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What Is Cognitive Decline and How Does It Affect Hearing?
Imagine forgetting the name of a loved one, struggling to follow a discussion, or losing track of familiar routines. Not just occasionally, but often enough to cause concern. As we age, these experiences can feel unsettling and are sometimes brushed off as “just getting older”. But what if there’s more to the story than memory alone? What if something as seemingly unrelated as your hearing plays a key role in how clearly your mind functions?
In this blog post, we’ll discuss the relationship between cognitive decline and hearing and how it’s important for early detection and management. We’ll explore how cognitive decline unfolds, who is most at risk, and what you can do to preserve your cognitive and auditory health.
Defining Cognitive Decline
Cognitive decline is a gradual deterioration in cognitive processes, including:
Memory
Problem-solving
Attention span
Language skills
Other mental abilities
When there’s cognitive decline, there’s a measurable drop in mental abilities such as memory, decision-making, attention, and language. While some changes in cognition are part of normal aging, others can indicate more serious cognitive disorders like Alzheimer’s disease or other forms of dementia. An often overlooked connection is the link between cognitive function and hearing loss, two conditions that can affect each other in complex ways.
A cognitive assessment for dementia is essential for identifying the severity and progression of decline. It helps clinicians and audiologists determine whether symptoms are due to normal aging or a more serious condition.
Additionally, it’s important to distinguish cognitive decline from a developmental disorder which has an early onset. Cognitive decline typically emerges later in life and is often related to age-related changes or underlying medical conditions.
Cognitive decline can vary in severity, from subjective cognitive decline (when someone senses their memory is slipping) to mild cognitive impairment and eventually dementia.
Cognitive Decline Causes
There are many causes of cognitive decline, and it’s rarely due to a single factor. Some of the most recognized include:
Neurodegenerative conditions like Alzheimer’s disease, Lewy body dementia, and other dementias
Cardiovascular issues such as high blood pressure and cholesterol levels, which can reduce blood flow to the brain
Head injury or brain trauma
Medication side effects, especially from anticholinergic medications or benzodiazepine behavioral side effects
Chronic health conditions like diabetes or depression
Substance abuse and poor lifestyle habits
Vision changes or hearing loss, which may limit cognitive stimulation
Genetics, particularly a family history of dementia
Environmental and social factors like social isolation, not having a nutritious diet, and lack of mental stimulation also affect our cognitive health.
Who Develops Cognitive Decline and When?
Cognitive decline primarily affects older adults as it is most commonly associated with aging. However, younger individuals may also be at an increased risk depending on health conditions or other factors. Not all memory issues are signs of decline; some may be related to stress, lack of sleep, or temporary illnesses.
A 2020 study reported that women may experience cognitive decline around age 73, while men may experience it around age 70, and develop dementia later. While aging is a major factor, some individuals may experience cognitive decline earlier, and not everyone will develop dementia.
Who Is at Risk for Cognitive Decline?
Other risk factors for cognitive decline include the following:
Genetics: Certain genes, like the APOE e4 gene, are linked to an increased risk of Alzheimer’s disease, a form of dementia.
Medical Conditions: Conditions like high blood pressure, high cholesterol, diabetes, and depression
Lifestyle: Poor diet, lack of exercise and physical activity, unhealthy habits like smoking and excessive alcohol consumption
Environmental Factors: Exposure to air pollution and head trauma
Hearing Loss and Cognitive Decline
Research shows that hearing loss is one of the strongest risk factors for cognitive decline, and those that has it have a 24% higher risk of developing cognitive problems. When the brain has to work harder to process degraded sound signals, cognitive load increases, leaving fewer resources for memory and thinking.
Hearing loss may also lead to social withdrawal, which reduces mental stimulation and can accelerate cognitive change. Over time, this may contribute to structural changes in the brain and reduced brain function.
Using hearing aids and seeking early treatment can help prevent cognitive decline by keeping the brain actively engaged in listening and conversation.
4 Stages of Cognitive Decline
Recognizing the stages of cognitive decline is important for early detection, timely intervention, and appropriate support. These stages reflect a gradual shift in mental function, from normal aging to more serious impairment, and can help guide individuals and healthcare providers in monitoring brain health.
No Cognitive Impairment
In this stage, individuals demonstrate normal cognition, with no noticeable changes in memory, thinking skills, or daily living. Cognitive abilities remain sharp, and standard assessments show no signs of decline. This is considered typical, healthy brain aging.
Subjective Cognitive Decline
Here, a person may start to sense that something is changing, perhaps forgetting names more often or feeling mentally slower. However, these concerns aren’t yet evident in cognitive testing. While not always a sign of disease, subjective cognitive decline can be an early indicator of future issues, especially if it persists or worsens over time.
Mild Cognitive Impairment
At this point, cognitive changes become more measurable and can be confirmed through testing. Individuals may struggle with complex tasks, such as managing finances or paying bills, but they can still live independently. MCI increases the risk of progressing to dementia, including Alzheimer’s disease.
Dementia
In the final stage, cognitive decline significantly affects daily life. Memory, reasoning, language, and problem-solving abilities deteriorate to the point where individuals need help with basic activities like dressing, cooking, or personal care. This stage may include various types of dementia, such as Alzheimer’s or vascular dementia, depending on the underlying cause.
Learn more about the connection between hearing loss and dementia here.
Cognitive Decline Symptoms
The symptoms of cognitive decline can differ depending on the stage, but many tend to follow a similar pattern. Knowing the signs early can help guide timely diagnosis and support.
Cognitive and psychological symptoms include:
Frequent memory lapses that interfere with everyday activities
Trouble focusing, processing information, or making decisions
Difficulty finding the right words or following conversations
Mood changes such as increased anxiety, irritability, or depression
Episodes of confusion or losing track of time and place
Personality shifts, including apathy or withdrawal from social interaction
These symptoms may develop gradually, and not all changes are cause for alarm. However, persistent or worsening signs should prompt a consultation with a healthcare provider.
Diagnosing Cognitive Decline
Early diagnosis of cognitive decline is essential for planning, intervention, and slowing progression. A healthcare professional will typically conduct a comprehensive evaluation, which may include:
Reviewing personal and family medical history
Performing physical and neurological exams
Conducting brain imaging (such as MRI or CT scans) to assess brain structure
Running blood tests to rule out underlying causes (e.g., thyroid disorders, vitamin deficiencies)
Administering cognitive screening tools, such as the Mini-Mental State Examination (MMSE), to measure memory, attention, and thinking skills
Cognivue Screening Tests
Cognivue is an FDA-cleared cognitive screening tool that evaluates multiple areas of brain function, including memory, executive function, and visual processing. Unlike traditional paper-based tests, Cognivue provides a personalized and computer-based snapshot of cognitive performance. It’s commonly used in both primary care and audiology clinics, especially for detecting early cognitive changes linked to hearing loss.
When Should You Get Professional Help for Cognitive Decline?
It’s time to consult a healthcare provider if you or a loved one experiences:
Difficulty managing daily tasks like cooking, shopping, or handling finances
Noticeable memory loss, confusion, or getting lost in familiar places
Personality changes, irritability, or increased anxiety
Trouble following conversations or understanding speech
Withdrawal from social activities or favourite pastimes
The sooner an underlying condition is identified, the more effective the treatment options can be.
Cognitive Decline Treatment and Management
Although there’s no cure for many forms of dementia, you can manage cognitive impairment through:
Treating medical conditions like high blood pressure and high cholesterol
Stopping or replacing medications such as anticholinergic drugs or benzodiazepines
Engaging in cognitive training and socially stimulating activities
Using hearing aids if hearing loss is present
Maintaining healthy blood pressure
Caring for Someone With Cognitive Decline
Supporting a family member with mild cognitive decline or dementia involves:
Creating a structured daily routine
Encouraging independence when safe
Using reminders or tools for memory support
Communicating clearly and calmly
Providing emotional support and involving professional caregivers when needed
What You Can Do To Delay Cognitive Decline
While some risk factors can’t be changed, many lifestyle habits can help prevent or delay cognitive decline. Consider the following:
Maintain a healthy diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids.
Stay mentally active through reading, puzzles, or learning new skills.
Engage in regular physical exercise.
Manage cholesterol levels, blood pressure, and blood sugar.
Get quality sleep and manage stress.
Stay socially connected and involved in the community.
Protect your brain from injury.
Avoid or limit substance abuse and harmful medications.
Address hearing loss early.
Conclusion
Cognitive decline is a complex, gradual process influenced by multiple factors, from genetics and medical conditions to hearing loss and lifestyle. At Bloor Hearing Clinic, we recognize the growing evidence linking hearing health to brain health. That’s why we offer hearing assessments and non-invasive cognitive screening tests designed to give you insight into your brain function.
Addressing hearing loss may be one of the most impactful steps you can take in maintaining cognitive wellness and keeping your brain healthy. Your hearing health matters today, and in the future well-being of your mind.