Understanding The Auditory Process
Believe it or not, hearing is the fastest sense that you have. Sight comes second, because it takes longer for information from your eyes to get to your brain. Meanwhile, it only takes your brain 0.05 seconds to recognize a sound wave, once it reaches your ear.
Your outer ear is responsible for conducting sound. This means the outer ear picks up sound in your environment. Sound waves travel through to the middle ear, where they are amplified and turned into vibrations by the ear drum. These vibrations travel to the inner ear, where they are translated into neural signals by your inner ear hair cells. These neural signals then travel to the brain, where they are processed as sounds.
There are a number of different causes for hearing loss. One of the most common causes is sensorineural hearing loss, caused by the loss of inner ear hair cells. Exposure to loud noises or certain classes of medication can damage these inner ear hair cells once they are gone, they do not regenerate. As a result, sensorineural hearing loss affects the way our brains process sound.
Hearing Loss And Dementia
Did you know that hearing happens in the brain? While our ears play a very important role in the auditory process, the brain is central to how we hear. In the past decades, researchers have found convincing information linking the potential risk for developing dementia with untreated hearing loss. Here, we take a look at the process of hearing and how untreated hearing loss affects your cognitive ability, possibly increasing the risk for dementia.
The Dangers Of Using Q
Every year, about 12 million Americans head to their healthcare providers with impacted or excessive cerumen, which means their ears are just full of earwax. All those checkups lead to about 8 million yearly earwax removal procedures performed by medical professionals , according to the American Academy of OtolaryngologyHead and Neck Surgery.
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What Is Earwax Buildup
Earwax is produced by glands in the ear canal. Although scientists are still not completely sure why we have earwax, it does trap dust and other small particles and prevent them from reaching and possibly damaging or infecting the eardrum. Normally, the wax dries up and falls out of the ear, along with any trapped dust or debris. Everyone makes ear wax, but the amount and type are genetically determined just like hair color or height. Smaller or oddly shaped ear canals may make it difficult for the wax our ears make naturally to get out of the canal. This can lead to wax impactions. This is earwax buildup.
The Dangers Of Excessive Earwax
The greasy buildup poses unrecognized risk in long-term care settings
Of all the indignities that come with aging, excessive earwax may be the most insidious.
That greasy, often gross, buildup occurs more often in older ears than those of the young, experts say. And when it goes unrecognized, it can pose serious problems, especially for the 2.2 million people who live in U.S. nursing homes and assisted living centers.
The excessive amount can cause hearing loss or ringing in your ears. Some people experience vertigo, which increases the risk of falling, said Jackie Clark, a board-certified audiologist who is president of the American Academy of Audiology. Right now, we see some correlation between hearing loss and cognitive decline.
Earwaxwhich is not really wax at all, but a substance called cerumen that binds with dirt, dust and debrisis normally produced by the body as a way to clean and protect the ears. In most people, the self-cleaning process works fine.
But in othersincluding about 10 percent of young children, 20 percent of adults and more than 30 percent of elderly and developmentally disabled peoplethe wax collects to the point where it can completely block the ear canal.
Up to two-thirds of people in nursing homes may suffer from that condition, known as impaction, according to 2017 guidelines for removal of impacted earwax issued by the American Academy of Otolaryngology-Head and Neck Surgery Foundation.
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Good Ear Care May Be Good For Your Brain
Could ear wax be impairing your cognitive health? By impairing your hearing, it might. And experts say that we might all benefit by taking note of this seemingly harmless substance that most of us give little notice to. Paying attention to ear wax may be especially important for anyone caring for someone with Alzheimers disease and older people who wear hearing aids.
Scientists increasingly recognize the importance of good hearing for brain health. In terms of modifiable risk factors for developing dementia, poor hearing has more of an impact than smoking, high blood pressure and lack of exercise. One analysis found that preventing or treating hearing loss in middle age has the potential to cut the likelihood of developing dementia years down the road by almost 10 percent.
Loss of hearing can contribute to social isolation, a known risk factor for Alzheimers disease and other forms of dementia. And even the mildest hearing loss, studies show, can take a toll on the brain.
Exposure to loud noise over a lifetime is a main reason for age-related hearing loss. But concerns have also been raised about ear wax, which can become impacted and dampen the ability to hear. Impacted earwax and loss of hearing can be a particular problem for patients with Alzheimers disease, impeding communication and worsening aggression and other difficult behaviors.
Clinical Practice Guideline: Cerumen Impaction. American Academy of Otolaryngology-Head and Neck Surgery. January 2017.
When To See Your Gp
Contact your GP surgery if you have particularly troublesome symptoms or eardrops haven’t helped after three to five days.
Your GP or practice nurse will look inside your ears to check if they’re blocked and might carry out some simple hearing tests.
They may suggest using eardrops for a bit longer, or they may carry out a minor procedure called ear irrigation to clean out your ear canal.
If these treatments aren’t suitable or don’t help, your GP may refer you to the ENT department of your nearest hospital for more specialised treatments such as microsuction or an aural toilet.
Dangers Of Using Cotton Swabs
Cotton swabs are frequently the go-to choice used to clean the wax out of the ear canals of people, which initially seems like a good idea unless you understand the anatomy and physiology well.
Only the outer one-third to one-half of the ear canal makes cerumen which functions to moisturize the skin and help prevent foreign bodies from entering deeper into the ear canal. The body also has hairs and the natural growth of canal skin is from the inside out, so it is normal for cerumen to “flow” out of the ear.
When people use cotton swabs they frequently clean out some of the wax, but also push some of it back deeper into the medial canal which cannot remove it well. It can get pushed up against the tympanic membrane and cause impactions that can impair hearing, can lead to infection and can be painful/difficult to remove.
Think of a cotton swab like the plungers used to load cannons. They can pack softer wax deeply in the ear canal against the eardrum.
If you use a cotton swab and create a formidable plug, preventing the eardrum from moving normally, it is quite easy to cause some significant hearing loss. Water can also be trapped behind these self-created wax dams and you may hear the water moving around in the ear.
When this happens, the ear will need to be lavagedwashed out by a gentle stream of warm water. Or, you will need to see your audiologist or healthcare provider, someone who can look inside your ear and remove the impaction professionally.
Reasons To Leave Earwax Alone
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
Follow me on Twitter @RobShmerling
Can you think of something you do thats nearly irresistible, widely popular, but a bad idea thats based on a health myth? Thats right, Im talking about inserting cotton-tipped swabs into your ears.
According to guidelines from the American Academy of Otolaryngology/Head and Neck Surgery Foundation, experts strongly discourage twirling cotton-tipped swabs in the ears. Heres why.
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Earwax Safeguards Your Ears
Its role is to protect the skin inside the auditory canal. It takes just a small break in that skin to cause an infection that leads to an earache. The strange texture of the earwax lubricates this skin, as well, and it is a natural antimicrobial, so it stops bacterial infections before they can start.
Earwax is similar to other protective elements on the body like nose hairs or tears. You dont think much about them, either, but they an important part of preventing infection.
Hearing Loss Linked To Alzheimerswhats The Connection
Studies suggest that hearing loss causes brain changes that raise the risk for dementia. Brain shrinkage When the hearing section of the brain grows inactive, it results in tissue loss and changes in brain structurecreating the first link between hearing loss and Alzheimers disease. Studies show that the brains of people with hearing loss shrinkor atrophymore quickly than the brains of people with normal hearing.Brain overload An overwhelmed brain creates the second link between hearing loss and dementia. When its difficult to hear, the brain must work overtime just to understand what people are saying. Straining to hear all day, every day, depletes a persons mental energy and steals brain power needed for other crucial functions like remembering, thinking, and acting. This can further set the stage for Alzheimers, dementia and other cognitive disorders.
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What Does It Mean When Earwax Becomes Impacted
We say that earwax is impacted when it has built up in the ear canal to such a point that there may be signs that something isnt quite right. Its important to note that most people might never need to clean their ears. Ears are designed to clean themselves. Earwax buildup and blockage often happens when people use items like cotton swabs or bobby pins to try to clean their ears. This only pushes the earwax farther into the ears and can also cause injury to the ear.
Studies Linking Untreated Hearing Loss And Dementia
A 2015 study from the University of Colorado, conducted by Anu Sharma of the Department of Speech Language and Hearing Science, looked at the brains neuroplasticity. Neuroplasticity is the ability of the brain to forge new connections, to determine the ways it adapts to hearing loss, as well as the consequences of those changes. Sharmas study first recorded the way brain waves responded to sound stimulus amongst adults and children who experienced hearing loss or deafness. They found that the areas of the brain responsible for processing vision or touch can recruit, or take over, areas in which hearing is normally processed, but which receive little or no stimulation in deafness and that cross-modal cortical organization meant that the brain was siphoning energy to overcompensate for hearing loss. According to Sharma, These compensatory changes increase the overall load on the brains of aging adults, which may be a factor in explaining recent reports in the literature that show age-related hearing loss is significantly correlated with dementia.
Researchers at Johns Hopkins University in Baltimore have led the charge on studies around hearing loss and the risk for dementia. In one notable study, Dr. Frank Lin and his team tracked 2,000 older adults over the course of six years. They found that 24% of test subjects were more likely to experience diminished cognitive decline, compared to those with normal hearing.
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The Relationship Between Memory And Hearing Loss
Your brain begins to get strained from hearing impairment before you even realize you have it. Your brain, memory, and even social life can, over time, be overwhelmed by the spillover.
How is so much of your brain affected by loss of hearing? Well, there are a number of different ways:
- Social isolation: Communication will become strained when you have a difficult time hearing. That can push some individuals to isolate themselves. Again, your brain is deprived of vital interaction which can lead to memory problems. The brain will continue to weaken the less its used. In the long run, social separation can result in depression, anxiety, and memory issues.
- Its getting quieter: Things will become quieter when your hearing begins to diminish . This can be, well, kind of boring for the region of your brain normally responsible for interpreting sounds. This boredom might not appear to be a serious issue, but lack of use can actually cause portions of your brain to weaken and atrophy. That can cause a certain amount of overall stress, which can interfere with your memory.
- Constant strain: Your brain will go through a hyper-activation fatigue, particularly in the early phases of hearing loss. Thats because your brain will be struggling to hear whats taking place out in the world, even though theres no input signal . This can leave your brain feeling tired. That mental and physical fatigue often results in memory loss.
Impacted Ear Wax Removal
If you experience vertigo due to wax build-up, or just suffer from impacted ear wax in general, dont reach for a cotton bud! Sticking anything in your ears, including cotton buds, is dangerous and could lead to you damaging your ear canal or worsening your symptoms.
Other alternative ear wax removal techniques like ear candling can also be dangerous and ineffective and are therefore not recommended1.
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Can Hearing Aids Help In Cognitive Decline
Hearing loss can put you at risk of depression, cognitive impairment, isolation, and anxiety. However, these problems can be alleviated with regular use of hearing aids when they are prescribed for your hearing loss. Hearing aids can help restore your communication function and improve your auditory memory and communication competence.
The University of Maryland Department of Hearing and Speech Sciences conducted research in which they monitored a group of first-time hearing aid users with mild to moderate hearing loss for six months. The research team has used various cognitive and behavioral tests to evaluate participants memory and hearing. After six months, participants showed significant improvement in listening, memory, and neural speech processing from using hearing aids. The findings of the research are published in Neuropsychologia and Clinical Neurophysiology.
The sooner you get your hearing loss treated with hearing aids, the better it will be for your brain and memory. Visit an audiologist near you to get your hearing tested and receive recommendations for the best hearing aids.
Contact us at to schedule an appointment with Dr. Chris Hoffmann!
How Memory Is Impacted By Hearing Loss
Did you turn up the TV last night? If so, it may be an indication of hearing loss. The problem is you cant quite remember. And thats starting become more of an issue recently. You couldnt even remember what your new co-workers name was when you were at work yesterday. Yes, you just met her but your memory and your hearing seem to be faltering. And theres just one common denominator you can find: aging.
Now, absolutely, age can be related to both loss of hearing and memory failure. But it turns out these two age-associated conditions are also connected to each other. That may sound like bad news at first . But there can be hidden positives to this relationship.
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Memory Loss Is An Early Warning System For Your Body
Memory loss isnt exclusive to hearing loss, naturally. There are plenty of things that can cause your memories to start to get fuzzy, including illness or fatigue . Eating better and sleeping well, for instance, can often improve your memory.
In this way, memory is sort of like the canary in the coal mine for your body. The red flags go up when things arent working properly. And having trouble recalling who said what in yesterdays meeting is one of those red flags.
Those red flags can be helpful if youre trying to watch out for hearing loss.
The Side Effects Of Excessive Earwax
But for many people, earwax is manifestly too much of a good thing. An ear canal plugged up with earwax can cause earaches, infections, and other problems. If it gets lodged in a certain way, earwax can cause a cough by stimulating the branch of the vagus nerve that supplies the outer ear. And, not surprisingly, an excess of earwax can result in some loss of hearing.
Guidelines from the American Academy of OtolaryngologyHead and Neck Surgery stress a let-it-be attitude toward earwax and warn against removal unless the earwax is causing a problem. Of course, sometimes it’s difficult to tell if the wax is the source of a problem without removing it and seeing whether the problem goes away.
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S To Reduce Your Dementia Risk
There are many factors that determine whether or not you will experience severe cognitive decline. Dementia is a complex set of diseases not completely understood by physicians and scientists. Risk factors are variables that contribute to your likelihood of getting a disease. For example, smoking cigarettes is a well-known risk factor for lung cancer. If you quit smoking, you reduce your risk of developing this cancer. Because the human body is extremely complicated, there are lots of different risk factors that come from your genetics, your environment, and your behaviors.
While it may not be possible to reduce your risk to zero, by taking steps to improve and maintain your brain health, you can significantly lower your likelihood of developing dementia. Lowering your risk can either slow the progression of cognitive decline or help stave it off completely.