Consequences of hearing loss: cognitive, social, psychological
Taking care of your hearing means taking care of your overall health. The direct connection between hearing loss and depression, social and emotional isolation, dementia, etc. has not been a secret for a while now. Let's talk more about them in detail.
With age many people not only experience hearing loss, but also a decline in mental abilities. Senile hearing loss affects the quality of life, which in some cases leads to loss of spatial orientation, delayed reaction, increased risk of falling, social isolation, memory impairment, and decreased overall performance.
At the initial stage of hearing loss, the human brain is still able to fill in the "verbal blanks", but at later stages this may no longer be possible. Negative experience of communicating with regular people who may be reluctant to contact the hearing-impaired and increased emotional vulnerability can lead to a decrease in social activity. This increases the risk of developing mental illnesses - depression and different phobias. Social alienation contributes to the emergence of depressive states, fear, and self-doubt. In this regard, many scientists associate hearing loss with memory impairment and dementia.
Depression and anxiety as consequences of hearing loss
It is a scientific fact that severe hearing loss can increase the risk of depression regardless of age, sex, place of residence, medical history and income.
11.4% of people with severe hearing loss also have a history of depression, while only 5% of people with normal hearing experience it.
Severe hearing loss can also trigger panic attacks. Even a mild hearing loss increases the likelihood of panic attacks by 32% whereas severe hearing loss increases this probability up to whopping 59%. The duration of hearing loss also affects the level of fear and depression: the longer a person lives with hearing loss, the more pronounced both of these conditions will be.
Emotional isolation leads to psychosis and paranoia
A meta-analysis of epidemiological studies has shown that hearing loss increases the risk of hallucinations, psychosis, and paranoia.
Social isolation and loneliness, which are late consequences of hearing loss, are risk factors for the development of psychosis. In addition, verbal misunderstandings lead to misinterpretations of social cues and the informational component of speech, which can cause paranoid states.
When much of the information received during communication is lost or reduced to a minimum due to hearing problems it becomes challenging to understand what emotions another person is experiencing and what mood they are in.
Challenges in determining the sound location or the appearance of strange rustling sounds can also provoke the appearance of visions.
Emotional stress caused by tinnitus
There is a clear correlation between the intensity of tinnitus and the state of clinical depression. Constant tinnitus significantly worsens the emotional state. Patients suffering from tinnitus and ringing in their ears often have a history of increased sensitivity to sounds and difficulty falling asleep.
Dementia and cognitive impairment
Many studies show that people with hearing loss are more likely to suffer from dementia. Moreover, hearing loss is one of direct prerequisites for dementia development. The latest systematic meta-analysis shows a relationship between pre-pubertal hearing loss and a significant decline in all cognitive areas, as well as an increased risk of general cognitive impairment and dementia. In case of mild hearing loss, the risk of dementia increases twofold, moderate hearing loss increases the risk threefold, while in severe cases — fivefold.
Hearing loss increases the risk of mental illness? Or is it the other way around?
There is a fair amount of evidence that points to a connection between hearing loss and mental disorders. On one hand, hearing loss can be viewed as an early sign of incipient dementia, rather than as its cause. On the other hand, the communication difficulties that arise due to hearing loss significantly limit social integration, which in of itself can lead to depression and dementia. Ultimately, both diseases may be caused by some other reason.
Thus, there are many systems that can contribute to the development of mental disorders. But the four most commonly expressed and discussed hypotheses by which scientists try to explain the connection between hearing loss and cognitive decline are as folows:
1. False diagnosis due to hearing loss hypothesis
The Mini-Mental State Examination (MMSE) is the most commonly used test to assess cognitive functions and diagnose dementia. Since most of the elderly people have some degree of hearing impairment, 16% of subjects were misdiagnosed with dementia. At its core, hearing loss distorts all neuropsychological processes related to speech and sound perception. The simplest explanation for poor test results is that subjects with hearing loss simply misunderstand some questions or may have missed important test instructions.
2.General hypothesis
Inflammations, vascular pathologies, and other systemic neurodegenerative processes can lead to hearing loss, depression and cognitive impairment. This is due to a functional disorder of the central nervous system. Thus, a supposed cause-and-effect relationship between these phenomena may arise. It has been proven that structural and biochemical changes in brain cells and the connections between them lead to inhibition in brain function. Based on this, the ability to perceive speech in complex communication situations (like, for instance, in a background noise) deteriorates. According to this hypothesis, hearing loss and mental performance are considered separate from one another as independent areas caused by some third factor.
3. The high auditory load hypothesis
The high auditory load hypothesis states that with more or less severe peripheral hearing loss the processing of incomplete acoustic information requires additional concentration. In layman’s terms, hearing-impaired people need to focus more on the perception and processing of acoustic information and because of this other cognitive processes, such as short-term memory, memorability and recall, may not be involved. At the same time, a person will remembered any words and sentences that they misheard worse than those that they caught on.
4. Sensory deprivation hypothesis
Peripheral hearing loss means that refined sensory information no longer reaches the auditory cortex. Over time, this leads to changes in the structure and functioning of the central, auditory, and cognitive systems. These degradation phenomena primarily affect brain areas responsible for sound and speech.
Medical visualization shows that people with severe presbycusis have significant losses in the primary auditory cortex and right temporal lobe. With the increased cerebrospinal fluid volume loss of brain volume could be interpreted as atrophy due to neural degeneration in the medulla due to lack of input from the inner ear. These pathological changes increase the risk of depression by reducing cognitive reserves and interfering with normal emotional regulation.
Hearing Loss and General Physical Health
Hearing loss in old age is associated in many scientific studies with general physical health deterioration. While it’s not a direct consequence of hearing loss, it is caused by its side effects such as stress, fear, and depression. Living in constant stress due to hearing loss can lead to various somatic disorders like high blood sugar level and high blood pressure.
