What was the reason the patient initially booked an appointment?
The patient booked an appointment with me as he felt his ears were blocked with wax, he was struggling to hear, and this was greatly affecting conversation with his family and friends. He was becoming withdrawn from the family, depressed and could not take part at social gatherings. He had bilateral hearing aids from an AQP provider and wasn’t hearing well with them at all.
The gentleman had been referred for memory assessment by his GP as there were some concerns over his memory and there had been some safeguarding issues. Research into the links between hearing loss and dementia has reported that:
- Hearing loss is the largest modifiable risk factor against dementia
- The risk if getting dementia almost doubles if you have an untreated mild hearing loss
- With a moderate hearing loss, the risk of dementia triples
- With a severe untreated hearing loss a person is five times more likely to develop dementia. (Lancet Commission, 2020)
The symptoms of hearing loss can be like some early signs of dementia. For example, the gentleman had become confused and had struggled to follow conversation. When a person has hearing loss, it can make diagnosing dementia more difficult. They may have difficulties with some of the questions they are asked in the assessment, or their hearing loss may mask the difficulties they are having.
It was important to ensure the gentleman was hearing to the best of his ability with ears that were clear of wax and hearing aids in good working order. This would hopefully enable the professional doing the memory assessment to come to the appropriate conclusions.
What happened during the appointment?
The gentleman had used olive oil ear drops in both ears prior to the appointment. Everything was explained fully, and I made sure the gentleman understood the microsuction procedure. A history was taken and consent to treatment was obtained. The wax was removed from both ears using microsuction. The gentleman noted an immediate improvement in his hearing following wax removal and he was able to hear well with his hearing aids.
What was the outcome of the appointment?
The gentleman was very happy following wax removal as his hearing improved greatly. The gentleman had the memory assessment the following week. The family made sure the clinician carrying out the memory assessment was fully aware that the gentleman had a hearing loss.
The gentleman had not had a hearing test in the last 3 years, and he was advised to contact his hearing aid provider for a repeat hearing test and fine tune/change over of his current hearing aids. If the gentleman was experiencing early signs of dementia, it is important to have regular hearing tests, ideally every 2 years. There is good evidence that proper diagnosis and management of hearing loss reduces the additional risk of dementia caused by that loss.
Hearing aids, particularly when started early, are an extremely effective intervention that reduce not only the risk of, but potentially the impact of, dementia.