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Mom has been hard of hearing for years, and she has never been a good listener, but lately it's been a little different. Sometimes her responses are incoherent. Sometimes I'll say something and she'll stare blankly at me as if I just asked her "What's 371 divided by 13?" before responding. Sometimes I'll speak at a normal tone of voice and she'll understand from across the room. A while ago I was sitting across the table and said, in a normal tone of voice, "Take your pills, Mom," and it was as if I didn't say anything. I know her hearing isn't that bad. (And she has no problem with taking her pills.)


Is it possible for cognitive decline to cause hearing loss or comprehension problems that seem like hearing loss? Is there a way I can test this through observation?

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It takes a while for them to process and comprehend. What you are describing is the progression of the Dementia. Which can also cause hearing loss and eye problems too. They go into their own little world too. Like a little kid. They get engrossed in a TV show or playing they don't hear you.

Not sure if you can "test" it. One day she could be with it and the next day not. One moment she could be with it the next ...

Dementia is a progressive Disease. My Mom had changes every month. Some decline faster than others.
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Lymie61 Feb 2019
I think the hearing loss has been a well known problem for this person for a long time so while hearing loss and dementia may be related it doesn't sound like dementia is the main cause of hearing loss in this instance though hearing loss may be contributing to the behaviors that look like dementia as well as any actual developing dementia.
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JoAnn has the best answers!

My own DH is a brilliant man--like genius level smart, but to talk to him (or try to, I should say) you;d think he was "slow". He cannot hear, so by the time the original comment or question has been posed, you get the feeling he's not "all there".

I have heard and read that deafness can cause neural decline--you don't hear, you stop thinking and you don't "get" all of what is being said.

My kids all think dad is showing signs of dementia. He's not. He just can't hear.
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I would get her seen by an Ear, Nose and Throat specialist to rule out any physical reasons, like excessive wax. Then I would get her hearing tested by a professional. That will help you understand if it is hearing loss or cognitive impairment, if she can't follow directions that is a pretty good sign she needs to see a neurologist for further testing.

Please don't assume that she has dementia, it will cause frustration for everyone because the real problem is being dismissed, if there is a problem.

Sometimes I don't hear everything because my head is stuffy or there is back ground noise that is interfering, I have no hearing loss, been checked by both the above to rule out treatable issues.

Good luck getting to the bottom of this.
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No, I don't want to jump to the conclusion that this is dementia. I'm just trying to get an idea of what I'm dealing with so I know what to look for going forward. Mom has many age-related issues and readily admits it, but for some reason she is sensitive about her hearing and is terrified of getting dementia. That's why I would never in a million years be able to get her go to ENT doctor, and especially a neurologist.
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You could try banging two saucepan lids together when she is not looking and see if she jumps. Or call her name when she is facing away from you to see if she hears you. I mean just as a rudimentary hearing test. If it's hearing loss, there may be certain tones she can't hear. I can understand my husband just fine, but my boy's high-pitched voice sounds like a bird chirping madly to me. Sigh, hearing aid time I guess.
Good luck!
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According to the audiologist where my husband was recently tested, loss of hearing can cause dementia.

Of course not every person who has dementia has hearing loss.

John Hopkins Dr Frank Lin says your odds increase of developing dementia with the degree of hearing loss. This from a 12 year study.

https://www.hopkinsmedicine.org/health/healthy_aging/healthy_body/the-hidden-risks-of-hearing-loss
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Just out of curiosity how or does this affect people deaf from birth. I don't really expect you to have an answer but my granddaughter (whom I've raised) is deaf from birth and so are many of her friends. I wonder if something else is in play with deafness/dementia?
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I don't know what the culprit is here, one, the other, or both. It's true that hearing loss can exacerbate dementia because your brain just has less to process and "gets out of practice."

Definitely have her ears an hearing checked, see if the aids are working properly, are correctly adjusted for her needs, are not clogged with earwax, and have good batteries.

My mom's aids are always getting clogged.

For m mom though, it's a combination. Hard of hearing and sometimes not understanding a word or two, just blanking out on the meaning. Sometimes it seems like she loses the ability to follow a sentence, thengets it back.

I also suspect she play games at times too. Acts like she doesn't understand me and then puts on a big show of abjectly and tearfully apologizing, so I'll feel sorry for her.

All this is to say that it can be really difficult to tease apart hearing loss from declining cognition. The first thing it to rule out whatever you can with the ears and the hearing aids. Then go from there.
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Thanks Kittybee,

Mom doesn't have hearing aids, and I doubt that I could convince her to see an ear doctor. She's going to have to be almost stone deaf before she'd even consider it!
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I have a similar problem with DW. If she wants to do something then that is the most important thing in the universe. It may the TV or a reflection in the mirror or even want to fold the wash cloth. She sometimes will just look at me and then turn away. Other times, depending on what she wants, she will follow instruction.

Hearing loss is a confused beast. Manys the time I have to figure out a missing word to know what the speaker is saying. And trying to understand children is a lost cause. Even the female voice at times is a loss.
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You said she is afraid of getting dementia and you doubt you could get her to a audiologist. You could use her fear to get her hearing tested. Nothing ventured nothing gained so don’t assume she won’t go. Tell her you read a study that points to hearing loss as a factor in dementia and that it would be a good idea if you BOTH got your hearing tested as a preventive measure. Hearing tests are free by the way. Would you be willing to do that?
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Just heard on the news a couple days ago that music can prevent or slow dementia, and it doesn't matter whether you play an instrument, sing, or just listen, but do so on a regular basis. My mom was a music teacher and sang around the house all the time or sat at the piano. My dad misses her desperately (she passed 8yrs ago) and still listens to 33rpm records on the stereo in his bdrm before bed every night or while working at his desk during the day. He sang in the church choir up until 2yrs ago at age 89 when he started using a walker. He also is hard of hearing and has difficulty sometimes processing my questions or comments, mostly because he hears a "b" as a "d" or an "f" as an "s" or the like, so I make him look at me so he can see my mouth. That usually clears it right up for him. He's still quite sharp cognitively.
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My mother is not hard of hearing but has advancing dementia. Sometimes she acts as if she doesn't hear me. I think she is often in her own world and is either incapable of responding and understanding or doesn't want to be bothered.
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For all we are beginning to understand about the brain, this sort of thing can be so difficult to tease out. My parents had hearing loss for years before they were both diagnosed with different forms of dementia. Looking back, I have to wonder whether the hearing loss was actually early comprehension loss, or the early onset of damage to the part of the brain where hearing lives. For me, it has been easier to just accept the changes as something to be lived with, regardless of the reason. If they don’t hear, I repeat, more slowly and a touch louder. If they still don’t hear, I simplify. I do hope you find the answers you are seeking, even if those answers are finding a way to cope with definitive diagnosis.
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I have said to my brothers for years, that my Dad has mild dementia. He has had hearing problems for years. they said he only had hearing loss. When he finally agreed to go to an ENT, the doctor said he had waited so long the neural pathways had deteriorated, and the Aids would help but not be satisfactory. 2 years later he went to an audiologist who told him he has to wait 1 year before deciding if they work, because the neural pathways need to be 'awakened'. He wore the aids for 4 months with frequent adjustments, and then gave up. On the other hand he also had a sudden cardiac death, 11 years ago. Fortunately he was at the heart doctor and hooked to an EKG when it occurred. After 2 rounds of cardiac resuscitation he had a heart beat. As the neurologist told him he should not be, let alone functioning. After that incident, and each defibrillator shock, his hearing, processing, and vision got worse. As it was explained to me it was a vascular dementia, because when his eyes were examined they were fine, not even a need for glasses, his hearing when tested though bad did not change to the level of hearing loss he said he had. Catching those words and processing them as some have said can be a hearing problem can also me a dementia problem. Hearing is a 5 point process. the ear picking up the sound, sound getting to the short term memory to hold while the brain accesses long term memory to make sense of it and then the verbal or physical command formed and being sent. Break down can happen in any of those steps. Because I had to work with my Dad and my brothers only visited with them they could not distinguish the difference. His has been mild 10 years and maybe now 1 year into the beginning of moderate. He still is quite functional, but no longer watches TV, can only read for a few minutes before having difficulty to concentrate, as he says. His hearing he complains is worse weekly and his head feels foggy.
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I don't have dementia but I do have significant hearing loss. Right now I am unable financially to get hearing aids. I find that if I am busy and don't hear one of my adult children say something it helps to get my attention if they say "MOM!" first before they start talking. Then I know they are not talking to someone else and they expect me to listen and respond. A small thing perhaps but sometimes phrasing can help a lot.
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20Eagle16 Feb 2019
That is a good technique, dazednconfused. I used it a lot with my mom. If you are having trouble with the cost of hearing aids, there are organizations that help provide same at a very low cost. For example, I just donated my mom's hearing aid, so that others might benefit. You might find some help. I would not put off getting hearing aids. Yes, they are horribly expensive...in some cases. But, try your best to buy on credit if you have to. Hearing loss can impact you greatly later on. As I mentioned on this post, hearing loss has been shown to be a contributor to cognitive decline. Hang in there.
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Sometimes elderly people have difficulty hearing a high pitched voice but respond well to a lower pitched voice. Could this be the case with your Mom?
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I don't think my voice is particularly high-pitched. I'd say in the tenor range. She doesn't seem to have as much trouble hearing my sister-in-law.
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NewandTrying... From the research that I have seen, often it is the opposite, i.e., loss of hearing can contribute to cognitive decline. My mom fought against getting a hearing aid for a long time. It was not until she was in her early 80s that she got one for her one ear. I believe the damage was already done by then. How much of a contribution to her Alzheimer's this had, I do not know, but I am just conveying what I have read in the past. If you mom does not have a hearing aid, I would encourage you to work with her to get one or a set. If she already has hearing aids, I would encourage you to get her to an doctor who knows what he/she is doing and see if you can get the hearing loss under control. From personal experience with my mom, I assure you that things can only get worse. Take action now!
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Beatty Apr 2019
Agree.

My Mum fought a hearing test for about 5 years. At least 2 more to get & actually wear the hearing aides.

Now a few years later, after a stroke, she refuses to wear them at all. Missing out on so much conversation. Tells me her news, then hangs head & disengages. I try every visit to have a 1:1 chat so she can lip read.

Attention span is only about 3 sentences now. Doesn't have a dementia diagnosis (yet) but they are many signs.
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My mom had hearing loss a few years before she was diagnosed with Alzheimer's.  She'd miss the gist of conversations, because she'd only pick up a sentence or 2, out of context. For example, we went to visit one of her friends, who said, "I've been so busy with parties, obligations, etc., that it was nice to sit home and just watch TV," and my mom said to my husband and me, when we were driving home, "She's such a nice woman, she shouldn't have to sit home and watch TV." I don't know if there was a causal or casual relationship between hearing loss and dementia, but I just tried to make the best of it. My mom had hearing aids, but she was uncomfortable wearing them. When I typed, "causal or casual," it brings up a good point, only tangentially related to hearing loss. My mom was reading a pharmaceutical pamphlet about a drug she was taking, and she misread "causal" for casual. This was when she had her full faculties,  so I'd suggest asking your mom to repeat things to you, if you're telling her something important, to make sure she hadn't misheard or misinterpreted something. If you can misread, you can mis-hear.
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That is so much like my mother. I'll say something and it's as if she only hears one particular word. Then she'll launch a story related to that word:

Me: "Mom, I think we should start preparing for the on-coming hurricane."

Mom: "I remember when Joe and Ester lived in Jacksonville and Ester was scared because a hurricane was coming..."
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Yes, when I talked my late dad without having to look at me, he couldn’t hear me. However, he kept asking me with his frustration tone of his voice that he wanted me to look at him when I talk to him so he could comprehend what I was saying.

I am partly deaf since I was a baby due to my cerebral palsy. I can hear voices, but I need to read lips to understand the subjects. Even though I wear hearing aids, I don’t like using the phone because of my hearing loss.

Get your mom's attention before you speak. I find that elderly people who have dementia, with hearing difficulties or not, have a very low attention span to grasp the conversation.
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She probably isn't paying attention to you - I did a test on my son who wasn't responding appropriately by standing behind him & dropping a pile of metal cookie sheets & muffin pans - he didn't jump so I had his ears checked & he had some wax - it is a short free test
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Beatty Apr 2019
Made me laugh with the baking trays!
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Yes, yes, yes! This is a fact that you will find in the medical literature with a little searching. (Of course true dementia and hearing loss do occur together, as well.) It seems hard for us to believe that someone wouldn't just say "what?" when they don't hear you but I think over time people give up since they're so used to not hearing what's going on and being a part of it. The saddest thing, and frankly it's a crime, is that insurance doesn't usually cover hearing aids, and most people can't afford them. Is this not a medical condition? Of course it is! I hope this changes in the future.
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I know that, for my dad, the hearing loss is complicated by some dementia. He has had some degree of hearing loss for many years. But now, at 88, there is quite significant loss of hearing. As time has gone on, he had also developed some dementia. Even if you get his attention and are looking right at him, he often cannot comprehend what you are saying, and replies inappropriately. For both of my parents, unfortunately, this is all accentuated by heavy alcohol intake, but that is a subject for another day!
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My mom does not have dementia but every so often when she doesn't hear what I've said she will repeat back the words that she thinks she hears that would have absolutely NOTHING to do with the conversation I just had with her. Ties sounds like pies, mirror sounds like here, and so on.

I ask her "why do you think I would say a word like that in a conversation about x,y,z?"
"Oh I don't know."
Well, she does know.
It did concern me a little because I thought that confusion or something was setting in, but I swear down, she is still all there mentally.

One of the best ways I knew she was in denial of her hearing loss was when I took her to her primary and spoke up about it. The Primary Care doctor totally understood and said to us both, "That is fixable we can get you tested and get a hearing aid for you."

To which mom responded, "Well sometimes I'm really not listening."

Please, if that was true you would not have asked me why I'm buying my husband a red and a blue silk PIE for his birthday last year. (Tie)...

I told mom that if I ever lose my hearing I'd run out and get a hearing aid. Some seniors feel embarrassed to wear them. I'd be more embarrassed about asking how the pies tasted when they're wearing their new birthday tie.
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Lymie61 Feb 2019
Hahaha, you probably know this by now but hearing aids and adjuncts are very different (or can be) from the ones your mom is picturing. Depending on her issues they even make them now that disappear completely nothing behind the ear so one would have to be looking for it to see it. You could even point out to her that she has know idea by looking at people how many of them are using aids these days.
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My DH had a problem with hearing consonants. You cannot observe, this has to be checked by a professional.
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My mom had hearing loss and dementia from Parkinson’s. She was given hearing aids to use (just after the Parkinson's diagnosis). She returned the hearing aids and told me they were too expensive. I felt terrible for her, because I knew that she and Dad could easily afford her hearing aids (Dad had worn his for years).

I later asked a hearing specialist about having my mom wear hearing aids. When we discussed that she had the Parkinson’s and dementia, she encouraged me not to force my mom to get them. She said that although my mom had some hearing loss, the main problem was the mental process of thinking through what she had heard. For Mom, she needed time for the brain to process, so even hearing well would not change that.

That being said, there is a link with hearing loss and dementia. For those who are younger (like me), clear hearing is important and when hearing loss has occurred and isn't treated, studies have shown that dementia can be linked to this. So if you're younger and having hearing loss, it is good to get it checked and get the necessary devices to improve your hearing.
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Aphasia = trouble pulling up the words you want when speaking. Receptive aphasia = trouble understanding the words and phrases others are saying, even when hearing is OK or using a hearing aid. Aphasia and receptive aphasia are common in dementia. Combined with any hearing loss, they have a serious negative impact on communication abilities.
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My Mum has mild dementia and has had progressively worsening hearing problems from childhood. She often uses her hearing problems as an excuse for not understanding/not remembering something. She will pretend she didn't hear me tell her something, when I know that's not true, as we have had a whole discussion about the subject.

I just pretend that I accept she hasn't heard me and give her the information again.

She has a Bone Anchored Hearing Aid, which she makes all sorts of excuses not to use and I'm sure that's because she knows she won't have an excuse for "not hearing" things!
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Oh yes, the hearing issue. It’s the old which came first quandary, the chicken or the egg. The bottom line seems to be a good medical/neurological/hearing assessment. It seems to me it is a disservice to everybody to try and skimp on the diagnoses. Everybody suffers, and too soon. I’m there with you guys, spouse plays the TV so loud, 24/7, I’m afraid the police will come knocking someday, for disturbing the peace, committed via TV. I cannot get the man to consider hearing test any more than I can get him toman eye doctor for a diabetic eye exam.
Grandma used to say, in response to parenting questions, you gotta just keep them and love them. I hope somebody, someday, will treat me so kindly, lol.
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HVsdaughter Feb 2019
Get him TVears! They're great. My dad loves them, and it saves my hearing and sanity. I use them sometimes after he's gone to bed. I got the 2-pair deal in case he leaves one pair out of the charger base too long and then doesn't have it to watch his evening shows.
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Get her to a neurologist and an audiologist.
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My aunt came with me to get hearing tested, but only after her doctor said she had wax plugging her ear. A specialist was needed to remove it and then check her hearing. We both needed hearing aids, so it was actually my aunt helping me out.

She also has dementia, but sometimes she fakes poor hearing of something that she doesn't want to hear. One day I said, it is time for getting ready to go to the doctor's. "What?" 3 times, and I grinned, asking if she was teasing me.  She giggled and said Yes.
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I know you have probably heard of this already but have her tested for a UTI too. My mother’s behavior and then Dad’s 2 years later alerted me to ask. Dad had one and he was seeing his brother on the sofa but his brother had been dead for years. Mom was behaving strangely too and saw a man with a brief case she thought. No she did not. She had a UTI that was messing with her mind. She had dementia anyway so we almost missed that.
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It is most likely a brain/hearing problem. The only way to determine if it is a hearing problem, have her examined and tested by a physician who is highly qualified and board certified. But I suspect too it is partially dementia but she seems to still have the ability to "selectively listen". Get a doctor to check out her brain capacity and an ear/nose/throat doctor to test her hearing - and then go from there as at least you would know. This cannot be observed - it requires medical intervention to be sure.
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