Sensory impairment and dementia risk: What’s the connection?

Vision loss and hearing impairment are a natural part of aging for many people. But those sensory conditions may also mean you’re more susceptible to cognitive (mental) decline, which can leave you struggling to remember, think and make decisions.

Recent studies show that as you develop issues with vision and hearing, you could be up to twice as likely to develop dementia (severe cognitive decline). But according to David Reuben, MD, chief of geriatric medicine at the David Geffen School of Medicine at UCLA, needing glasses or a hearing aid does not necessarily mean you’ll develop dementia.

“Researchers have studied the association between cognitive decline and sensory issues for years. There are a lot of associations with both vision and hearing loss, but no conclusions,” Dr. Reuben says. “It’s still unclear whether hearing or vision loss contribute to developing dementia or whether some of these impairments are simply a sign of cognitive decline.”

No matter how sensory impairment and dementia are linked, Dr. Reuben suggests taking the following steps to keep your mind and senses stronger as you age:

Understand cognitive decline

About 11% of Americans age 65 or older live with dementia – defined as severe cognitive decline that interferes with the ability to perform daily activities. But cognitive decline is a process that happens over time. Understanding that process may help you to recognize the signs of cognitive issues early.

According to Dr. Reuben, the stages of cognitive decline include:

• Normal aging: You occasionally have trouble remembering names, words and parts of a grocery list, but usually recall the forgotten item later.
• Mild Cognitive Impairment (MCI): Your memory issues become more common and may be apparent to others or during your doctor’s evaluation, but tend not to interfere with daily functions or activity.
• Dementia: Memory deficits interfere with your daily functions, such as paying bills, taking medicine correctly or driving.

“Struggling to remember little things every once in a while is associated with normal aging. But if it becomes common or severe, the problem should be investigated further by your primary care provider (PCP),” Dr. Reuben says. “About 10 to 15% of people diagnosed with MCI will transition to dementia each year. That means that about half of all people diagnosed with MCI will develop dementia within five years of that diagnosis.”

Address any vision and hearing loss

Approximately one in three people over the age of 65 has hearing loss, vision impairment or both. These conditions may result in social isolation, depression and decreased physical activity – all challenges associated with cognitive decline and dementia.

“If you have hearing or vision loss, you’re missing out on what’s going on around you,” Dr. Reuben says. “If you don’t hear a conversation well or see what’s happening, it’s hard to fully process the information, which, in turn, may impair your function and your quality of life.”

If you are having any issues with vision, hearing or memory, Dr. Reuben suggests taking your concerns to your PCP, who can do a full assessment. “Sometimes we have people come in with memory issues,” he says, “but we’ll realize there’s hearing loss. Often when they get a hearing aid, their memory improves.”

Lower your dementia risk

In addition to keeping your eyes and ears working well, there are other proven ways to lower your risk for dementia. Dr. Reuben recommends lifestyle changes based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. The study was the first to identify interventions that help to prevent or slow cognitive decline.

To help lower your risk of dementia, Dr. Reuben suggests making lifestyle choices in the areas of:

• Cardiac and vascular health, by maintaining healthy blood pressure and cholesterol levels
• Cognitive stimulation, by finding an enjoyable activity that challenges your brain in a different way than your typical daily activities do, such as learning a new musical instrument
• Nutrition, by choosing to eat a diet rich in fruits, vegetables and whole grains
• Physical activity, by exercising every day

“None of these changes are easy,” Dr. Reuben says. “They all require behavioral modification and a commitment. While there is no certainty or guarantee that you won’t develop dementia, making lifestyle changes is the best way to lower your risk.”

Talking to your physician about healthy aging

Most physicians discuss healthy aging during your yearly check-up. But if your PCP doesn’t approach the topic, don’t hesitate to mention any concerns you have or changes you’ve noticed.

According to Dr. Reuben, the detection of MCI or dementia tends to come from patient complaints, a concerned family member or during the Medicare Annual Wellness Visit, which requires the provider to conduct a cognitive assessment.

“Cognitive impairment is something we talk to patients about all the time,” he says. “Enlisting your doctor’s help is the best way to make sure you get the care you need.”

For an evaluation of your vision, hearing or cognitive function, reach out to your primary care provider.