Why You Must be Offered a Cognitive Screening for Dementia

Unlocking Sound Wellness: The Vital Role of Hearing Healthcare Specialists Over Primary Care Advice

Dementia is the single largest unaddressed public health threat in the 21st century and we must remain on the front lines of this crisis every day.

We all know a friend, neighbor or loved one who has been touched by Alzheimer’s or dementia and understands the devastating toll this disease takes on families.

It has been nearly a decade since the first reports indicated a strong correlation between hearing loss and dementia. We live, eat, sleep, and breathe this knowledge every day. Since then, Dr. Keith Darrow has become the only National Certified Alzheimer’s Disease and Dementia Care Trainer in the field of hearing healthcare. Our practices do qualitative dementia screenings and offer patients the opportunity for genetic testing of known dementia-related genes. We also offer patients the opportunity to have an F.D.A-cleared (Food and Drug Administration) computerized test of cognitive function.

To put it lightly… we are obsessed with finding ways to help patients understand their dementia risk, improve their cognitive function, and take steps to prevent the disorders of dementia.

Every 3 seconds another person is diagnosed with dementia. That means, in the time it takes you to read this sentence, another person has been diagnosed with dementia. That is another person who has been handed down the diagnosis of fatal brain failure, another family that will have to pay the emotional toll of caring for a loved one at least ten years beyond that person’s mental capabilities. At an average cost of $57,000 per year to care for a loved one with dementia—it is also one of the costliest diseases on the planet.

Nearly 9 out of 10 older adults get their blood pressure checked when they visit their primary care doctors. Only 16% are even asked about problems with memory or thinking.

Our assessment tool, Cognivue™, is an important and innovative psychometric tool for cognitive evaluation. This test evaluates six cognitive domains: visuospatial, executive function/attention, naming/language, memory, delayed recall, and abstraction. With this tool, we also measure two speed performance parameters: reaction time and speed processing.

Every hearing healthcare practice in America should have a quantifiable means of assessing cognitive function and evaluating dementia risk. Here are two things we know, unequivocally:

1. Hearing loss is correlated with an increased risk of dementia by as much as 200-500% (depending on degree of hearing loss).
2. Four out of every ten (or 40%) of people diagnosed with dementia are considered PREVENTABLE.

Perhaps the scariest medical statistic we have ever come across was from a survey of Medicare beneficiaries: Half of Americans with Alzheimer’s disease have not been diagnosed, and half of those with a diagnosis have not been told about it. If you need to, please re-read that last sentence. Thankfully, new state laws are popping up all over our country that address this issue and require proper dementia training of most healthcare clinicians.

In 2017, the European Dementia Commission put forth the ‘holy grail’ on the state of dementia in our world. We will not bore you, or perhaps scare you, with the details, i.e., the overwhelming number of people who have dementia, the exponential increase in expected dementia diagnoses in the next 10-20 years, or all the things we do on a daily basis to increase our risk of dementia, but we will summarize how you can err on the side of caution and increase your chances of living a dementia-free life!     A report, published in the Lancet (FYI—the Lancet is among the oldest, most respected, and most widely read medical journals in the world) and recently updated in 2020 lays out the ‘How To’ of preventing dementia.

NOTE: These twelve items are listed IN ORDER of percentage chance of avoiding dementia if this risk is eliminated:

1. Hearing Loss—The early medical treatment of hearing loss is the most modifiable lifestyle factor for reducing the risk of dementia.
2. Increased Education: Your mother was right—stay in school and never stop learning.
3. Stop Smoking: If the threats of lung cancer and emphysema are not enough to get you to stop smoking, perhaps ending up without dementia will.
4. Depression: Addressing depression in older age is critically important for cognitive health, and healthy hearing goes a long way to reducing depression.
5. Social Isolation: Hearing loss is a major contributor to social isolation and withdrawal from friends and family. Treat your hearing loss and stop living in isolation.
6. Traumatic Brain Injury (TBI): While most TBIs are the result of an accident, preventative measures should always be taken to reduce the incidence of TBI, therefore reducing the risk of dementia.
7. Physical Inactivity: People with hearing loss are less physically active. This has been shown time and time again in research and likely is the result of increased social isolation in older adults with hearing loss.
8. Hypertension: What is good for the heart is good for the mind! Cardiac conditions compromise blood flow to nearly all major organs, including the brain and the ear. Love yourself and take care of your heart.
9. Air Pollution: This was recently added to the list as air pollution might act via vascular and/or respiratory mechanisms and reduce proper blood and oxygen flow to the brain.
10. Diabetes: Several studies suggest that the brains of people with Alzheimer’s disease are in a ‘diabetic state’, partly due to the decrease and insensitivity to insulin. Diabetics are at least twice as likely to experience dementia.
11. Obesity: Being overweight is an emerging concern when it comes to dementia. The rates of increased BMI in older adults are growing and may be contributing to cognitive decline.
12. Alcohol Intake: Like most things we enjoy in life, moderation is key. Consuming less than 21 units of alcohol per week (the equivalent of two bottles of wine per week) can help to reduce the risk of cognitive decline and dementia as we age.

Because we are obsessed with helping people prevent dementia, allow us to summarize the above findings of the Dementia Prevention, Intervention and Care Report (2020) two more ways:

1. Treating hearing loss is:
   • 8 times more effective at reducing your risk of dementia than reducing obesity.
   • 8 times more effective at reducing your risk of dementia than reducing diabetes.
   • 4 times more effective at reducing your risk of dementia than reducing hypertension.
   • 4 times more effective at reducing your risk of dementia than increasing physical activity, and
   • 2 times more effective at reducing your risk of dementia than increasing social engagement with others.
2. Treating hearing loss is more effective at reducing your risk of dementia than if you reduce obesity, diabetes, alcohol consumption, and heart disease and increase physical activity, combined!

We hope this gets our point across. While we certainly cannot guarantee that if you do everything on this list that you will not get dementia, we do guarantee that you are doing everything you possibly can to reduce your risk of getting dementia.

Please visit us at www.excellenceinaudiology.org for more information.