DEAR MAYO CLINIC: I've heard there might be a link between hearing loss and brain health. Can you explain how it could affect my cognitive function and what I can do to reduce the risks?

ANSWER: Humans by nature are social. People enjoy being with others, sharing stories, laughing at a joke, dancing to a favorite song, greeting a neighbor, discussing concerns or offering consolation. These connections, whether close or casual, are essential to emotional well-being and brain health.

But hearing loss can break the connection. When a person can't hear what others are saying, they may feel left out, uncomfortable, anxious or even depressed. You may have seen this happen in your own friend or family group. Someone smiles and nods, but you know they didn't catch the conversations around them.

As people withdraw from the work and social activities they enjoy, they become more isolated. Numerous studies show that isolation brought on by hearing loss is harmful to our brain health and cognition. People can't remember what they can't hear.

Other benefits of addressing hearing loss include:

• Laughter is great medicine. But if you miss the punchline, you don't glean those mental health benefits.
• Music makes memories. You've been collecting a playlist of songs throughout your life. Those songs trigger memories and help build and maintain the ear-to-brain path.
• Purpose adds meaning to life. Social activities such as working, joining clubs or service organizations, volunteering or caring for grandchildren can give you purpose. If you have a standing coffee date, it gives you something to look forward to. Hearing loss may cause you to pull back from these purpose-giving activities.

Overcoming stigmas  

Hearing loss has many causes, including exposure to high levels of industrial or recreational sounds, such as factory work, farm equipment or woodworking; military service; loud music; and genetics. Regardless of the cause, it's essential to have your hearing assessed and, if recommended, be fitted with hearing aids as soon as you get a diagnosis of hearing loss. The longer you wait, the more lost sounds your brain will have to relearn.

For many, there's a stigma around getting hearing aids. Unlike needing glasses, people may feel that needing hearing aids is a sign of aging and feebleness. But addressing hearing loss is a sign that you're taking care of your overall health and wellness, and it sends a message to others that you intend to maintain healthy connections with them.

The average age when people get their first hearing test is in their mid to late 50s. Primary care professionals also are increasingly recommending hearing evaluations as part of wellness checkups. However, it still may take five to seven years or more after a diagnosis of hearing loss before some people decide to get hearing aids. 

Not your great-grandparents' hearing aids

Today's hearing aids have entered the digital era. They're often self-adjusting, which allows you to manage the sound environment more successfully. Most hearing aids have an app for smartphones that offers a wide variety of features. Manufacturers have redesigned the look of hearing aids so that they're attractive, stylish and comfortable. They're also available at prices to fit different budgets.

In the early days of using hearing aids, some wearers may find their new world of hearing difficult. Sounds can feel loud, brittle or annoying. That's because the slow progression of hearing loss is a form of sensory deprivation. The brain gets used to a quieter, more muffled world, so the immediate restoration of sound with hearing aids can be startling and even distracting. Rather than viewing hearing aids as a quick fix, consider them to be an education process for the brain. It will take time and patience for the brain to recapture, organize and give sounds meanings again.

Those who consistently wear their hearing aids full time gain the most benefit. Taking hearing aids in and out throughout the day or leaving them out for days or weeks at a time reduces the benefit and extends the time required for your brain to adapt. Hearing aids are meant to be in your ears, not your sock drawer. 

Some states have hearing aid trial periods, so if you don't like them after the trial period, you can return them. Your audiologist will be happy to work with you to find successful solutions.

Treat hearing loss early for brain health

The link between hearing loss and brain health has gained more attention and urgency in recent years, including media coverage of discoveries of the connection between hearing and neurocognitive changes, such as Alzheimer's disease and dementia. Talk to your healthcare professional and request a hearing test. Identifying and treating hearing loss early plays a vital role in maintaining and supporting brain health and emotional well-being. — Dana McCray, Au.D., Audiology, Mayo Clinic Health System, Albert Lea, Minnesota

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