What does new drug for Alzheimer’s have to do with hearing loss?

What does last week’s approval of a new drug for Alzheimer’s have to do with hearing loss? Nothing, according to the articles and commentary that I read about the drug. Hearing loss was not mentioned in a single news story or commentary.

The drug, brand-name Aduhelm, is the first new treatment for Alzheimer’s in 18 years. The FDA’s decision to approve the drug was made despite opposition from the agency’s independent advisory committee, which said that the evidence raised significant doubts about whether the drug is effective, and noted the risk of serious side effects, including swelling and bleeding in the brain.

Biogen set a list price of $56,000 a year per patient. Very few patients will end up paying that amount, but their insurance companies might. Medicare has not yet said whether it will cover the drug. The insurer Cigna said that beyond the cost of the medicine itself, diagnostic care and safety monitoring will cost another $30,000 a year.

Medicare won’t pay for your $3000 hearing aids, but should you develop signs of Alzheimer’s, it seems likely that it will kick in the $56,000 to treat you with Aduhelm.

The new drug was approved without evidence that it slows symptoms of Alzheimer’s. But it does reduce levels of amyloid, which forms a plaque in the brain, and which is thought to cause symptoms. For a fuller discussion of the new drug and the controversies around it, this New York Times article is excellent. F.D.A. Approves Alzheimer’s Drug Despite Fierce Debate Over Whether It Works.

So what does this have to do with hearing loss? In 2011 an epidemiological study by Frank Lin of Johns Hopkins School of Medicine and others found a strong association between hearing loss and dementia, including Alzheimer’s. The greater the degree of hearing loss, the earlier the onset and severity of the dementia. These findings do not suggest that hearing loss causes dementia, although that could turn out to be the case.

Lin and others are conducting a long-term study to see whether the use of hearing aids or other devices mitigate the risk. If their study shows that hearing aids do help delay the onset of dementia, or lessen its severity, many people with hearing loss will be relieved. But that has not yet been definitively proved.

A smaller study, published in 2015, did find some evidence that hearing aids could help, but not why. The researchers suggested that because hearing loss can cause depression and social isolation, which then affect brain health, the use of hearing devices helps offset those other conditions, and thus slows dementia. You can read more about this study in an article I wrote for AARP online. 

The FDA’s approval of a controversial and expensive drug for Alzheimer’s struck some with hearing loss as sadly ironic. Medicare famously does not cover hearing aids, which are expensive and out of range for many users. A typical brand-name hearing aid costs about $3000, and most people need two. But $6000 sounds cheap compared to the cost of Aduhelm.

In 2020, a study by Columbia researcher Justin Golub and others found that even subclinical hearing loss is associated with cognitive decline. Normal adult hearing is defined as the ability to hear at 25 decibels or less. Golub’s paper found that hearing levels below 25 dB were also associated with cognitive decline. The authors wrote that the findings “suggest that the association between hearing loss and impaired cognition may be present at earlier levels of hearing loss than previously recognized; the current 25-dB threshold for defining adult hearing loss may be too high.”

We may find in the next few years that treating hearing loss can help offset dementia. That would be welcome news. But without affordable hearing aids and hearing care, widespread treatment is unlikely to happen. Medicare won’t pay for your $3000 hearing aids, but should you develop signs of Alzheimer’s, it seems likely that it will kick in the $56,000 to treat you with Aduhelm.

***

For more about living with hearing loss, read my books “Smart Hearing: Strategies, Skills and Resources for Living Better With Hearing Loss” and “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You.” Both are available as ebook and paperback on Amazon.com.

14 thoughts on “What does new drug for Alzheimer’s have to do with hearing loss?

  1. And what about ototoxicity — hearing loss caused by a pretty long list of prescription medications? I believe many (most?) doctors who prescribe don’t consider the possible effects on hearing of “maintenance” dosages of such drugs. I, for one, discovered too late that two drugs I took for several years for prevention of migraines were on the ototoxicity list. My neurologist never told me and perhaps never knew.

    Like

  2. As a retired family doctor and having hearing loss myself I can see the direct correlation between hearing loss, whether you know you have it or not, and becoming more withdrawn, becoming more self deprecative, and becoming more isolated because you sound stupid when you make mistakes by not hearing correctly. I have experienced the above and I don’t see that it’s going to improve a lot even with the $6000 worth of hearing aids I wear. My wife’s way of speaking and the frequencies of her speech are such that no hearing aid will improve the communication. And some other people have a sharp edge on their speech and I can understand them across a room, in a church, a restaurant, or a gymnasium. Love those people.

    Also, why is it considered offensive when you offer some people Katherine‘s book about “Shouting Won’t Help“? Very few of the people that I have recommended it to have bothered to obtain it, much less read it.

    Until you experience hearing loss yourself you non hearing impaired people have no clue what we put up with. We might as well have Alzheimer’s. We would get more help and attention.

    Like

    • David Wilcox, I agree that the experience of hearing loss is little understood by those who don’t have it. I’d add that another person’s hearing loss can also be hard to understand. We all experience it differently. That’s why in Shouting Won’t Help I wrote about not only my experience with hearing loss but in depth about some other people’s. Thanks for the comment.

      Like

    • David Wilcox – Thank you for your excellent comment. I seldom read a comment that so perfectly mirrors my own experience.

      My last set of HAs did indeed cost me $6000. Even that fix did not last. Five years ago I got a cochlear implant in the left side and have enjoyed a major improvement in hearing and understanding.

      Even so, what has not improved are things like noisy echoey rooms, groups with everyone speaking at once, the dreaded public address system and the growing number of people who mumble, speak too fast, who won’t look at the person they are speaking to and my favorite – foreign speakers who blithely think they are speaking American English and for whom I have all kinds of sympathy. However, it’s still a problem specially when I am depending on them for important information ON THE PHONE! Technology has not and likely will not effectively address all these situations, at least in my lifetime.

      Bottom line is that I hear and understand better today than in decades, but community, government, my family and friends all have a long way to go to fully acknowledge the extent that hearing loss permeates our lives, and what they can do about it.

      Wheelchair ramps are everywhere. What I need are audio loops, realtime captioning, subtitles and most of all thoughtful understanding. Those are my ramps.

      Like

  3. Hello David Wilcox,

    It can be frustrating trying to communicate when you have a hearing loss. I recommend signing up for the HLAA Virtual Convention, June 24-26, 2021. https://www.hearingloss.org/programs-events/convention:
    “The Latest in Digital Inclusion Technologies”, Friday, 5:45-6:45 PM may give you some useful coping tips. The programs on Thursday and Saturday are worthwhile, too. Good luck!

    Like

  4. Oh, David, Your last line had me chuckling: “We might as well have Alzheimer’s. We would get more help and attention.” True, because the ‘disease’ of Alzheimer’s would most likely infringe more upon others. We hard-of-hearing folk have a ‘silent disability’ that normal hearing folk often think can be ‘fixed’ with hearing aids. We know better. It takes a lot of self-advocacy and the constant help of willing communication partners (who look at you when speaking, slow down, change seats with us in restaurants, et. al.) to stay optimally engaged in life.

    As for this drug, I have no faith in it for the reasons you suggested, Katherine, and from experience with my Mother who was given a ‘Memory Pill’ (Donepezil (Aricept®): approved to treat all stages of Alzheimer’s disease).that didn’t help at all and ultimately almost killed her. She was 90 and fading fast. At her doctor’s appointment that my sister and brother took her to (I, her usual health advocate, was on crutches with a broken toe) they were talking about maybe inserting a feeding tube. At this same appointment, the doctor doubled her Donepezil. Reason? Guess the increase was standard on some pharma chart. When I noticed this, I checked Donepezil s side effects. Almost to the letter, my Mother had been experiencing them causing her recent downward progression. I called the doctor to ask if there was a specific way to discontinue the med. She never answered my call, so I stopped Donepezil completely on a Monday; by Saturday my Mother was up and eating. On Sunday, we went to mass, out to breakfast and food shopping! Then we were blessed to have my Mom around for another two good years…

    Big Pharma finances these studies and promotes with mega-advertising. Look at the constant drug ads bombarding us on TV! How can we trust them? We have to stay vigilant and do our homework before swallowing any pill. If they and their big bucks were pushing for universal hearing aid availability and reimbursement through Medicare, the government might listen. But, without significant financial gain, big money companies won’t bother.

    Like

  5. Debra, I love your comments…
    Caveat emptor.
    And, as MLK Jr. said:
    “Our lives begin to end the day we become silent about things that matter.”

    Like

  6. There is nothing more important than a hearing aid fitted by a qualified audiologist. I am not a fan of over-the-counter hearing aids. Do these over-the-counter hearing aids have directional microphones to accommodate your hearing in a noisy restaurant or airplane? What about Telecoils or Wide Dynamic Range Compression programs whereby loud sounds become softer or soft sounds become louder. I do believe that hearing loss is affecting the quality of life for seniors and others and many articles have been written about how hearing loss may lead to dementia. For those interested, who speak and listen a Captioned Phone is available. Log on to http://www.captel.org or http://www.CaptionCall.com. Join the Hearing Loss Association of America and receive their bi-monthly magazine Hearing Life. A magazine for better hearing.

    Like

    • HI Hermine, The Bose allows you to adjust the sound input to screen out background noise. The AirPods also have noise suppression. You can read more about both by clicking on the links.
      Of course they have drawbacks — they cost a fraction of what hearing aids usually cost. But for people with mild to moderate hearing loss, who don’t want to or can’t pay for $6000 hearing aids, unreimbursed by insurance, they are a good start.
      Thanks for commenting. You always make good points.

      Like

Please leave a reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s