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(MRC DTP) Improving outcomes for people with dementia by treating hearing impairment

Project Description

Approximately 420,000 older people live in care homes in the UK. Dementia is the largest single health-related determinant of care home admission (Bharucha et al., 2004). The majority of care home residents are affected by both dementia and hearing impairment.

Many cases of hearing impairment in care home settings are undiagnosed and/or unsupported (estimated 250,000 cases; Action on Hearing Loss, 2012). Care home residents affected by dementia may struggle to recognise and take action on their hearing impairment (Action on Hearing Loss, 2012). Untreated hearing impairment among those with dementia is particularly problematic because hearing impairment exacerbates dementia-related symptoms, including depression, agitation, hallucinations and anxiety (e.g. Haque et al., 2012). Redressing the effects of hearing impairment represents an important opportunity to improve outcomes for people living with dementia (Mamo et al., 2017).

Managing hearing impairment in the care home setting is challenging but crucial. Hearing aids are the primary intervention for hearing loss but hearing aids are often underused in care homes (Action on Hearing Loss, 2012). Care home staff do not typically receive training in how to maintain hearing aids effectively (e.g. Haque et al., 2012). People with dementia are more likely to select sub-optimal hearing aid settings, forget to wear or lose small-sized hearing aids (Action on Hearing Loss, 2012).

Personal Sound Amplification Products (PSAPs) are low cost (~£100) devices that deliver sound to the wearer via headphones and sometimes the “loop setting” on a hearing aid. PSAPs increase the audibility of sounds and improve hearing in background noise. However, unlike hearing aids, PSAPs do not require a prescription. For older adults with decreased manual dexterity, the easy-to-wear headphones and simple controls incorporated into PSAPs may be preferable to traditional hearing aid controls (Mamo et al., 2016).

PSAPs are a potential alternative/addition to hearing aids for addressing hearing problems in care home residents with dementia.
In this project we will assess PSAPs as a low cost, accessible therapeutic intervention to support care home residents with hearing impairment and dementia. Using qualitative and quantitative methods, we will work with care home residents, relatives and care home staff to assess the impact of PSAPs in alleviating the symptomatic burden of dementia through i) improved quality of life, ii) improved hearing and communication and iii) increased social engagement in care home residents. This proposal will inform services that fully meet the communication needs of hearing-impaired care home residents with dementia.

Piers Dawes:

Rebecca Millman:

Iracema Leroi:

Funding Notes

This project is to be funded under the MRC Doctoral Training Partnership. If you are interested in this project, please make direct contact with the Principal Supervisor to arrange to discuss the project further as soon as possible. You MUST also submit an online application form - full details on how to apply can be found on the MRC DTP website View Website

Applications are invited from UK/EU nationals only. Applicants must have obtained, or be about to obtain, at least an upper second class honours degree (or equivalent) in a relevant subject.


Action on Hearing Loss (2012). A World of Silence: The case for tackling hearing loss in care homes.

Bharucha, AJ, Pandav, R, Shen, C, Dodge HH, Ganguli, M. (2004). Predictors of nursing facility admission: a 12-year epidemiological study in the United States. Journal of the American Geriatric Society 52: 434-439.

Haque, R, Abdelrehman, N, Alavi, Z. (2012). “There’s a monster under my bed”: Hearing aids and dementia in long-term care settings. Annals of Long-term Care 20: 28.

Mamo, SK, Reed, NS, Nieman, CL, Oh, ES, Lin, FR. (2016). Personal sound amplifiers for adults with hearing loss.
The American Journal of Medicine 129, 245-250.

Mamo, SK, Nirmalasari, O, Nieman, CL, McNabney, MK, Simpson, A, OH, ES, Lin, FR. (2017). Hearing care intervention for persons with dementia: A pilot study. American Journal of Geriatric Psychiatry 25: 91- 101.

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