Age-related hearing loss is the second-most common health condition in Australia, affecting a whopping 58 per cent of those aged over 60, and 74 per cent of people aged 70 and above. And while this alone is concerning, the bigger issue many face is the close link between losing your hearing and being diagnosed with dementia.
Estimates suggest people with mild hearing loss are twice as likely to develop dementia as those with healthy hearing, and those with severe hearing loss are five times as likely to develop the condition. Now this may sound dire, but there is hope.
Emerging evidence suggests that treating an individual’s hearing loss can actually improve their cognitive performance, with the benefits spreading also to their partner and wider family.
Although most research to date focuses on individuals as separate entities, there’s untapped value in recognising people, not only as individuals, but also as parts of broader ‘cognitive systems’ involving their spouse, family, friends, and wider communities. Some researchers are beginning to view long-married older adult couples as individuals who have a lifetime of experience communicating, remembering and thinking together
This base of shared knowledge and experience leads to the formation of an interdependent system between the couple, where they provide crucial support for each other’s cognition. It really makes sense then that the health and wellbeing of one member of a couple can affect the health and wellbeing of the other. The effect of one’s disabilities on their spouse is known as third-party disability. Therefore, if one member of the couple has hearing loss, the negative effects of this are felt by both members of the couple.
As a baseline definition, researchers agree on three main factors of third-party disability from hearing loss: emotional impacts, communication impacts and lifestyle impacts.
Firstly, emotional impacts on the spouse can include experiences of being emotionally drained due to the requirement to adapt to the needs of their partner with hearing loss, and feeling stressed, depressed or anxious about their partner’s hearing loss. Communication impacts on the other hand can include a reduction in the willingness to engage in idle chatter with their partner. The use of a hearing device can become a contentious issue itself, making for defensive interactions within the couple.
Meanwhile, lifestyle impacts can include not socialising as frequently due to the partner with hearing loss becoming reluctant to go out (as they cannot hear others well), and the partner with hearing loss not wanting to be separated from their spouse who ‘helps them hear’.
Another area that hasn’t been considered previously is the cognitive impacts on the spouse, which is thought to include a larger cognitive load from the spouse needing to think for their partner, such as keeping them up to date in conversations. The impact of greater strains in emotional, social and lifestyle spheres is likely to also reduce cognitive capacities, and increase vulnerability to mental and physical health problems, cognitive decline and possibly even dementia.
A key point to remember is that there are two different ways to view our hearing: audiometric performance (how well you perform on a hearing test requiring you to detect different frequencies) and functional performance (how well you can hear in your everyday life).
A person can perform well on an audiometric test, but may struggle to hear in everyday life, such as in conversations or if someone is talking in another room. A big predictor of how much hearing loss impacts your life with your spouse is not how well you hear, it’s how well you and your partner think you hear. Common practice has been to wait until audiological results are poor and then you’re suggested hearing aids, but we instead urge that treating hearing loss at the first sign of functional impairment is better for protection against cognitive decline.
Third-party disability and the risk for dementia can both be reduced by addressing the underlying hearing loss. This can be done easily by either using a hearing device, or attending classes as a couple that teach communication skills to help overcome hearing loss difficulties, such as Group Audiological Rehabilitation.
Unfortunately, a major barrier to people receiving this care is the stigma that hearing loss is shameful and should be hidden. As a result, only one in five Australians who could benefit from a hearing aid actually use one. It begs the question, if you had high blood pressure, you would take medication right? So if you have hearing loss, why would you not use hearing aids? It can have a major impact on a couple, and not in a bad way.
Studies that have tracked couples before and after one member received hearing aids have shown benefits across mental health, communication and lifestyle factors for both people in the relationship. The good news is eligible individuals can access subsidised hearing aids through government support programs. This includes people who have a pensioner concession card.
This article was co-written by Gabi Picard and Viviana Wuthrich from the Centre for Ageing, Cognition and Wellbeing and Macquarie University.
IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.