On a trip to see the tulip bulbs in Holland five years ago, Maryélise Lamet of Shutesbury noticed that her husband, Sterling, wasn’t hearing her even while wearing his hearing aids.
She also noticed he wasn’t taking charge as much as he usually did and was struggling with Dutch, a language, he spoke fluently.
They were both used to difficulties caused by Sterling’s hearing loss that had been diagnosed 10 years earlier, but this seemed different.
“I knew there was still something going on that was impairing his understanding of conversation,” she said.
Back home, Sterling’s audiologist at the Center for Language, Speech and Hearing at the University of Massachustts, Amherst said there was no change in his hearing.
“But I knew that there was an appreciable change in the way he was hearing me,” Maryélise said.
For a few years, Maryélise, 69, and Sterling, 73, who had had a long, harmonious marriage, struggled to communicate. The strain led them to a counselor who advised Sterling to get evaluated at the Memory Disorders Program at Baystate Medical Center in Springfield.
After a battery of tests and brain scans, they received the diagnosis: Alzeimer’s disease, the most common form of dementia which causes problems with memory, thinking and behavior.
“I became aware that he was living in a pretty different world that I had been living in,” Maryélise said.
“He was feeling the impact of confusion — of everyday not knowing.”
Neither had considered that his hearing loss might be related to his new diagnosis, but his audiologist Tomma Henckel, at the Center for Language, Speech and Hearing at the University of Massachusetts in Amherst, said it could be.
Studies in recent years done by John’s Hopkins University and the National Institute on Aging have found a correlation between hearing loss and the development of dementia.
The research, which focused on people between the ages of 75 and 84, found that cognitive abilities — including memory and concentration — of people with hearing loss declined 30 to 40 percent faster than in people with normal hearing over six years. It also found that a common pathology may underlie both or that the strain of decoding sounds over the years may overtax the brains of people with hearing damage, leaving them more susceptible to dementia.
On average, the older adults with hearing loss who participated in the study, developed an impairment in their cognitive abilities 3½ years sooner than those with normal hearing.
The lead author Frank Lin, a doctor at John’s Hopkins who specializes in otology and the medical and surgical management of hearing loss, speculated that hearing loss could also lead to dementia by making individuals more socially isolated, a known risk factor for cognitive decline.
It’s possible that treating Sterling Lamet’s hearing loss delayed the onset of dementia or made the diagnosis less severe, Henckel said.
“If you can treat someone and at least make them more functional, you are going to delay the really hardcore dependence and support that they need and also just make them happier because they can be more engaged,” she said.
Deborah Reed, audiologist and owner of Ascent Audiology and Hearing in Hadley would agree.
“Hearing loss is a sensory deprivation, so when our brain is deprived of sound it is deprived of that connection to the environment — our world gets smaller — and the sensory deprivation continues to get worse,” she said.
“By treating the hearing loss we are trying to slow down the progression or at least affect functioning, to keep things working as long as we possibly can,” she said. “When you have hearing loss, you start to get depression, so then your brain starts to atrophy some more.”
Henckel says the connections between hearing loss and dementia are unclear, but seem to exist. “There are three possibilities, none of which excludes the other,” she said. “Hearing loss causes dementia, dementia causes hearing loss or something causes both.”
Still, some medical professionals are leery about drawing conclusions.
The studies out of John’s Hopkins are not definitive and no cause has been found, said Stuart Anfang, a psychiatrist at Baystate Medical Center in Springfield.
However, he said, stress on the brain from straining to hear could cause some degree of cognitive impairment. “You could be taxing the brains reserves.”
Sterling Lamet was diagnosed with age-related hearing loss, which is often caused by the natural erosion of the auditory hair cells in the cochlea, the organ that sends a signal along a nerve to the brain.
“Basically, our ears collect the sound and send it up to our brain and our brain has to figure out what is going on,” Henckel said.
Despite getting treatment for his hearing loss soon after it was discovered, Sterling Lamet developed dementia anyway. Still, Henckel says, it’s an important step to take. “Treating hearing loss and reducing that disability is going to make dementia patients much more functional,” she said.
In Sterling Lamet’s case, problems from the dementia and hearing loss were insidious. The couple say before his diagnoses, they always communicated well, working together as study abroad advisers at the UMass before retiring.
“We had an incredible partnership way of doing almost everything,” Maryélise said. “We had a wonderful time bringing up our two daughters and sharing so many interests.”
The couple is still working through everyday struggles. Sometimes Sterling can’t follow the steps of a recipe when cooking dinner. During conversations, sometimes he can’t seem to find the right word.
Despite the challenges, they say they are enjoying the small pleasures, taking life as it comes, spending time with their six grandchildren.
Every spring they take long walks in the woods to watch the birds.
These days, Sterling has little trouble hearing them chirp. He recently got fitted with new hearing aids.
While there is no way to tell what difference these will make in the long term, the couple is optimistic.
“Anyone who has cognitive difficulty will tell you, there are great days and there are other days that are not so easy,” Maryélise said.
Skills that Sterling developed long ago, he still enjoys with ease, like playing the clarinet in a jazz band. He is also a master baker, churning out French baguettes like Julia Childs, says his wife.
He still loves to paint watercolors of birds like blue jays, perching on the tree branches outside the window of their Shutesbury home.
Some days he hears better than others. Some days his mind is clearer than others.
“When there is a good day, and he is fresh and has had a really good rest, then he hears me better.”