Healthy hearing to a healthy brain

Primary care providers need to pay attention to hearing loss in their patients, recognizing that it’s one of several modifiable risk factors for cognitive decline — ultimately making the brain more susceptible to dementia. That’s the gist of a new scientific statement from the American Heart Association (AHA).

The connection between hearing loss and dementia has been clearly established by multiple studies. In 2014, Johns Hopkins research concluded that hearing loss is a risk factor in an estimated 36% of U.S. dementia cases. And, in 2020, The Lancet Commission reported on a University College London (UCL) study, which found that untreated hearing loss in midlife is the largest modifiable risk factor for developing dementia.

The AHA scientific statement takes this issue to a new, actionable level by advising physicians to identify and manage modifiable dementia risk factors, including hearing loss, as a way “to mitigate or forestall the onset of (cognitive) decline before it happens.” The article notes “that although approximately one-third of older adults experience hearing impairment, it remains largely untreated.”

While it targets primary care providers, the AHA statement holds significant implications for health insurance organizations and health plan members.

First, consider the profound personal and financial implications of dementia. An article published by the American Journal of Managed Care (AJMC) sums up the situation succinctly: “Alzheimer’s disease is the most common cause of dementia and the fifth leading cause of death in adults older than 65 years. The estimated total healthcare costs for the treatment of Alzheimer’s disease in 2020 is estimated at $305 billion, with the cost expected to increase to more than $1 trillion as the population ages.”

Not surprisingly, much of this expense is borne by Medicare, Medicaid and private health insurance companies.

Beyond the direct costs of treatment, people with Alzheimer’s and other dementias have twice as many hospital stays per year as same-age individuals with no dementia, according to the Cure Alzheimer’s Fund. They’re also more likely to suffer from other chronic conditions. In 2019 per-person health care and long-term care payments for Americans with Alzheimer’s and other dementias were more than 4.5 times higher than payments for other beneficiaries, says the organization.

All of the evidence to date points to one inescapable conclusion for health plans: It’s in their best interest, as well as the best interest of their members, to support the proactive management of dementia risk factors — which includes the treatment of hearing loss.