Assistant Professor of Communication Disorders Sara Mamo at the University of Massachusetts Amherst School of Public Health and Health Sciences recently received a five-year, $745,000 grant from the NIH’s National Institute on Deafness and Other Communication Disorders to study age-related hearing loss in people with mild cognitive impairment or Alzheimer’s disease and related dementias. The goal is to identify techniques and tools to improve their ability to engage with family, caregivers and friends and to enhance their quality of life. The two-part study will include laboratory-based experiments and a field study of older adults.
Dr. Mamo says, “We know there are associations between age-related hearing loss and dementia, and they probably feed off each other. There are a couple of ideas out there about what’s going on. One says there is a common cause for both conditions; your biological systems are slowly failing and if you’re aging more rapidly than someone else it’s not just one system that’s declining.”
“The other idea is that hearing loss accelerates one’s cognitive declines because people with hearing loss are more isolated, their social interactions are more taxing, they’re fatigued by the effort it takes to communicate and it happens gradually, so people may be backing out of situations that have become difficult and they may not realize how isolating it is until they’re way down that path,” she adds.
“We don’t have enough evidence to say which of these is the case, but we do know we need to address this problem because the population is aging. In fact it’s estimated that two-thirds of people over 70 have hearing loss. With this study we are interested in knowing if we treat the hearing loss, can we slow down the cognitive decline. We already know that the earlier the intervention the better, because the sooner people can adjust to using hearing aids and good communication behaviors, the better.”
The laboratory arm of the study will test the ability of older adults with and without early-stage cognitive impairment or dementia to understand speech in difficult listening environments, such as in the presence of “white noise” or other people talking. Dr. Mamo says, “We know that way down the line in dementia there are a lot of communication problems, but we don’t know if there are problems in the early stages. Either answer will be useful because it will inform us about rehabilitation services that will be most useful to persons with hearing loss and cognitive decline.”
The research audiologist will conduct the field part of her study at in Programs of All-Inclusive Care for the Elderly (PACE) centers in Massachusetts where older adults receive all-inclusive health care. One goal will be to investigate the population-level observation that people with age-related hearing loss have more negative health outcomes, such as more falls and more hospitalizations, for example.
“I want to identify where problems might be happening and create an intervention that can be applied at the group level,” she notes. In a pilot study at one PACE site, she found that it was helpful to install a speaker system to boost room acoustics. Dr. Mamo also wants to provide PACE staff with training and portable amplification systems similar to those found in churches and theatres to boost hearing and speech comprehension for older adults with hearing loss, “because not hearing what’s happening can lead to a lot of agitation, fear, anxiety and other problems in elder care,” she points out.
“We hope that taking a group approach can help a lot of people at once,” she says. “We want to set up the environment to be more functional for everyone. For example, the changes we made with the sound system cost $1,200 and that’s less than one hearing aid. I think there is a lot that can be done that’s not expensive. We’re taking a public health rather than a medical approach, which is an exciting new path in hearing research.”
Dr. Mamo’s NIH grant is a mentored patient-oriented grant and her primary mentor will be hearing researcher Dr. Karen Helfer at UMass Amherst, with alumna Dr. Catherine Palmer of the University of Pittsburgh and surgeon Dr. Frank Lin at Johns Hopkins School of Medicine.