Hearing loss, dementia and music

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Outlined below is some information relating to hearing loss, dementia and music which has been put together by the Action On Hearing Loss Charity.

Is dementia linked to hearing loss?

Yes. A report by Gill Livingston and colleagues shows that mid-life hearing loss is the number one potentially modifiable risk factor for dementia (Lancet, 2017).

What research do we have?

Please visit our blog. Over the last few years, there is growing evidence of a link between dementia/cognition and hearing loss. Hearing loss and dementia are linked with ageing and often occur together as we get older – the majority of people with dementia are over 70 and nearly three quarters of people over 70 have hearing loss. There is strong evidence that mild hearing loss doubles the risk of developing dementia, with moderate hearing loss leading to three times the risk, and severe hearing loss five times the risk. Hearing loss can be misdiagnosed as dementia or make the symptoms of dementia appear worse.

Common symptoms of dementia

  • memory loss
  • confusion (not remembering what they were saying)
  • difficulty with thinking and decision making (should they answer the door?)
  • decline in skills needed for everyday living (not remembering how to cook)
  • changes in ways of communicating (not being able to find the correct word, mixing up words, or repeating what’s been said).

Common symptoms of hearing loss:

  • difficulty hearing other people clearly and misunderstanding what they say, especially in group situations
  • asking people to repeat themselves and/or speak more slowly
  • having the volume for music/TV higher than other people need
  • difficulty hearing the phone/doorbell
  • finding it difficult to tell which direction noise is coming from
  • often feeling tired or stressed, from having to concentrate while listening.

Why is it important to have the correct diagnosis?

People with dementia can have difficulty communicating with others, including finding the right words, or signs, for what they want to say. They will have difficulty processing what they’ve heard, particularly if there are distractions. This difficulty in processing information (when there is competing information, auditory or otherwise) can be one of the first signs of some form of cognitive impairment.

Proper diagnosis and management of hearing loss, including provision of hearing aids, reduce the risk and impact of dementia and other issues, such as falls and depression.

Although dementia is diagnosed in later life, changes in the brain usually start developing many years before. A recent study looked at the benefits of building a “cognitive reserve”, meaning that if the brain’s networks were strengthened, it could continue to function in later life regardless of the damage. Lifestyle factors can play a vital role in increasing or reducing an individual’s dementia risk. It is suggested that not smoking, keeping healthy, doing exercise and treating high blood pressure and diabetes can all help reduce the risk of dementia for some, as well as cardiovascular disease.

Remember that not everyone will successfully change their risk of dementia, as some risk factors are hereditary, and cannot be changed. If you are worried about hearing loss or dementia, it is best to speak to your GP who will then refer you to the appropriate professional for further investigation, for example an audiologist or ENT Consultant for hearing difficulties.

We recommend people get their hearing tested and, if they have hearing loss, to get hearing aids, as the evidence suggests that they can help reduce the risk of dementia and its impact.

Information for care home staff

Click here to view – Guidance for residential care homes

1. Be alert to the early signs of hearing loss

When new residents arrive, be aware of the signs of hearing loss, such as asking others to repeat things, failing to follow conversation in noisy places, and behavioural changes such as withdrawal from social activities.

Care staff should encourage people to seek help and be aware of the role of the GP in referring people for a hearing test. Our Hearing Check – www.actiononhearingloss.org.uk/hearingcheck – can help identify people who may need a hearing test. Portable hearing screening devices are also available.

2. Provide support to help people get the most out of their hearing aids

If the person has a hearing aid, record this in their care plan and make a note of other accessories that may be needed, such as replacement batteries or tubing. When someone is fitted with hearing aids by their audiologist, they should be provided with written instructions on how to operate and maintain their hearing aids.

Carry out regular checks to make sure that hearing aids are functioning and fitted correctly. If hearing aids are worn continuously, hearing aid batteries typically last no more than a week and hearing aid earmoulds and tubing require regular cleaning.

Please get in contact with our hearing aid support service if you are unsure of how the hearing aid works or are concerned that hearing aids are not working, visit www.actiononhearingloss.org.uk/heartohelp.

Please get in contact with the person’s audiology service provider if you are unsure of how the hearing aid works or are concerned that hearing aids are not working. In some areas, our Hear to Help services also offer support to people living in care homes. To find out more, please visit:  visit www.actiononhearingloss.org.uk/heartohelp.

3. Provide support to help people access earwax removal services

Untreated earwax is the biggest cause of temporary hearing loss. Wax blocking the ear canal can also cause hearing aids to whistle and hearing aid tubing blocked by wax will need to be cleaned regularly or replaced.

If you think someone has an earwax blockage, they will need to see their GP. If you think the tubing of person’s hearing aid is blocked, contact the person’s audiology service provider.

4. Ask people if they need help to communicate or understand information

If people who are deaf or have hearing loss need staff to follow simple communication tips or if they need more communication time when receiving care, make sure this is recorded in their care plan.

In England, ensuring communication and information needs are recorded and met is a legal requirement under NHS England’s Accessible Information Standard.

5. Make sure the care home environment is welcoming for people with hearing loss

A high level of background noise can make it difficult for people with hearing loss to understand what is being said and participate fully in conversations and social activities. Carpeted floors, padded tablecloths and soft furnishings should be used wherever possible to help absorb background noise.

People with hearing loss may also benefit from assistive technology, such as hearing loops, personal listeners and flashing smoke alarms, which is usually provided or funded by local authority sensory services.

6. Take account of the cultural and communication needs of people who are Deaf

Deaf people whose first or preferred language is British Sign Language (BSL) will need specialist care and support that recognises their language and the culture of the Deaf community. They may also need support from a qualified BSL interpreter, as well as help to contact family and friends, and local Deaf clubs or other community groups.

Advice for musicians

1. Don’t get too close to the speaker or the band

The closer you are, the louder the noise reaching your ears. This could result in permanent tinnitus (ringing in the ears) or premature hearing loss. The risk of damage is determined by how loud the music is, how long you are exposed to it, and your susceptibility to noise.

2. Take breaks when performing

Regular breaks from playing music will give your ears a rest. The longer you and your audience are exposed to loud music, the greater the risk of hearing damage.

3. Wear earplugs

The best way to protect your hearing is to use earplugs that are designed for listening to music. These do not muffle the sound but just reduce the volume. There are lots of different earplugs available, ranging from the inexpensive to the custom-made.

Advice when performing

1. Be aware of the hearing ability and accessibility requirements of your audience

When you are offering live music, be aware of who in the group is wearing a hearing aid and where the best position for them to sit in will be. Have the care homes staff checked that hearing aids are in full working order? Ensure that the listening equipment for hearing aid users is set up correctly and switched on, and that people benefitting from it are in the right position to do so.

2. Make sure there is enough space between your band/performers and the audience

If audience members are seated too close to you when you are playing loud music, they may experience tinnitus (ringing in the ears) or hearing loss if exposed to loud levels of music over time. Sitting too close to your instruments or speakers increases the risk of hearing damage, as people are more exposed to high noise levels.

If someone appears to react sensitively to sounds, they may wish to move further away from the music. Ask care staff if they know of any residents that react sensitively sounds.

Consider the length of time within the session and whether you may need to include some time for a short break. Take time to reflect on the session and make any changes if people seem uncomfortable.

3. Offer earplugs to everybody

Raise awareness of the importance of hearing protection when exposed to loud music, as some people will not consider the risk until it’s too late. Hand out free earplugs, so that everybody has a choice to protect their hearing.

4. Create an open and accepting environment

Every audience member is different. Encourage an open culture in the room where your audience feel welcome to interact, react and participate with the performance and each other if they want to.

For more information about being a musician and looking after your hearing, please visit:


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