Volume 124
August 10, 2022
  • Trustworthy Information
  • Therapeutic Patient Education
  • Health Literacy Skills
  • Quality of Evidence
  • Pearls of Wisdom™ Concept
  • Cognitive Decline Pearls

From a public health viewpoint, we know Cognitive Decline’s complex relationship to hearing loss is difficult to explain and understand. Healthcare consumers require trustworthy information to make well-informed decisions which, in the real world, is easier said than done. From lacking awareness to scare tactics, obstacles are numerous.

The World Health Organization defines therapeutic patient education as education that helps patients to learn and to develop many competencies as well as to adapt behaviours leading to the improvement of health.

To facilitate improvements in peoples’ health literacy skills, hearing care leaders should steadily develop their own scientific base of knowledge, with this previously featured Quality of Evidence hierarchy an essential guide:
With consumers and fellow healthcare providers, educational curation integrates peer-reviewed research which is relevant, trusted and comprehensible. To inspire achieving these imperatives, we previously highlighted:
#25
“At the core of each Did You Know? topic is our Pearls of Wisdom™, a valuable research synopsis for you, colleagues, referral sources and occasional patients (an engineer perhaps?) eager to learn from reputable resources like you.

“As best practices will attest, Pearls of Wisdom are insightful catalysts for internal reference, team training, patient consults and community outreach. Exclusively designed with a research paper flow, each edition features sections on:

“Reference Terms
  • Introduction and Public Health Policy Importance
  • Key Research Statistics
  • Key Research Results and Discussion
  • Practical and Clinical Applications
  • Research References

“By selecting pertinent peer-reviewed journal articles, highlighting intently and integrating key points, this useful resource consistently differentiates your practice. With hundreds of thousands of words distilled into a proprietary collection of concise formats, hearing care leaders are empowered to naturally convey vital educational information in patient-friendly ways.”

Pearls of Widsom
With respect to how hearing loss relates to Cognitive Decline, these Pearls of Wisdom™ are worthy of intent focus:
“Hearing loss currently impacts an estimated 20% of the global population, or more than 1.5 billion people. By 2050, estimates now project nearly 2.5 billion people with hearing loss, such that nearly 1 in 4 individuals will have some degree of loss.” 1
“Globally, the cost of unaddressed hearing loss is estimated at over $980 billion annually. Economic costs of lost productivity due to hearing loss is estimated widely at $1.8–$194 billion in the United States alone.” 1
“Individually, over a span of 10 years, the difference in mean total healthcare costs for someone with hearing loss compared to someone without hearing loss is over $22,000 in the United States, due in part to increased rate of hospitalizations, higher risk of hospital readmission, and longer hospital stays.” 2
“By 2034, the population over the age of 65 years in the USA is projected to outnumber those under the age of 19 years for the first time in US history. Moreover, by 2060, the number of individuals over the age of 65 will almost double from 49 million in 2016 to over 94 million.” 3
“Broadly, mild cognitive impairment refers to a symptomatic predementia phase in which the cognitive impairment demonstrated is beyond that expected based on age, education history, or other individual characteristics. A formal diagnosis of MCI is made via clinical, cognitive, and functional observed criteria.” 4
“According to survey data, the prevalence of MCI is reported to be between 20%–40% in adults ages 65 years and above in most world regions and approximately 25% for community living older adults in the United States.” 5
“Compared to the prevalence of dementia, MCI occurs five times more frequently than dementia in the older population.” 6
“Our results demonstrate that hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults. The magnitude of these associations is clinically significant, with individuals having hearing loss demonstrating a 30% to 40% accelerated rate of cognitive decline and a 24% increased risk for incident cognitive impairment during a 6-year period compared with individuals having normal hearing.” 7
“The use of hearing aids may decrease risk presented by mediators within the hearing and dementia pathway by reducing social isolation or depression risk for older adults, which can worsen dementia symptom trajectories.” 8
“These findings suggest that hearing aid use may compensate for impairments at the level of the auditory sensory input system, rather than at the level of the central nervous system. That is, the effects of hearing aid use may provide an immediate effect on encoding of working memory and selective attention ability, most likely by improving audibility and decreasing the cognitive load of the listening task.” 9
1 World Report on Hearing, 2021; https://www.who.int/publications/i/item/world-report-on-hearing

2 Reed, N., Altan, A., Deal, J., Yeh, C., Kravetz, A., Wallhagen, M., et al. (2019). Trends in health care costs and utilization associated with untreated hearing loss over 10 years. JAMA Otolaryngol. Head Neck Surg. 145, 27–34. doi: 10. 1001/jamaoto.2018.2875

3 Vespa J, Medina L, Armstrong DM (2020) Demographic turning points for the United States: population projections for 2020 to 2060. U.S. Department of Commerce, U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/publications/ 2020/demo/p25-1144.pdf

4 Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH et al (2011) The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guideline for Alzheimer’s disease. Alzheimers Dement 7:270–279

5 Ward A, Arrighi HM, Michels S, Cedarbaum JM. Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimers Dement. 2012 Jan;8(1):14-21. doi: 10.1016/j.jalz.2011.01.002. PMID: 22265588.

6 Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013 Jan;9(1):63-75.e2. doi: 10.1016/j.jalz.2012.11.007. PMID: 23305823.

7 Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase-Helzner E, Satterfield S, Ayonayon HN, Ferrucci L, Simonsick EM; Health ABC Study Group. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013 Feb 25;173(4):293-9. doi: 10.1001/jamainternmed.2013.1868. PMID: 23337978; PMCID: PMC3869227.

8 Kales HC, Gitlin LN, Lyketsos CG; Detroit Expert Panel on Assessment and Management of Neuropsychiatric Symptoms of Dementia. Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. J Am Geriatr Soc. 2014 Apr;62(4):762-9. doi: 10.1111/jgs.12730. Epub 2014 Mar 17. PMID: 24635665; PMCID: PMC4146407.

9 Desjardins JL. Analysis of Performance on Cognitive Test Measures Before, During, and After 6 Months of Hearing Aid Use: A Single-Subject Experimental Design. Am J Audiol. 2016 Jun 1;25(2):127-41. doi: 10.1044/2016_AJA-15-0067. PMID: 27249016.
With these Cognitive Decline-related Pearls of Wisdom™ in mind, next week will feature educational designs which are utilized to reputably share quality information. See you then.
Bruce Essman
CEO
High Definition Impressions (HDI)



314.276.7392

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