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Dual Sensory Impairment

What Is Dual Sensory Impairment?



Age has its benefits—such as retirement and senior citizen discounts—but it also comes with its share of challenges. As we age, it’s not uncommon to see changes in our health—especially in our vision and hearing. In fact, various studies indicate that anywhere from 10 to 20 percent of those over the age of 70 have a condition known as dual sensory loss.

Although having problems hearing and seeing can seem overwhelming, a timely and effective diagnosis along with the proper rehabilitation strategies can greatly minimize its impact.

When a person begins to experience declines in both their vision and hearing, it’s defined as dual sensory loss, or dual sensory impairment. The condition can be congenital (present at birth) or it can occur naturally as part of the aging process. For people with severe vision and hearing loss, it's known as deaf-blindness.

Other causes include genetic diseases, such as Usher’s syndrome. It can also occur after a traumatic brain injury or blast exposure.


Why Is It Important To Seek Treatment?

Research has linked dual sensory impairment to avoidance of social interactions and a diminished quality of life, according to a systematic review of studies looking at dual sensory loss and depression in older adults.

"Dual sensory loss is poorly understood, under-recognized and under-diagnosed," the authors wrote. "This is particularly the case in its mild form since it may be undetected by the individual, or onset may initially be in one domain at a time (vision or hearing deterioration)."

Although it may seem natural to experience a certain amount of loss in hearing and vision as you age, both can significantly impact a person's health, safety and quality of life. Hearing loss in and of itself, for example, is strongly linked to cognitive impairment in older adults.

The good news: Studies show that people who receive treatment for dual sensory impairment have a higher quality of life and a lower risk of death than people who don't receive treatment.

Dual Sensory Impairment Can Be Overwhelming.

Combined with other health issues associated with aging, dual sensory loss can seem overwhelming, said Dr. Ying-Zi Xiong, PhD, a postdoctoral fellow at the Gigi & Carl Allen Envision Research Institute in Wichita, Kan. (ERI) and a research associate at the University of Minnesota.

Xiong, whose two-year research project at ERI explores new ways to help people diagnosed with dual sensory loss, said the condition is especially challenging for older adults because it compromises the body’s natural sensory compensation abilities.

“People with hearing loss can rely on their vision and people with vision loss can rely on their hearing,” Xiong said. “For example, audiobooks can help vision-impaired people with reading and closed-captioning can help hearing-impaired people while watching videos. These aids are less helpful for people with dual sensory loss.”

Treating Dual Sensory Loss.

Because the majority of people with dual sensory loss still have functional vision and hearing, they will likely benefit from rehabilitation once they’ve received a proper diagnosis from a qualified medical professional.

“Rehabilitation therapists can help with adaptation and accommodation after sensory loss," Xiong said. "They will prescribe assistive devices and teach coping strategies, which will make everyday tasks and communications much easier.”

But first a person needs a thorough medical assessment to see what's causing the hearing loss and vision loss. For example, the eye disease glaucoma—which is more common in older people—can lead to vision loss and should be treated by a doctor.

“When it comes to treatment, ophthalmologists and otolaryngologists are the experts,” Xiong said. “Although treatment might not necessarily cure the vision and hearing conditions, they can often slow down deterioration, stabilize the condition and relieve discomforts. Maintaining the use of residual vision and hearing is a great exercise for the brain and with time we become more and more efficient in using the visual and auditory information.”

Is Dual Sensory Impairment Preventable?

Xiong said while it’s difficult to control family histories that include inherited vision or hearing disorders such as macular degeneration and Usher’s syndrome, recent research indicates a healthy lifestyle can improve your odds.

Not smoking, eating a healthy diet and engaging in regular exercise can reduce the risk of developing eye conditions. The best way to protect against noise-induced hearing loss is to limit your exposure to loud sounds. Emerging evidence is also showing that a healthy diet may also reduce the risk of hearing loss.


How To Seek Help.

If you or a loved one are noticing changes in your vision and hearing, schedule an appointment with a medical professional immediately. If you are diagnosed with dual sensory impairment, work closely with your medical team to identify appropriate assistive devices, coping strategies and other rehabilitation activities to address your individual needs. Most importantly, engage the help of your loved ones in the education and rehabilitation process.

“Family support is crucial for older people who are dealing with dual sensory loss,” Xiong said. “We need to be patient when elders have communication problems and encourage and create opportunities for them to engage in social interactions.”

 

Contributed by Debbie Clason, staff writer, Healthy Hearing

January 21, 2020

 

 

 

 

A Resolution You Can Keep

 

When a new year comes around, many people make resolutions or goals for themselves to help improve their lives. For some it's a fitness goal, for some it's a resolution to be a better friend, and for others it may be to pick up a new hobby that brings them joy. Sometimes people succeed with these resolutions but oftentimes they don't. Success usually comes from having the determination to do something and also by having a plan.

 

We know of one resolution that is worthwhile AND is very easy to do: It's to take care of your hearing!

 

Many people ignore their hearing health. Ignoring signs of hearing loss can affect one's work, their relationships, and even their emotional well-being. Many times hearing problems can be prevented and/or corrected if you seek out professional help.

 

How can you do this, you ask?  Call us, and we can help you understand where you are with your hearing health and help you to know the things you can be doing to prevent or treat your hearing loss. A quick phone call to us is all you need to start your new year's resolution off right.

 

Call us in our La Palma office at (714)523-4327 or our Huntington Beach office at (714)842-2700. We look forward to seeing you!

HAVE A HAPPY NEW YEAR!!

 

Hearing Aids Might Reduce Dementia Risk


 

For people with hearing loss, using a hearing aid is associated with a reduced risk of three common health problems of aging — dementia, depression and falls — according to a recent study in the Journal of the American Geriatrics Society.

This study adds to the growing body of research that links hearing loss to memory issues and dementia. “Cognitive decline is much higher among people with hearing loss,” says study author Elham Mahmoudi, an assistant professor in the department of family medicine at the University of Michigan.

The new study also suggests using hearing aids might help delay the onset of dementia in some people, and it’s the largest study to date to look at this possible connection, Mahmoudi says.

Here’s what this and other research has shown about hearing loss and the brain.

 

The hearing aids-dementia connection

The study found that people who received hearing aids in the three years after being diagnosed with hearing loss had lower rates of dementia, depression and falls than those who didn’t get the devices.

To get these findings, University of Michigan researchers examined managed-care insurance claims from 114,862 adults with hearing loss between 2008 and 2016. All were 66 or older.

The researchers looked at the study subjects’ insurance claims for three years after their hearing loss diagnosis. They did this to determine which people with hearing loss had been prescribed a hearing aid, which had not, and which study subjects in both groups were later diagnosed with dementia, depression or a fall-related injury. Then they compared the difference between the hearing aid group and the non-hearing-aid group.

 

What earlier studies have found

A lot of prior research has found that hearing loss is connected with an increased risk of memory problems.

In a 2018 analysis published in JAMA Otolaryngology-Head & Neck Surgery, researchers pooled the results of 36 studies and found that age-related hearing loss was linked to an increased risk of dementia and cognitive decline and impairment.

(Other previous research has also linked hearing loss to depression and falling.)

Fewer studies have been conducted on whether the use of a hearing aid might delay or prevent the onset of dementia, says Jennifer Deal, an assistant scientist in epidemiology at the Johns Hopkins Bloomberg School of Public Health, who wasn’t involved in the new study.

But like the new research, several small studies that have addressed the question in recent years have found that the use of hearing aids is linked with a lower risk of dementia.

 

How hearing loss might affect the brain

Scientists don’t have definitive answers about the effects of hearing loss on brain health. One theory, Deal said, is that when your hearing is damaged, the brain must expend more effort to decode the sound signals it takes in, possibly at the expense of other brain functions.

Another hypothesis is that hearing loss changes the physical structure of the brain in a way that could harm memory — and some evidence from brain imaging studies supports this theory.

Hearing loss can also increase a person’s feeling of social isolation, because the condition makes it harder to communicate. And social isolation is linked to a number of health problems, including heart disease and Alzheimer’s.

 

Could hearing loss cause dementia?

Neither prior studies nor the new one offers firm proof that hearing loss is a cause of dementia. It’s not clear yet what actually causes Alzheimer’s or some other types of dementia.

The new study was observational — meaning it looked only at data on existing health outcomes, rather than testing the effects of a hearing aid. So, while it found a pattern, it couldn’t establish that hearing problems actually cause dementia.

And, say researchers, a number of other factors could have influenced the outcome of the study. For instance, the researchers weren’t able to factor in socioeconomic status in their analysis. That’s important because people with more education and economic resources have been found to be less likely to experience cognitive decline as they age.

For scientists to be able to say definitively that hearing loss is a cause of dementia, a randomized controlled trial is needed, comparing similar groups of people, some of whom have their hearing loss treated with a hearing aid, and some who don’t.

Deal and her research team are conducting one such trial, so she hopes to be able to answer this question within a few years.

 

The upside of hearing aids

While the new study found that for people with hearing loss, using hearing aids was associated with a lower risk of dementia, that doesn’t mean aids can prevent dementia or even reduce risks.

It’s just too early to say, without the results of a randomized controlled trial.

Still, the upside of using these devices for hearing loss can be substantial.

“If someone is considering a hearing aid, we do know that it should help improve the quality of life, help with communication,” Deal says. “We do know there are benefits, we just don’t know if cognition is one of them.”

 

What to do if you have hearing trouble

If you notice you’re having difficulty hearing — frequently turning the television up, asking people to repeat themselves or missing parts of in-person or over-the-phone conversations — see your doctor.

Hearing loss may be reversible, if it’s caused by a problem such as earwax clogging your ear canal, an infection or a damaged eardrum. A doctor can evaluate your ears for potential physical problems that could be interfering.

And have your hearing tested. If the problem with your hearing isn’t fixable, you can find out how extensive the damage is. A hearing professional can tell you whether you might benefit from a hearing aid.

And if your health-care providers think a hearing aid will help you, it’s best to start using the device sooner rather than later.

“Research suggests that the earlier you adopt [a hearing aid], the better the outcome,” Deal says.

Source: Consumer Reports 2019
 

How Are Your Ears Related To Balance?

 

 

Audiologists, hearing healthcare providers, and ear specialists can be the first line of differential diagnoses if you have symptoms and/or bouts of vertigo, lightheadedness, spinning, imbalance, unsteadiness, whirling, and difficulty walking while veering to one side or the other. These symptoms can often be overlooked as they can be episodic, subside, or be alleviated with medications. However, these symptoms are disruptive to daily life and can impact your quality of life. To avoid recurrence, it's vital that you seek a professional and medical consult to be able to document and evaluate your symptoms.

 


What to expect at your first visit with a hearing healthcare provider

First, you may be asked to fill out a questionnaire to assess your symptoms. An accurate diagnosis is based on a complete medical history and series of vestibular function testing. EarQ Director of Audiology, Dr. Natalie Phillips, stresses the importance of obtaining a comprehensive history of symptoms and occurrences for each patient. "We look at the onset of dizziness. Was it sudden or gradual? We need to know the duration—does it last minutes, hours or days? Is the dizziness constant or does it occur in episodes? Are the symptoms improving? Can you identify what might worsen the symptoms? Are there any accompanying audiological symptoms such as hearing loss, pain in the ears, fullness, or tinnitus (ringing or sounds in the ears)? Is there a history of allergies or migraines? Is there a history or family history of heart problems or high blood pressure? Are there any recent head trauma or changes in vision? Are there any neurologic symptoms including numbness or weakness in the face or extremities?" Each of these questions provide more information to help identify if the cause of the symptoms is related to the ear or if other specialties need to be involved in the diagnosis, such as cardiology, allergy, physical therapy, ophthalmology, or neurology.

 

Common diagnoses for vertigo symptoms


The vestibular function testing that is performed at an audiologist's office searches for common causes of your symptoms including Meniere's disease, benign paroxysmal positional vertigo (BPPV), labyrinthitis and vestibular neuritis, as well as other common etiologies.

Meniere's disease is associated with a buildup in fluid pressure inside the inner ear. In addition to attacks of vertigo, a patient can also experience fluctuating levels of hearing loss, tinnitus (ear ringing or roaring) and a sense of fullness in the affected ear.

BPPV, a fairly common diagnosis, results when crystals inside the ear become dislodged. "Calcium crystals, normal structures in the inner ear, break loose and float into another part of the ear," explains Dr. Phillips. "This causes a spinning sensation when changing head positions, usually triggered by movement, such as getting out of or into bed, when laying down, rolling over onto the side, and even sometimes bending over and looking upward to grab something out of the kitchen cabinet. Each episode is brief, on the order of seconds to less than a minute."

Labyrinthitis and vestibular neuritis are disorders that result from an infection that can affect the transmission of sensory information from the ear to the brain. Symptoms can result in vertigo, dizziness, and balance, vision, and hearing issues. Labyrinthitis occurs when an infection can affect both branches of the vestibulo-cochlear nerve, resulting in hearing changes along with dizziness or vertigo. Vestibular neuritis affects the branch associated with balance, resulting in dizziness or vertigo, but no change in hearing. Symptoms usually last on the order of weeks to sometimes months and improve over time with the use of medications to control the nausea and suppress dizziness. In some cases, vestibular rehabilitation exercises help following medication therapy.

Although it may be difficult to identify what may have caused your symptoms, the proper diagnosis is vital for effective treatment. Some balance problems begin with allergies or a bad cold. Others are due to autoimmune disorders. A head injury can trigger episodes of vertigo or disequilibrium. Chronic neck pain or stiffness can cause vertigo or imbalance. In yet other cases, it's unclear what may have brought on the condition.

 

Treatments for balance disorders

Treatment depends on the diagnosis and can range from oral medications for symptom alleviation to physical therapy for balance retraining to surgical procedures. Treatment for BPPV involves repositioning the dislodged ear crystals. "We do repositioning maneuvers to get the crystals back to where they need to go," says Dr. Phillips. "It's a nice, simple treatment where the patient gets pretty immediate results. The difficult thing is that this condition can spontaneously occur, resolve, and reoccur. People who try to do these maneuvers at home may actually make it worse."
For some conditions, anti-nausea drugs may be prescribed to alleviate the symptoms associated with vertigo. Other patients will benefit from dietary adjustments such as a low-salt diet, or possibly surgical options to correct physical abnormalities associated with particular disorders. Many patients benefit from physical therapist directed vestibular rehabilitation therapies.
Pinpointing the source of a balance problem and coming up with an accurate diagnosis to put all the pieces together requires a thorough analysis of the patient's medical history to evaluate all symptoms as well as comprehensive vestibular function testing. Other specialists may be consulted prior to a diagnosis such as a neurologist, cardiologist, ophthalmologist, neuro-ophthalmologist, and physical therapist. With the end goal in sight of alleviation and possibly elimination of dizziness or other symptoms affecting balance, "I encourage patients that if they don't find the answer, seek a second opinion," recommends Dr. Phillips. "It's helpful to go to a clinic with the proper equipment and multiple specialties within the same office to be able to collaborate and intervene earlier for a quicker recovery and return to a better life and function."

 

 

 

Source: EarQ.com

 

5 Early Signs of Hearing Loss

Hearing loss is often a sneaky thief. It can creep up on you gradually, stealing your hearing in such small increments you suddenly find yourself straining to understand conversation and missing some of your favorite sounds.

 

How can you tell if you have hearing loss? Only a qualified hearing health professional can tell you for sure, but here are five signs you may not be hearing your best.

Consonant sounds are hard to hear

'Did you say show or throw?'

If you’ve lived long enough to develop presbycusis, or age-related hearing loss, you may have lost your ability to hear high-frequency sounds. In speech, that translates to the consonant sounds S, F, Th, Sh, V, K, and P. These sounds are important because they help you distinguish between like-sounding words—for example, “show” and “throw” or “keep” and “peep.”

As a result, you may misunderstand important parts of the conversation and respond inappropriately or think people are mumbling. In other words, you can hear but not understand.

Common sounds have seemingly disappeared

Take a moment and think—when was the last time you heard birds singing or crickets chirping? Do you hear the car’s turn signal when it’s blinking? Are you having trouble hearing your wife or grandchildren when they speak?

These higher pitched sounds and voices register at frequencies of 2,000 Hz or higher, which those with high frequency hearing loss have trouble hearing.

Understanding conversation in crowded places is increasingly difficult

Another symptom of high-frequency hearing loss is the inability to distinguish speech in noisy environments. As a result, you may find yourself avoiding social situations like family get-togethers or impromptu celebrations with friends at local gathering places where you’re forced to concentrate on understanding the conversation.

You strain to listen—and it’s exhausting

If you find you're straining to listen to the conversation and are more exhausted than usual at the end of the day, you may have listening fatigue. Like a fading radio state or bad phone connection, you have difficulty following the conversation.

Most people are surprised to learn that hearing is a brain activity. When your auditory system is compromised, it takes a lot more effort for your brain to process the sound it receives from your inner ear. In effect, the signal is broken.

 

Your ears ring constantly

The Centers for Disease Control (CDC) estimate more than 50 million people suffer from some degree of tinnitus, making it one of the most common health conditions in the country.

Both age-related hearing loss and noise-induced hearing loss can cause tinnitus, a condition also known as ringing in the ears. In these two situations, researchers believe tinnitus may be the brain’s way of filling in the missing frequencies it is no longer receiving from the auditory system.

What’s the solution?

High-frequency hearing loss is typically a type of sensorineural hearing loss, which means hair cells in the inner ear have been damaged. These hair cells are responsible for converting sounds into signals and sending them along the auditory nerve to the brain for interpretation. In addition to age, this type of hearing loss can be caused by noise, disease, infection or genetics.

Although sensorineural hearing loss isn’t curable, it can be treated with hearing aids or cochlear implants. Diagnosis and treatment is important because untreated hearing loss has been linked to mental health conditions such as anger, depression, anxiety, isolation, frustration, loneliness and decreased cognitive function.

Seek help from a hearing healthcare professional

Today’s hearing devices are sophisticated marvels of technology, with the ability to amplify the high frequencies you may be missing without amplifying the low frequency sounds you hear just fine. A hearing healthcare professional can evaluate your hearing and help you determine which hearing device is best for your hearing loss, lifestyle and budget.

Even if you aren’t experiencing any of these signs of hearing loss, don’t wait for a problem to occur. Treat your hearing health like you would vision or overall physical health and schedule annual hearing examinations with a professional you trust.

Contributed by Debbie Clason, staff writer, Healthy Hearing

 
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