Alzheimer’s Dementia and Hearing

Dale Johnson: June is Alzheimer’s & Brain Awareness Month and what does that have to do with proper hearing health? More than you might think. Dr. Sandra Miller of complete hearing in Lincoln is the expert for The Conversation Starts Here every Saturday morning on KFOR, FM 103.3, 1240 AM. Check out Complete-Hearing.com.

Dale Johnson: Good morning Dr. Miller.

Dr Sandra Miller: Good morning. Welcome to June.

Dale Johnson: Where did March go for heaven’s sake?

Dr Sandra Miller: Where did the last three months of our lives go? It just seems like it went by in a blink.

Dale Johnson: Before we discuss the differences between Alzheimer’s and dementia and wrap that into a hearing conversation today on the show, review for new listeners, joining us on the radio, the protocol that your Complete Hearing staff have continued to model and perfect to accommodate the safety of patients during this pandemic.

Dr Sandra Miller: Absolutely. We have found that COVID is kind of gone out of the news cycle a little bit with the other things happening in our nation but we are still very diligent and forthright in terms of what we’re doing in the office. They’re still following all the guidelines that do come from our local governments, our mayor, and our governor. Just to tell you that we are still keeping our lobby closed for now. We did reintroduce … What we have is something called walk-in hour. We’re doing that curbside and that simply means you get to drive up between 11:30 and 12:30 and we’re going to take care of you. We had some of our patients having a concern that we were having a drop-off. They’d have to drop their hearing aids off and then we would call them to come back and pick them up when they were finished.

Dr Sandra Miller: Well you can imagine for a person who has hearing difficulty, that it’s not very easy to be without their hearing aids and so we will bring it back. We typically have this when our doors are open every day, Monday through Friday from 11:30 to 12:30, we have walk-in hour services.

Dr Sandra Miller: So we are bringing that back and we’re just doing it curbside, which has been really fun. We’re going to make it super energetic and we’re going to have some fun activities happening during walk-in hour but our lobby will continue to stay closed. We are seeing patients. We just have a protocol of making sure things are … We’re taking your temperature. We’re still doing a screening. We are requiring masks still in the office and it’s just still keeping all those protocols pretty much the same.

Dr Sandra Miller: What I would tell the listeners to do and anybody who’s curious of what’s going on, we just put the COVID-19 update on our website. Great place to just click and we update it weekly just to let you know what’s happening.

Dale Johnson: So get to know Complete Hearing by going to Complete-Hearing.com where you can also hear previous conversations from this show. Complete Hearing at 4200 Pioneer Woods Drive in Southeast Lincoln. That’s in the neighborhood of 70th and Pioneers.

Dale Johnson: All right. With all that said, Dr. Miller bring in our guest for this morning’s conversation.

Dr Sandra Miller: Well, I was so excited to really bring on Cassie Larreau-Bailey. She is going to be the Walk Organizer. She’s out of Kearney for the Alzheimer’s organization.

Dr Sandra Miller: So I think it’s really important for the listeners to know that one thing that we think about at Complete Hearing is that we’re just not about the ear. We’ve talked about it many times. We treat the person from top to bottom and we take into account cognition and so we do really support the Alzheimer’s Association.

Dr Sandra Miller: We want to be part of supporting them and because June is Alzheimer’s & Brain Awareness Month, I thought it’d be a great time to talk to Cassie about what she does supporting them in terms of what they have going on in terms of their walk and just raising awareness and then really talking about how the symptoms of dementia and Alzheimer’s really mimic those of hearing loss and I thought we could go through that together today.

Dale Johnson:
Good morning Cassie.

Cassandra Larreau-Bailey: Good morning. Thanks for having us.

Dale Johnson: Symptoms and causes of dementia. Help us understand Alzheimer’s and the differentiation between it and dementia.

Cassandra Larreau-Bailey: When we talk about dementia, it’s more of an umbrella term. There are actually over 200 different kinds of dementia. It depends on what area of the brain is being impacted. Alzheimer’s accounts for about 70% of the cases that have been diagnosed and so Alzheimer’s is the most common form of dementia but there are numerous other kinds. Parkinson’s is a form of dementia. There’s Lewy body, frontotemporal. There are all different types and they act a little bit different and so Alzheimer’s accounts for the most cases of dementia.

Dr Sandra Miller: So I think it’s really interesting when we think about some of the symptoms that we typically see when people come in and they say I’m having a hard time understanding. My mom or dad or significant other seems confused. They’re not the same kind of person anymore. They don’t want to go out socially. What happens is we kind of go well, is this something tied to are they not hearing well or is this really a cognitive problem? And so a lot of times in our office, we’re hoping to assess both but when we start to see those symptoms, I think sometimes they’re like where do we first turn to get this evaluated?

Cassandra Larreau-Bailey: I always encourage people. If they have questions or concerns that they should reach out to their primary care provider to do a cognition test. That’s a great first step and they’re able to say yes, we have some concerns. We need to have a further conversation or there are lots of other factors. Like you said, hearing impairment is something that could mimic dementia. There are other things, depression, anxiety. There are a lot of things that could also account for some things that might mimic dementia, medication concerns, those types of things. However, having that initial conversation with your primary care provider is absolutely that first step in getting the diagnosis and the help that you need.

Dale Johnson: Cassie and Dr. Miller, let me jump in. Does Alzheimer’s and dementia cause hearing loss or because of what’s going on in the brain, is it the brain that isn’t capable of translating or interpreting and therefore it seems like there’s hearing loss?

Cassandra Larreau-Bailey: Truthfully, I believe that it can go either way and there were a couple of studies that were done that were presented at our Alzheimer’s Association International Conference in 2019. That is a conference where lead researchers in dementia across the world come together and share findings and things that they’re working on and there were two studies that focused on sensory impairment and dementia. What both of those studies found is that if there is some kind of sensory impairment whether it be hearing, vision, smell, taste, that it increases your chances of developing dementia. And so for those who have either hearing or vision impairment, one study found that it increases their chance of developing Alzheimer’s by 10% and if they have both hearing and vision, it increases their chance of developing Alzheimer’s by 112%, which is pretty significant and so there is definitely that factor that says that hearing impairment can increase those chances of developing Alzheimer’s.

Cassandra Larreau-Bailey: However, on the flip side, it can go the other way as well because in Alzheimer’s and other forms of dementia the brain is being impacted and as the disease progresses, it impacts our ability to do very basic things that we’re used to doing. Speech becomes problematic. When we’re looking at our agility, our ability to walk, to pick things up, those things become more challenging and so naturally, going along with that, our sensory is impacted as well and so hearing is something that’s impacted because the brain is forgetting how to take in a message and process it in that hearing way.

Dr Sandra Miller: I think it’s such a great point. We many times talk about when we work with a patient, we tell them that when you have hearing loss, the hearing part of your brain is not doing the hearing because it’s searching for the information and so your working memory and everything goes kind of to the frontal lobe and so there’s kind of what we call cognitive load just meaning you’re having trouble processing to begin with and then we throw hearing loss on top of it and now the brain has to work even harder.

Dr Sandra Miller: And so the cognitive part or the thinking part of the brain now starts to take over and that puts a huge load on the brain and so what happens is when you start to have symptoms not only of this confusion or misunderstanding or we always want to know if we can provide some hearing to you and re-stimulate the brain for that sound, that takes the load off the front of the brain and you’re better, easy to have cognitive ability to understand and remember.
 
Dr Sandra Miller: Hearing aids are not a cure in terms of that. There’s not … I like your question Dale. Is this a cause/effect and we’ve talked about this before. They’re very highly correlated. I think the statistic you just shared Cassie is amazing. With vision and hearing it’s 110% more likely. And so when you think about taking the senses that we have and diminishing them how the brain has to work extra hard and when they have a brain that’s already under impact, this just adds to that difficulty and so we need to get our senses re-engaged so the person can be engaged, can have their brain working the way it does.

Dr Sandra Miller: We always talk about the brain being like a muscle. We have to exercise that muscle for all its senses and so I’d love to talk a little bit about Cassie today, the website, and I was amazed at all the information that is available and so just can you talk about that a little bit and some of the resources that are available?

Cassandra Larreau-Bailey: So if you visit alz.org/Nebraska, when you visit the landing page, of course we have Alzheimer’s & Brain Awareness Month at the forefront because we’re celebrating this month, celebrating that brain health piece, but there is a search part so that’s wonderful. If there is any topic that you have questions about, you can type into that search bar and it is going to send you into whatever part you might be looking for. In this case, I actually utilized our website because I wanted to make sure that I had our most up-to-date information about what we have been talking about at the Alzheimer’s Association for hearing health and how that impacts dementia.

Cassandra Larreau-Bailey: And so when you type it in, I think I had three or four pages come up of different information that had discussed hearing loss in relation to Alzheimer’s and dementia but if families are looking for resources, it’s truthfully an amazing spot to start. It can get you in contact with a local chapter here in Nebraska or if you have loved ones who are in another state, it’s incredible because the association operates nationwide. And so if you are caring for a parent here in Nebraska but you have a brother or sister who’s maybe struggling for it in Colorado, then you can say hey, reach out to the Alzheimer’s Association. They have support groups. They have education. They have endless amounts of resources and we can support the family and other states as well.

Cassandra Larreau-Bailey: The website’s a great start because if you’re wanting to just know a little bit more about dementia, a little bit more about Alzheimer’s or another type of dementia, if you have questions about knowing the 10 signs, things that show it’s not normal aging, if you’re looking for presentations, then it’s a great start. I always joke that it’s a little bit of a black hole of information. I tend to start reading and I just, I go and I go for hours and I have no idea where my time went. It’s an absolute incredible resource.

Dale Johnson: All that at alz.org/Nebraska. Cassie, can you stick around and join us for another conversation and we’ll have it for the following Saturday?

Cassandra Larreau-Bailey: Absolutely. Thank you so much.

Dale Johnson: All right. Dr. Miller will join Cassie next week for The Conversation Starts Here.