Does hearing aid use
really affect cognitive ability?
Jason Galster, Ph.D., Justin Burwinkel, Au.D and Katherine Stevens, Ph.D.
The relationship between hearing loss and
cognitive ability has been the focus of research
across multiple disciplines, causing a convergence
among psychology, gerontology, epidemiology and
audiology. This work has resulted in meaningful
observations, allowing us to determine that people
who suffer from untreated hearing loss exhibit
greater cognitive impairment than their normal
hearing peers or their peers with appropriately
treated hearing loss. Many questions remain,
including the impact hearing aids have on cognitive
ability.
Today, we understand that patients with differing
cognitive abilities will demonstrate different hearing
aid outcomes. As an example, older adults with
reduced cognitive ability are more susceptible to
distortions in sound quality from hearing-aid
processing (Arehart et al., 2013). These same
patients also show mild benefits of slower
compression, when compared to faster
compression time constants (Souza & Sirow, 2014).
In both cases, providing a hearing aid that is less
prone to distorting the speech signal when
amplifying was beneficial to the cognitively impaired
patient.
Amplitude compression in hearing aids isn’t the
only signal processing technology that can interact
with cognitive ability. Features like directional
microphones and digital noise reduction allow
patients to perform difficult listening tasks while
also efficiently completing secondary tasks. Even in
cases where individuals scored 100 percent on a
speech-in-noise test, performance of a secondary
task might improve when these features are
activated (Wilson, 2011; Desjardins & Doherty,
2014).
As with almost any perceptual ability, the details
of these interactions are far more complicated than
could be addressed in this article. Take the case in
which the cognitive demands of listening change
with hearing aid experience.
Faculty at the University of Linköping in Sweden
have recently completed a study in which cognitive
abilities were compared to hearing aid outcomes at
the time of hearing aid fitting and incrementally
over the following six months. Data collection
began four months prior to being fitted with
hearing aids, at which time patients completed
tests of cognition and speech recognition; the latter
were administered again at the hearing aid fitting
appointment and at three month intervals
afterward. After six months of hearing aid use,
speech recognition had improved, but correlations
between cognitive measures and speech
recognition had declined. In other words, at the
time of hearing aid fitting, cognitive ability held a
stronger relationship to speech recognition. These
observations suggest that the cognitive requires of
listening decreased as patients adapted to hearing
aid use.
As clinicians we should be prepared to inform
patients that our most recent research has begun
to confirm that hearing aid use attenuates some
negative effects of cognitive decline. Many details of
these benefits remain unclear; we can speak of
them in generalities but should not take the leap to
suggest that hearing aid use affects onset of
cognitively-related disorders such as dementia or
Alzheimer’s disease.
Does hearing aid use really affect cognitive ability?
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References
Arehart, K. H., Souza, P., Baca, R., & Kates, J. M. (2013). Working
memory, age and hearing loss: susceptibility to hearing aid distortion.
Ear Hear, 34(3), 251–260. doi:10.1097/AUD.0b013e318271aa5e
Dawes, P., Emsley, R., Cruickshanks, K. J., Moore, D. R., Fortnum, H.,
Edmondson-Jones, M., . . . Munro, K. J. (2015). Hearing Loss and
Cognition: The Role of Hearing Aids, Social Isolation and Depression.
PLoS ONE, 10(3). doi:10.1371/journal.pone.0119616
Deal, J., Sharrett, A., Albert, M., Coresh, J., Mosley, T., Knopman, D.,
Wruck, L. & Lin, F. (2015). Hearing impairment and cognitive decline: A
pilot study conducted within the Atherosclerosis Risk in Communities.
Neurocognitive Study. American Journal of Epidemiology 181 (9), 680–690.
Desjardins, J. L., & Doherty, K. A. (2014). The Effect of Hearing Aid Noise
Reduction on Listening Effort in Hearing-Impaired Adults. Ear & Hearing,
35(6), 600–610. doi:10.1097/AUD.0000000000000028
Lin, F. (2011). Hearing loss and cognition among older adults in the
United States. The Journals of Gerontology A: Biological Sciences and
Medical Sciences 66 (10), 1131–1136.
Lin, F., Ferrucci, L. & Metter, E. (2011). Hearing loss and cognition in the
Baltimore longitudinal study of aging. Neuropsychology 25(6), 763–770.
Lin, F., Yaffe, K., & Xia, J. (2013). Hearing loss and cognitive decline in
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Ng, E.H.N., Classon, E., Larsby, B., Arlinger, S., Lunner, T., Rudner, M.,
Ronnberg, J. (2014). Dynamic relation between working memory capacity
and speech recognition in noise during the first six months of hearing aid
use. Trends in Hearing 18, 1–10.
Souza, P. E., & Sirow, L. (2014). Relating Working Memory to Compression
Parameters in Clinically Fit Hearing Aids. American Journal of Audiology,
23, 394-401. doi:10.1044/2014_AJA-14-0006
Ng, E.H.N., Classon, E., Larsby, B., Arlinger, S., Lunner, T., Rudner, M., &
Rönnberg, J. (2014). Dynamic Relation Between Working Memory
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doi:10.1177/2331216514558688.
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3430 Veterans: Comparisons with Pure-Tone Thresholds and Word
Recognition in Quiet. Journal of the American Academy of Audiology, 22(7),
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