We Are What We Hear: Hearing Loss, Dementia and Brain Change

We Are What We Hear: Hearing Loss, Dementia and Brain Change
Dr. Ogan Gurel, MD


Life is all about change. The body and mind adapt to the world around us. An unhealthy diet tends to lead to obesity. The mind is likewise adaptable: we know that role models shape us from young and we were constantly reminded by our parents to “stay away from bad influence.” And so we are what we eat, what we see—and indeed what we hear.

Hearing loss affects many worldwide

Most of us have heard that hearing loss is a big problem, recognizing that with aging populations and an increasingly noisy world, it is only going to get worse. According to WHO (World Health Organisation), 5.3% of the world’s population has disabling hearing loss with about one-third of persons over 65 years of age being affected.

Hearing and Brain Structure

There is a strong connection between hearing and the brain: sounds are perceived in the inner ear, which are then changed into electrical signals via nerve pathways to the brain. The latest research has shown that decreased hearing ability changes the structure and function of the brain – the brain regions related to hearing and understanding language were actually smaller in people with hearing loss.

Hearing Loss and Dementia

Hearing loss is also connected to overall cognitive decline and conditions such as Dementia. While the medical community are still trying to understand how the two are connected, there are a few theories:

  • People with hearing loss tend to feel isolated, since it’s hard to join in conversations or be social with others when you can’t hear.
  • If you have hearing loss, your brain needs to work harder to process sound. That may take away resources that it could use for other important activities.
  • If your ears can no longer pick up on as many sounds, your hearing nerves will send fewer signals to your brain. As a result, the brain declines.

You can do something about Hearing Loss: Try Hearing Aids today in Singapore

hearing aid Singapore
The best news is that Hearing Aids are a highly effective solution for those with hearing loss. If we are near-sighted, we don’t just blindly stumble along—but get glasses. If we have chest pain, we don’t just meekly wait for the heart attack—but seek a doctor, and strive to improve our diet and lifestyle. And likewise, when it comes to hearing, we take a hearing test and get properly fitted hearing aids that will continue to fill and inspire our minds with beautiful sounds.

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Types of hearing loss

Types of hearing loss

Hearing loss can be caused by many different circumstances and can occur at any age. There are three basic types of hearing loss:

Conductive hearing loss

Conductive hearing loss is a decrease in sound due to problems located in either the middle ear or the outer ear. This type of hearing loss is often treatable with the right type of intervention such as medication or surgery. The conductive hearing loss can have several causes. Among them are ear infections which tend to cause fluid in the middle ear, wax in the ear canal or a perforation of the eardrum.

Sensorineural hearing loss

Sensorineural hearing loss is a problem related to the inner ear and/or the nerve pathways between the inner ear and the brain. Along the most common causes of sensorineural hearing loss are:

  1. Aging
  2. Infection
  3. Excessive exposure to noise
  4. Meningitis
  5. Certain genetic disorders
  6. Meniere’s disease
  7. Viruses

The sensorineural hearing loss is not correctable and is treated with hearing aids.

Mixed hearing loss

The mixed hearing loss is the occurrence of both a conductive hearing loss and a sensorineural hearing loss at the same time. Thus, the inner ear and nerve paths are damaged as well as a blockage in either the middle ear or the outer ear. While the conductive hearing loss can usually be corrected, the sensorineural problem is permanent and hearing aids are usually prescribed.

Sooner is better

The sooner you take steps to manage your hearing loss, the easier your process will be. The ability to hear resides in our brain; the longer it is deprived of sounds, the harder it is to teach it to hear those sounds again. Wearing hearing aids can prevent or reduce this negative impact.

Getting treatment can improve your quality of life dramatically:

  • Greater self-confidence
  • Closer relationships with loved ones
  • Improved outlook on life

Source: http://www.resound.com/en-US/about-hearing-loss#anchor1

Tips to Improve Communication when Talking with Someone with Hearing Loss

Hearing aids alone may not let a person with hearing loss to communicate successfully in all listening situations. As a family member or friend of a person with hearing loss, you can help improve communication by following a few simple suggestions. Remember, communication involves at least two individuals: a talker who sends the message and a listener who receives the message.

1) Gain attention

Gain the listener’s attention before you begin talking, for example, by saying his or her name. If the person with hearing loss hears better from one ear, move to that side of the person. If necessary, touch the listener’s hand, arm, or shoulder lightly. This simple gesture will prepare the listener to listen and allow him or her to hear the first part of the conversation.

2) Maintain eye contact

Face the person with hearing loss. Make eye contact. Your facial expressions and body language add vital information to the communication. For example, you can “see” a person’s anger, frustration, and excitement by watching the expression on his or her face.

3) Keep hands away from face

When talking, try to keep your hands away from your face. If you are a smoker, hold the cigarette in your hands while talking. You will produce clearer speech and allow the listener to make use of those visual cues.

4) Avoid covering or changing the shape of your lips and mouth

Most listeners make use of lip-reading. Lip-reading helps improve recognition of some sounds and speech that are more difficult and especially in difficult listening situations. To help with lip-reading, do not overdo or create odd lip shapes when applying lipstick, do not talk with food in your mouth and do not chew gum. Keep in mind that heavy beards and moustaches can also hide your mouth.

5) Speak naturally

Speak distinctly, but without exaggeration. You do not need to shout. Shouting actually distorts the words. Try not to mumble, as this is very hard to understand, even for people with normal hearing. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process speech.

6) Rephrase rather than repeat

If the listener has difficulty understanding something you said, find a different way of saying it. If he or she did not understand the words the first time, it’s likely he or she will not understand them a second time. So, try to rephrase it.

7) Converse away from background noise

Try to reduce background noises when conversing. Turn off the radio or television. Move to a quiet space away from the noise source. When going to a restaurant or making dinner reservations, ask for a table away from the kitchen, server stations, or large parties.

8) Move to an area with good lighting

When in a restaurant or other social gathering, sit where there is good lighting so that your face can be more easily seen. Also, avoid strong lighting coming from behind you, such as through a window.

Writing, texting, using visual media (such as pictures, diagrams and charts) and finger spelling are other methods of communication. If the person you are speaking with is deaf and uses sign language, communicating by sign language would be the most ideal.


  • Steps to Better Hearing: There is More to Hearing Loss than Just a Hearing Aid. hearingloss.org
  • Medwetsky L. Hearing loss. In: Duthie: Practice of Geriatrics, 4th ed. Saunders; An Imprint of Elsevier; 2007 (23):294-295.

Source: http://my.clevelandclinic.org/health/diseases_conditions/hic_Hearing_Loss_Communication_Strategies_for_Family_and_Friends/hic-tips-improve-communication-when-talking-someone-hearing-loss

Improving hearing loss with hearing aids

Improving hearing loss with hearing aids

A hearing care specialist can identify the type of hearing loss you or your loved one has.  They will also measure the degree of your hearing loss and discuss treatment options; and if hearing aids are part of that treatment, they will introduce you to the styles and technologies that best fit your unique situation.  

Wearing a hearing aid means rediscovering the pleasure of gathering with friends and family, feeling more confident at work, and enjoying movies, music and TV programs. A hearing aid means living with all of your five senses again.

Modern hearing aids are almost invisible

Today’s hearing aids are as small, comfortable and attractive as they are powerful and they have limited impact on your appearance. In fact, most people will not even notice you are wearing one. Not being able to hear is actually more visible than wearing a hearing aid.

Choosing a professional

Finding a good hearing healthcare professional is an important first step in managing hearing loss. He/she will help you find the right hearing aid for you, make sure it is programmed properly and help you adjust to your new hearing aids.

Source: http://www.resound.com/en-US/about-hearing-loss#anchor1

Why can’t I hear?

Why can’t I hear?

Early signs of hearing loss can be subtle. Can you hear people but not always understand what they are saying? This is a common symptom of hearing loss.

Why? In 90% of all cases, hearing loss occurs when the delicate hair cells in the inner ear are damaged or not functioning properly. This means the brain does not receive all the information it needs to understand speech.

Usually this occurs first in the high frequency sounds, such as /f/, /s/, and /th/, that become difficult to hear. That’s why women’s and children’s voices sound softer and garbled. Imagine removing all the high keys on a piano and asking someone to play a well-known melody. Even with only six or seven keys missing, the melody might be difficult to recognize. People with hearing loss experience a similar variation of the soundtrack of their lives every day.


Recognizing the need for a hearing aid can be tricky

Because most hearing losses develop gradually, it is common not to recognize it immediately. Gradually the sounds of chirping birds or rustling leaves disappear without you even noticing it. Many people do not become aware of the problem until it starts to affect speech recognition and communication.


Hearing loss is not uncommon

More than 500 million people worldwide experience some degree of hearing loss. You might be one of them! If you are, hearing aids may help you regain your hearing so you can live the life you are used to.


Source: http://www.resound.com/en-US/about-hearing-loss#anchor1

10 cool facts about hearing

Did you know

  • Fish do not have ears, but they can hear pressure changes through ridges on their body.
  • The ear’s malleus, incus and stapes (otherwise known as the hammer, anvil and stirrup) are the smallest bones in the human body. All three together could fit together on a penny.
  • The ear continues to hear sounds, even while you sleep.
  • Sound travels at the speed of 1,130 feet per second, or 770 miles per hour.
  • Dogs can hear much higher frequencies than humans.
  • Ears not only help you hear, but also aid in balance.
  • Snakes hear through the jaw bone and through a traditional inner ear. In essence, snakes have two distinct hearing mechanisms, which helps them hear and catch prey.
  • Sitting in front of the speakers at a rock concert can expose you to 120 decibels, which will begin to damage hearing in only 7 1/2 minutes.
  • Thirty-seven percent of children with only minimal hearing loss fail at least one grade.
  • Male mosquitoes hear with thousands of tiny hairs growing on their antennae.

Source: American academy of audiology

Will hearing aids help my tinnitus?

Tinnitus (“TIN-a-tus” or “Tin-EYE-tus”) refers to “ringing in the ears” when no other sound is present. Tinnitus can sound like hissing, roaring, pulsing, whooshing, chirping, whistling, or clicking. Tinnitus can occur in one ear or both ears. Below are some commonly asked questions about tinnitus.

Is tinnitus a common problem?
Yes. Almost everyone at one time or another has experienced brief periods of mild ringing or other sounds in the ear. Some people have more annoying and constant types of tinnitus. One-third of all adults experience tinnitus at some time in their lives. About 10%–15% of adults have prolonged tinnitus requiring medical evaluation. The exact cause of tinnitus is often not known. One thing is certain: Tinnitus is not imaginary.

Is tinnitus a disease?
No. Just as fever or headache accompanies many different illnesses, tinnitus is a symptom common to many problems. If you have tinnitus, chances are the cause will remain a mystery.

What causes tinnitus?
Conditions that might cause tinnitus include:

  • Hearing loss
  • Ménière’s disease
  • Loud noise exposure
  • Migraine headaches
  • Head injury
  • Drugs or medicines that are toxic to hearing
  • Anemia
  • Hypertension
  • Stress
  • Too much wax in the ear
  • Certain types of tumors
  • Too much coffee
  • Smoking cigarettes

Why is my tinnitus worse at night?
During the day, the distractions of activities and the sounds around you make your tinnitus less noticeable. When your surroundings are quiet, your tinnitus can seem louder and more bothersome. Fatigue and stress may also make your tinnitus worse.

How is the cause of tinnitus diagnosed?
Tinnitus is a symptom of a problem. The first thing you should do is to try to find out the underlying cause. You should have a medical examination with special attention given to conditions associated with tinnitus. You should also receive a full hearing evaluation by an audiologist to see if hearing loss may be causing your tinnitus.

Should I see an audiologist?
Your hearing should be tested by an audiologist to see if hearing loss is present. Since tinnitus can be associated with a number of hearing-related conditions, the hearing (audiologic) evaluation can help provide information about the cause and treatment options for you.

Can tinnitus actually be measured?
Tinnitus cannot be measured directly. The audiologist relies on information you provide in describing your tinnitus.
The audiologist will ask you questions such as:

  • Which ear is involved? Right … left … both?
  • Is the ringing constant?
  • Do you notice it more at certain times of the day or night?
  • Can you describe the sound or the ringing?
  • Does the sound have a pitch to it? High pitch … low pitch?
  • How loud does it seem? Does it seem loud or soft?
  • Does the sound change in volume or pitch over time?
  • Do you notice conditions that make the tinnitus worse—such as when drinking caffeinated beverages, when taking particular medicines, or after exposure to noise?
  • Does the tinnitus affect your sleep … your work … your ability to concentrate?
  • How annoying is it? Extremely so or not terribly bothersome?

In discussing your answers to these questions, the audiologist can give you information that will increase your understanding of your tinnitus.

Knowing more about the cause of your tinnitus can be a great relief. When the possible cause of your tinnitus is understood, your stress level (which can make tinnitus worse) is frequently reduced. You can “take charge” by anticipating, preventing, and changing situations that make your tinnitus worse.

How is tinnitus treated?
The most effective treatment for tinnitus is to eliminate the underlying cause. Tinnitus, in some cases, can be a symptom of a treatable medical condition. Unfortunately, in many cases, the cause of tinnitus cannot be identified, or medical or surgical treatment is not an option. In these cases, the tinnitus can still be managed using a variety of other methods. Be sure to discuss with your doctor any medical treatment options before considering tinnitus management.

Tinnitus management can include:

  • Biofeedback
  • Hypnosis
  • Electrical stimulation
  • Relaxation therapy
  • Counseling
  • Habituation therapies
  • Tinnitus maskers
  • Sound machines

Audiologists and otolaryngologists (ear, nose, and throat doctors, or ENTs) routinely collaborate in identifying the cause of tinnitus and providing treatment and management. A treatment that is useful and successful for one person may not be appropriate for another.

Will a hearing aid help my tinnitus?
If you have a hearing loss, there is a good chance that a hearing aid will both relieve your tinnitus and help you hear. Your audiologist can assist with the selection, fitting, and purchase of the most appropriate hearing aids for you. Your audiologist will also help you learn how to get the best use out of your hearing aids.

What is a tinnitus masker?
Tinnitus maskers look like hearing aids and produce sounds that “mask,” or cover up, the tinnitus. The masking sound acts as a distracter and is usually more tolerable than the tinnitus.

The characteristics of the tinnitus (pitch, loudness, location, etc.) that you describe for the audiologist determine what kind of masking noise might bring relief. If you have a hearing loss as well as tinnitus, the masker and the hearing aid may operate together as one instrument.

Like all other treatments for tinnitus, maskers are useful for some, but not all people. As with a hearing aid, a careful evaluation by an audiologist will help decide whether a tinnitus masker will help you.

Are there other devices that can help me?
Sound machines that provide a steady background of comforting noise can be useful at night or in a quiet environment. Fish tanks, fans, low-volume music, and indoor waterfalls can also be helpful. Today there are even applications for portable media players (iPod or MP3 players) that offer a variety of masking sounds that may reduce the annoyance of tinnitus.

Should I join a self-help group?
Tinnitus can be stressful because it can be difficult to describe, predict, and manage. Self-help groups are available in many communities for sharing information and coping strategies for living with tinnitus.

Often a self-help group promotes feelings of hope and control. Members of the group share strategies they have found successful in dealing with their tinnitus. It can help to be reassured that you do not have a rare disease or serious brain disorder or are not going deaf. With support, people with tinnitus usually find that they can cope with their tinnitus.

Source: American Speech-Language-Hearing Association

How long does it take for your brain to realize you have started to wear a hearing aid

THE ANSWER is “instantly.” The brain is able to detect amplified sounds immediately after the insertion of a hearing aid, as long as the damage is not too significant.
Normally when sound enters the ear, acoustic information is relayed from the ear to the brain via nerve cells, called neurons. As the sound gets louder, more neurons fire simultaneously, which in turn allows the brain to detect the change in volume.

A hearing aid acts as a microphone, magnifying sounds that enter the ear. Hearing aids are mostly used in people who suffer from hearing loss because of damage to hair cells, the small sensory cells in the inner ear. Healthy hair cells can detect the magnified sounds from a hearing aid and convert them into neural signals. But the greater the damage to a person’s hair cells, the more severe the hearing loss and the more the hearing aid will need to make up the difference.

Hearing aids are able to help millions of people decipher sounds they could not access before, but these devices do not help everyone to the same degree. That is because although hearing aids make sounds louder, they do not repair or compensate for the damage that has taken place in the ear and the brain. As a result, hearing aids help the signals reach the brain, but the brain may not be able to process the signals, making the hearing aid less effective.

Source: Kelly Tremblay, associate professor of speech and hearing sciences at the University of Washington

Why do you hear the ocean when you hold a seashell to your ear?

Do you remember trying this as a kid — Holding one of the seashells you grabbed as a souvenir up to your ear? It seems like no matter how far away from the ocean you are, you can still hold a seashell up to your ear and hear the roar of the waves rolling onto the shore. The best shells for producing this sound are the large, spiral conch shells.

Some people have suggested that the sound you hear from the seashell is the echoing of your blood rushing through the blood vessels of your ear. That is not the case. If that were true, then the sound would intensify after exercising, since your blood races faster after exercising. However, the sound is the same even after exercising.

Others say that the whooshing sound inside the shell is generated by air flowing through the shell – air flowing through the shell and out creates a noise. You’ll notice that the sound is louder when you lift the shell slightly away from your ear than it is when the shell is right against your head. However, this theory doesn’t hold true in a soundproof room. In a soundproof room, there is still air, but when you hold the seashell to your ear, there’s no sound.

The most likely explanation for the wave-like noise is ambient noise from around you. The seashell that you are holding just slightly above your ear captures this noise, which resonates inside the shell. The size and shape of the shell therefore has some effect on the sound you hear. Different shells sound different because different shells accentuate different frequencies. You don’t even need the seashell to hear the noise. You can produce the same “ocean” sound using an empty cup or even by cupping your hand over your ear. Go ahead and try it and vary the distance at which you place the cup near your ear. The level of the sound will vary depending on the angle and distance the cup is from your ear.

Noise from outside the shell also can change the intensity of the sound you hear inside the shell. You can look at the shell as a resonating chamber. When sound from outside enters the shell, it bounces around, thus creating an audible noise. So, the louder the environment you are in, the louder the ocean-like sound will be.

Source: Howstuffworks

10 tips for family communication

When you’re a family member coping with the hearing loss of a loved one, you may encounter frustration, the feeling of being ignored, separation from the relationship and isolation from daily family life. These are all normal reactions to the communication difficulties you are experiencing. However, family life doesn’t have to suffer if everyone can agree to follow these 10 tips.

1. Don’t take it personally
When communication challenges pop up, take a deep breath. Remind yourself – no one is purposely trying to be rude. If you don’t understand someone, take it in stride; you can fix it and move on, rather than letting it become cause for anger.

2. Get the listener’s attention first
When you want to speak to someone, especially when they’re involved in a task, gently touch them to get their attention before speaking. Alternately, saying their name and waiting for them to look at you before continuing ensures you have their attention before speaking. This gives them a chance to concentrate on listening to you and if necessary, reduce background noise by muting the TV or turning off the faucet, before you begin speaking.

3. Clearer is better than louder
Speaking clearly, enunciating each syllable, generally helps the person with hearing loss understand more than shouting.

4. Add pauses to your speech
People often think their family member with hearing loss will understand more if they slow speech down dramatically and drag out each word. This is a myth. It’s much more effective to slow speech down a bit by putting a slightly longer pause between each word, rather than saying the words slowly.

5. Avoid one-word answers
For a person with hearing loss, a one-word “yes” answer can sound strikingly similar to a one-word “no” answer. This is especially true in background noise or when the listener can’t see the speaker’s face. Instead, practice saying things like, “Yes, I did,” or “No, we weren’t.” Those extra syllables don’t take much effort and go a long way to helping the listener understand what you said. People with hearing loss can benefit from more words to gather the meaning. Even “cannot” is easier to understand than “can’t,” which is easily mistaken for “can” and may cause disastrous results.

6. Get closer
In challenging hearing situations, like restaurants, parties or places with lots of background noise, position yourself so you are face-to-face with the person with whom you’re conversing. Resist the temptation to call out from another room – walk to the location of the person you’re seeking and then talk at a normal level.

7. Rephrase, don’t repeat
If someone indicates they don’t understand what you said, avoid saying the exact same thing again. Instead, rephrase the sentence so it’s stated differently.

8. Get professional help
If communication difficulties are creating family conflict, help is available. Most hearing care practitioners are experts at helping family members learn new communication strategies and would be happy to assist. Advice coming from a neutral third-party is often easier to accept than when it comes from a loved one.

9. Wear the hearing aids
If you’re the person with hearing loss and you have hearing aids, wear them consistently. It shows you’re doing your part to enable communication. If you’re the family member of a person who is resistant to wearing hearing aids, show appreciation when they do wear them. Buying your loved one a package of hearing aid batteries is a kind gesture to show you care about being able to communicate with them.

10. Get the facts
If you think you or your family member may be having trouble hearing clearly, you owe it to yourself and your family to find out what’s going on. Only a licensed professional hearing care practitioner or physician can thoroughly test hearing and determine the best course of action for hearing loss. Don’t delay getting a hearing test – every day is a new opportunity to communicate effectively with your loved ones.

Source: Hearing Better