Go Figure: Untreated Hearing Loss is a Potentially Modifiable Midlife Dementia Risk Factor

Author: Bryan Hanson

In July 2017, the British medical journal, The Lancet, published a landmark compendium on the risk factors associated with dementia. These risk factors linked to dementia were separated into two categories: unmodifiable and modifiable. As these terms suggest, modifiable risk factors can be shaped by changes in behavior or lifestyle. Additionally, the article divided risk factors into early, mid, and late life.

The research found that hearing loss in midlife is the most consequential potentially modifiable risk factor associated with dementia. Audiologists are encouraged to leverage the findings of this British meta-analysis in their interaction with consumers and other healthcare providers, as it provides compelling evidence that early intervention is effective. The Figure tells a persuasive story of the positive impact audiology can have on broader health outcomes, beyond improving communication for persons with hearing loss. That is, early intervention to identify and remediate hearing loss may make a substantial difference on other downstream health-related outcomes, such as cognitive ability.

Worldwide, about 50 million individuals have dementia and that number is expected to triple within the next 30 years. In the United States alone, nearly six million adults have the condition and, given its relationship to aging, hearing loss is an expected co-morbid factor that has garnered considerable attention in the hearing care professions over the past six or seven years. The Lancet Commission on dementia, who created and published this figure, reviewed the best available evidence and produced recommendations on how to best manage, or even prevent, the dementia epidemic. The figure on the next page probably most effectively summarizes various potentially modifiable factors throughout the lifecycle, as well as the effect untreated hearing loss may have on dementia.

One key message from the Lancet Commission’s work is that dementia is not an inevitable consequence of aging. The Commission identified nine potentially modifiable health and lifestyle factors from different phases of life that, if eliminated or reduced, might prevent dementia. Although medical cures are currently not available to modify the underlying disease process, the Commission outlined pharmacological and social interventions that are able to help manage the manifestations of dementia.

One of these interventions, as the Figure clearly depicts, is minimizing the effects of hearing loss. Since hearing loss commonly begins to become a problem after the age of 50 years old, hearing loss is considered a midlife risk factor. Given the fact that hearing loss can be easily assessed, and minimal intervention involves the use of hearing protection and basic amplification technology, audiologists play an essential role in the care of adults at risk for developing dementia. Beyond hearing loss prevention and intervention, the Figure also underscores the interconnected role of audiology within the larger preventive healthcare system.

To read this open access article in its entirety, go to https://www.thelancet.com/commissions/dementia2017.    
About the Lancet: Best Science for Better Lives
The Lancet began as an independent, international weekly general medical journal founded in 1823 by Thomas Wakley. Since its first issue (October 5, 1823), the journal has strived to make science widely available so that medicine can serve, and transform society, and positively impact the lives of people.

Over the past two centuries, The Lancet has sought to address urgent topics in our society, initiate debate, put science into context, and influence decision makers around the world.

The Lancet has evolved as a family of journals (across Child and Adolescent Health, Diabetes and Endocrinology, Digital Health, Gastroenterology and Hepatology, Global Health, Haematology, HIV, Infectious Diseases, Neurology, Oncology, Planetary Health, Psychiatry, Public Health, Respiratory Medicine, Biomedicine, Clinical Medicine), but retains at its core the belief that medicine must serve society, that knowledge must transform society, that the best science must lead to better lives.

Source: Dementia prevention, intervention, and care. Authors: Gill Livingston, Andrew Sommerlad, Vasiliki Orgeta, Sergi G Costafreda, Jonathan Huntley, David Ames, Clive Ballard, Sube Banerjee, Alistair Burns, Jiska Cohen-Mansfield, Claudia Cooper, Nick Fox, Laura N Gitlin, Robert Howard, Helen C Kales, Eric B Larson, Karen Ritchie, Kenneth Rockwood, Elizabeth L Sampson, Quincy Samus, Lon S Schneider, Geir Selbæk, Linda Teri, Naaheed Mukadam

The Lancet, Vol. 390, No. 10113, Published on-line (open access): July 19, 2017.