Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer’s disease dementia: A qualitative study

Abstract

Objectives: Hearing aid usage supports communication and independence; however, many do not use their hearing aids. This study explored the experiences of hearing aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using thematic analysis. Ten people (six males, age range 75–86 years old) with mild cognitive impairment or Alzheimer’s disease who had been fitted with hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to using hearing aids, (2) practical aspects of hearing aids, (3) benefits of hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the experience of using hearing aids. This population may benefit from targeted strategies to support use of hearing aids. The findings from this study can inform future research to optimise use of hearing aids in this population.

Pure Tone Audiometry and Hearing Loss in Alzheimer's Disease: A Meta-Analysis

“…However, early treatments such as cholinesterase inhibitors and memantine may be used to slow the progression of AD symptoms (Anand and Singh, 2013;Sharma, 2019). Furthermore, lifestyle modifications such as increased aerobic activity, treatment of comorbid conditions as well as modifiable risk factors such as ARHL may slow progression of AD and lessen its impact on individuals and caregivers as secondary and tertiary prevention strategies (Khalsa, 2015;Hubbard et al, 2018;Jongsiriyanyong and Limpawattana, 2018;Mattson and Arumugam, 2018;Bhatti et al, 2020;Gregory et al, 2020).…”

“…Current hypotheses postulate that hearing loss increases cognitive demand and therefore predisposes individuals to AD neurodegeneration; that hearing loss results in social isolation which is a risk factor for AD; or that ARHL is an early clinical feature of AD pathology (Loughrey et al, 2018;Chern and Golub, 2019;Jafari et al, 2019;Ralli et al, 2019;Mertens et al, 2020;Utoomprurkporn et al, 2020;Knopke et al, 2021). Regardless of etiology, diagnosis of ARHL in AD may be useful since its treatment shows potential for being a modifiable risk factor to delay disease onset or slow rate of cognitive impairment (Hubbard et al, 2018;Jafari et al, 2019;Gregory et al, 2020;Mertens et al, 2020;Utoomprurkporn et al, 2020). As AD remains incurable, promotion of healthy lifestyle and reduction of modifiable risk factors remain the most practical and cost-effective methods of addressing the disease (Khalsa, 2015;Hubbard et al, 2018;Jongsiriyanyong and Limpawattana, 2018;Mattson and Arumugam, 2018;Bhatti et al, 2020;Gregory et al, 2020).…”

Dementia and hearing-aid use: a two-way street

“…Modifiable risk factors for dementia include untreated mid-life hearing loss, and it has been estimated that 8% of dementia cases globally are attributable to this factor (Livingston et al, 2020). Proposed mechanisms responsible for the relationship between hearing loss and the development of dementia include (1) common underlying pathology (probably vascular), (2) impoverished input affecting brain structure and function, (3) cognitive resources over-occupied in listening unavailable for higher functions, and (4) interaction between auditory function and dementia pathology (Griffiths et al, 2020).…”

“…It deserves mention that the influential Lancet Commission report (Livingston et al, 2020) citing these same three studies, states "The long follow-up times in these prospective studies suggest hearing aid use is protective, rather than the possibility that those developing dementia are less likely to use hearing aids." However, none of these studies controlled for HA use persistence, and one is cross-sectional, therefore we do Livingston et al explicitly point out elsewhere in their report that in order to have any helpful effect, HAs have to be usable by the patients concerned.…”

“…The authors interpreted this as “support [for] future research on whether HA treatment may reduce risk of cognitive decline.” However, HA use was only assessed at the end of the study, so if anything, the results point to the reverse direction of causality. In the third study, Gregory et al (2020) carried out qualitative interviews with sixteen HA owners with MCI or mild AD were conducted to explore experiences of HA use. Four themes emerged: (1) memory problems reduce use; (2) practical issues reduce use; (3) most participants found HAs to be beneficial; but (4) some show ambivalence about the need for HAs.…”