lind Alliance Priority Setting Partnership (PSP) for co-existing dementia and hearing conditions in partnership with Alzheimer’s Research UK (ARUK) and the Royal National Institute for Deaf People (RNID). Their goal is to ensure that future research in this field is directed by people with lived experience (e.g., patients, carers) and clinicians (e.g., audiologists, general practitioners) so that it is impactful, beneficial, and tackles the real-life challenges facing these groups. The PSP will identify the top 10 priorities for research about the prevention, diagnosis, and treatment of dementia and hearing conditions, which will guide research funding, commissioning, and policy in the future. The PSP will entail reviews of published evidence, as well as surveys and a workshop with patients, carers, and clinicians. To learn more or to get involved, please contact the PSP coordinator (sian.calvert@nottingham.ac.uk), follow the PSP on Twitter (@DementiaHearPSP), or visit the PSP website. 

You can learn more about this topic in another INTERDEM member blog: “My hearing’s going” – Professor Tom Dening on hearing aids. 

Dr Eithne Heffernan^1,2,3 

1. Senior Research Fellow, NIHR Nottingham BRC, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, UK. 

2. Member of INTERDEM Academy Management Board 

3. Lead of JLA PSP for Co-Existing Dementia and Hearing Conditions 

References: 

1. Lisan et al. (2022). Prevalence of Hearing Loss and Hearing Aid Use Among Adults in France in the CONSTANCES Study. JAMA Netw Open, 5: e2217633.  

2. RNID. (2023). Facts and figures. Accessed 01/03/2023. https://rnid.org.uk/about-us/research-andpolicy/facts-and-figures/ 

3. Livingston et al. (2020). Dementia prevention, intervention, and care:2020 report of the Lancet Commission. Lancet, 396: 413-446. 

4. Lin et al. (2011). Hearing loss and incident dementia. Archives of Neurology, 68: 214-220. 

5. Ray et al. (2019). Dementia and hearing loss: A narrative review. Maturitas, 128: 64-69. 

6. Heffernan et al. (2022). Considerations and Research Priorities for Adults Living with Co-existing Dementia and Hearing Loss. Alzheimer Europe Conference, Bucharest. 

7. Mamo et al. (2018). Hearing loss treatment in older adults with cognitive impairment: A systematic review. Journal of Speech, Language, and Hearing Research, 61, 2589-603. 

8. Broome et al. (under revision). Patient perceptions of cognitive screening in adult audiology services: A qualitative exploration. Frontiers in Neurology. 

9. Dawes et al. (2023). Development and validation of the Montreal cognitive assessment for people with hearing impairment (MoCA-H). Journal of the American Geriatrics Society, 10.1111/jgs.18241.