In early October, two of us attended a conference called Aging and Speech Communication in Bloomington, Indiana. I was struck by what I heard (no pun intended) about how similar the impacts of reduced hearing and the impacts of reduced memory were on one’s willingness and ability to effectively socialize with others.
As we grow into older adulthood it is common to experience increased difficulty in accurately perceiving speech in a noisy environment. A noisy environment is just what we often find ourselves in when in a social situation because most situations involving socializing include associated background noise. For example, talking with a neighbor you bumped into at the grocery store, having a coffee with a friend at a local café, attending a party, or just having a conversation around the dinner table – especially if more than one conversation is going on or music is playing in the background. When attending the conference I previously mentioned, I had the occasion to have dinner with a group of scientists in a loud bustling restaurant. I could barely make out what the gentleman across the table from me was saying. I found I had to focus all of my attention on accurately hearing his words. Now, it was a particularly noisy restaurant, but the experience has got me wondering about how good my own hearing is, which I have so far taken for granted. It also gave me some firsthand experience with respect to how difficult it is to hold the conversational thread in mind when a good portion of your mental resources are being devoted to perceiving speech.
Research shows that older adults with hearing loss do more poorly on tests of learning and memory as compared to their peers without hearing loss. This is true even in ideal hearing conditions when it can be verified that the person with reduced hearing did accurately hear the information. One of the theories accounting for this finding is referred to as ‘limited resource capacity’. Essentially, perceiving the auditory information is more demanding of attention for those experiencing hearing loss, which means they have fewer mental resources to devote to learning and committing information to memory. Unfortunately, if you are an older person experiencing hearing loss, which affects as many as two thirds of older adults, then you have got two problems: First, your threshold for sound detection has reduced, in other words, you need the volume turned up; AND second, because of the process of aging you already have some trouble distinguishing speech from background noise and increasing the volume doesn’t help this problem. These difficulties can make socializing less enjoyable.
People with hearing difficulties often report spending less time interacting with other people. Common statements include “I just can’t be bothered because everybody mumbles” or “I don’t enjoy it because I have to ask people to speak up, and they don’t like it, so when in company I just tend to sit there”. The above statements are similar in spirit to what we hear from our clients with mild cognitive impairment (MCI) about how memory decline has impacted their enjoyment of social activities. Some examples of statements from people with MCI include: “I used to tell a lot of jokes, but I’ve stopped because I’m worried I may tell one to someone I’ve already told it to before”; and “When I am in a group I don’t talk that much anymore, I just stay quiet”. The statements from both groups indicate reduced interactions with others and suggest reduced enjoyment when in the company of others.
Hearing loss and MCI among older adults have both been independently associated with increased risk for future dementia. There is no research I know of linking improved hearing, or use of hearing aids, with reduced risk of dementia. There are, however, studies showing an association between greater social engagement (interactions with other people) and reduced rate of dementia in older adults. Thus, withdrawal from social activities is the exact opposite of what is recommended, particularly in vulnerable groups, such as those experiencing hearing loss or MCI. Indeed we devote a whole chapter to the topic of social engagement in our book ‘Living with Mild Cognitive Impairment’ because it is recognized as an important lifestyle choice that promotes cognitive health.
Social engagement has been shown to benefit mood, the ability to manage stress, and affords us the opportunity to participate in mentally stimulating interactions with others. Any time we are engaged in activities with others a number of complex cognitive operations must be performed. We need to pay close attention to what the people around us are doing and adjust our behaviour in response. We also need to remember. That is, to hold information in mind, and sometimes update it as new information comes in, while we wait for our opportunity to act. This means just having a conversation with someone involves attention and memory thinking processes. Typically people enjoy doing activities with others and it’s great to know that social activities we enjoy may also help prevent cognitive decline.
The take home message here is if you suspect you may have hearing loss get your hearing checked and, if necessary, get fitted for a hearing aid AND USE IT. Why? Because improving your hearing will: a) free up mental resources to improve your memory capacity; AND b) improve your ability to hear and interact with others in conversation allowing you to reap the cognitive health benefits of social engagement.