The research,

published in the Journal of Speech, Language and Hearing Research (April,

1999), further showed that hearing aid treatment for the patient with

Alzheimer's disease living at home with a caregiver actually may benefit

the caregiver as much as the patient.

"This

is the first on-site study of patients with Alzheimer's disease who have

hearing loss and are living at home with a caregiver," stated principal

investigator Catherine V. Palmer, PhD, assistant professor of communication

science and disorders at the university and director of the Center for

Audiology.

"We were

able to show the positive impact of managing hearing loss with hearing

aids by measuring treatment compliance and reduction of problem behaviors

as reported by caregivers," she said. "We hope that our research

may encourage primary care physicians and audiologists to become more

willing to provide accessible hearing assistive care to this patient population

and caregivers to become more motivated to seek hearing assistive care.

"Studies

and clinical procedures related to Alzheimer's disease largely have ignored

the hearing ability of either the patient or caregiver' yet the majority

of Alzheimer's disease treatment and investigation depends on communication

ability, and caregiver complaints often involve communication-based issues."

Although previous

studies showed that more than 60 percent of aging individuals with organic

mental syndromes such as Alzheimer's also have impaired hearing, hearing

deficits may be the most frequently unrecognized condition of patients

with Alzheimer's.

The impairment

often is masked by other behavioral symptoms of the disease, and patients

may communicate adequately in ideal quiet conditions.

In addition,

patients with Alzheimer's traditionally have been considered difficult

to test for hearing loss and difficult to manage because of anticipated

patient noncompliance.

"Diseases

can interact to make a pair of diseases much more disabling than either

one alone, and this may be the relationship between Alzheimer's disease

and hearing impairment associated with aging," said Dr. Palmer. "Besides

its effect on communication, hearing loss has been attributed to eliciting

feelings of helplessness, depression, passivity and negativism and has

been associated with an accelerated and rapid cognitive decline in subjects

with dementia or Alzheimer's disease."

For the study

her team of audiologists conducted research entirely in the homes of eight

patients with Alzheimer's disease who were hearing impaired and had not

been using hearing aids.

Five spouses,

two daughters and a son who handled caregiving duties also participated

in the study. During the first home visit, the researchers administered

hearing tests to the patients similar to those conducted in a clinical

setting.

Patients were

fitted with the most technologically advanced hearing aids to wear in

both ears. Before the devices were given to the patients, the caregivers

were trained to identify and document certain hearing-related problem

behaviors of patients on a daily basis for one-and-a-half to two-and-a-half

months. The researchers made weekly visits to the homes to collect the

data.

Documented

problem behaviors included the following:

Hearing things

that are not there.

Being unable

to hear.

Talking nonstop.

Playing the

TV/radio too loud.

Repeating

questions.

Making negative

statements.

Presenting

with searching behaviors.

Forgetting

recent responses to questions.

After this

period the patients began wearing the hearing aids. Caregivers continued

to collect daily data on the problem behaviors as well as hearing aid

wearing compliance for approximately two months post-treatment.

"We were

pleased to find that in each case the caregiver reported one to four problem

behaviors ­ such as hearing things that aren't there ­ were

significantly reduced," said Dr. Palmer.

In three of

the patients, all of the identified problem behaviors were reduced significantly

after hearing aid treatment. All but one of the behaviors were reduced

in another three, and one behavior was reduced in the remaining two.

When the caregivers

were asked if the hearing aid treatment improved the ability of the patients

to communicate, six out of eight reported a significant improvement, reported

Dr. Palmer. The remaining two said they were less sure.

Regarding patient

compliance, each patient wore the hearing aids between five and fifteen

hours per day. All but one patient wore them at least seven hours a day

The work of

Dr. Palmer's research team was supported by a grant from the National

Association for Alzheimer's Disease.

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