Alzheimer’s disease and untreated hearing loss share many symptoms, causing frequent misdiagnosis of Alzheimer’s in the elderly population. Research continues to suggest a strong association between hearing loss and Alzheimer’s. Since the most commonly used screenings for Alzheimer’s are administered verbally, screening for hearing loss should precede screening for Alzheimer’s.
Symptoms of both untreated hearing loss and Alzheimer’s disease are nearly identical (Chartrand, 2001).
Symptoms of untreated hearing loss include depression, anxiety, feelings of isolation, reduced communication ability, reduced cognitive input, inappropriate psychosocial responses, reduced mental scores, denial, heightened defensiveness, negativity, distrust, and paranoia.
Symptoms of Alzheimer’s disease include depression, anxiety, disorientation, reduced language comprehension, impaired memory (especially short-term memory), inappropriate psychosocial responses, loss of ability to recognize (agnosia), denial, defensiveness, negativity, distrust, and suspicion regarding other’s motives.
The body of research suggests a strong association between untreated hearing loss and forms of dementia like Alzheimer’s disease. In her article “Hearing Loss and Dementia: New Insights,” audiologist Dr. Kristi Albers notes the research suggests hearing loss puts older adults at risk for Alzheimer’s disease or other forms of dementia (Albers, 2012).
Due to the similarity of symptoms and the strong association between these two medical conditions, untreated hearing loss is sometimes misdiagnosed as Alzheimer’s. In a 1996 study involving 52 patients, 30 with a diagnosis of Alzheimer’s and 22 diagnosed with other forms of cognitive impairment, 49 patients (94 percent) had significant hearing loss. The authors of the study concluded: “the extraordinarily high prevalence of hearing loss in this selected population suggests that a hearing evaluation should be part of any assessment of cognitive function” (Gold, Lightfoot & Hnath-Chisholm, 1996).
Further complicating these issues is that the commonly used assessments for Alzheimer’s disease, like the Mini Mental State Examination (MMSE), the Sternberg Memory Scan and California Verbal Learning Test, are all administered verbally (Chartrand, 2005). Therefore, hearing professionals like Dr. Chartrand advocate that audiometric evaluation by a licensed audiologist and aural rehabilitation precede any clinical assessment of cognitive function (Chartrand, 2005).
For many elderly patients, untreated hearing loss — not Alzheimer’s disease — may be causing their symptoms. For proper diagnosis, it is imperative that these patients’ hearing is properly evaluated and treated prior to administering any cognitive assessment.
REFERENCES
Albers, K. (January 2012). Hearing loss and dementia: new insights. Minnesota Medicine. Retrieved from: http://www.minnesotamedicine.com/Past-Issues/Past-Issues-2012/January-2012/Hearing-Loss-and-Dementia-New-Insights
Chartrand, M.S. (November 2, 2001) Hearing health and Alzheimer’s disease. Hearing Review. Retrieved from: http://www.hearingreview.com/2001/11/hearing-health-and-alzheimers-disease/
Chartrand, M.S. (October 3, 2005). Undiagnosed pre-existing hearing loss in Alzheimer’s disease patients? Audiology Online. Retrieved from: http://www.audiologyonline.com/articles/undiagnosed-pre-existing-hearing-loss-1009
Gold, M., Lightfoot, L.A., Hnath-Chisolm T. (September 1996). Hearing loss in a memory disorders clinic. An especially vulnerable population. Archives of Neurology, 53(9):922-8. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/8815858