Is Hearing Loss Contributing to Your Mild Cognitive Impairment?

Here’s how hearing loss may affect your brain, what it can look like day to day, and how to get help.

How Hearing Loss Affects Brain Function

Researchers are still learning about the ways hearing loss may affect brain health and certain risk factors for cognitive decline. Here are some of the ideas they’re exploring.

Extra Mental Effort When you strain to hear something, a lot of your mental energy goes to catching the information in the first place, which leaves little capacity to take in and remember new information, says Mia Yang, MD, a geriatrician and memory specialist at Atrium Health in the greater Charlotte, North Carolina, area.

Many people make up for hearing loss for years without realizing how much work they’re doing, says William Even, an audiologist at UT Southwestern in Dallas.

“Hearing gives the brain a steady stream of information to work with, and when hearing loss reduces or distorts that input over time, the brain gets less good information,” Even says. There’s evidence that it adapts and reorganizes in response, he adds.

“I think about it like physical activity: If you stop using your legs, they become less capable,” he says. While it would be an oversimplification to say the brain responds to reduced sound in exactly the same way, the principle behind it is similar, says Even.

Social Withdrawal Hearing loss can leave people a little more, or sometimes a lot more, socially isolated, says Sarah Sydlowski, PhD, the audiology director of the Hearing Implant Program at Cleveland Clinic in Ohio. When complex conversations get harder to understand, people stop having them, which makes them harder still. “The less you do it, the harder it is to do,” she says.

The Effects of Hearing Loss on Daily Life

Hearing loss often shows up first in ordinary moments, and those moments are easy to blame on someone else or on the setting.

“Most patients talk about difficulty communicating with the people they spend the most time with, such as their spouse, children, friends, and family,” says Even.

Dr. Sydlowski sees the following as common early signs of hearing loss:

• Other people seem to mumble or not speak clearly.
• You ask people to repeat themselves more often.
• You turn the television up louder.
• Noisy places feel more stressful.
• You notice ringing in your ears (tinnitus).

Another clue is “when situations you used to easily handle have gradually become much harder,” says Even.

For someone with MCI, missing words can look like forgetting. “They may not hear the information in the first place and thus cannot remember it later,” says Yang.

Hearing loss can also affect results on some memory and thinking tests, particularly when instructions or test items are presented verbally, says Even.

How to Get Help for Hearing Loss

Talk to your doctor. “Hearing evaluations should be a routine part of preventive healthcare as we get older,” says Yang.

When memory is a concern, hearing is worth checking early, she says. “It can be an important and treatable cause of memory changes.” It doesn’t have to be complicated: In her own clinic, Yang rubs her fingers beside a patient’s ears (with their eyes closed) as a quick hearing check, even for people without hearing concerns.

Hearing loss is one of the most modifiable risk factors for cognitive decline, says Sydlowski. “If you identify it early, that also means that you can start managing it,” she says.

“It’s not about the brand, it’s not about the features; it’s about using a device that’s appropriate for the type and degree of hearing loss that you have,” says Sydlowski.

Don’t give up if the first option doesn’t work. Sydlowski recommends taking notes at first: what is working well, where you still struggle, and specifics about when and how.

Many people abandon their hearing aids after a period of frustration or disappointment without ever checking back in with their audiologist, she says. “If they don’t know what you’re experiencing, then they can’t make it better,” says Sydlowski.

Even agrees, saying, “Don’t assume that a disappointing first experience means hearing aids cannot help.” If you have memory problems, a family member or caregiver can help at appointments and with daily use, he says.

“People assume you have to have significant hearing loss to benefit from these devices, which is no longer true,” says Sydlowski. Only a fraction of the people who could benefit have one, she says.

Find ways to stay socially engaged. Rather than avoiding social situations, Sydlowski recommends finding ways to take control and make them work for you.

For example, where you sit can make a big difference in a noisy restaurant. She suggests choosing a table along the edge of the room, with your back to the wall.

Even says to face the person you’re talking with and ask them to face you, reduce competing noise when you can, and move somewhere quieter for important conversations.

“The goal is not perfect hearing in every environment. It’s to keep communication working well enough that hearing loss doesn’t become an additional barrier to staying engaged in conversations, activities, and relationships,” says Even.