Tinnitus, the perception of ringing, buzzing, hissing, or other sounds without an external source, is a common condition that affects around 15-20% of people. For many, tinnitus symptoms come and go, while for others they are more constant. In severe cases, tinnitus can significantly impact daily life and functioning.
A common concern among those experiencing tinnitus is – does this mean I have, or will get, Alzheimer’s disease? Alzheimer’s disease is a progressive, irreversible brain disorder that destroys memory and thinking skills over time. Could tinnitus be an early warning sign? Let’s take a closer look at the connection between tinnitus and Alzheimer’s disease.
Is Tinnitus a Symptom of Alzheimer’s Disease?
Tinnitus itself is not considered a symptom specific to Alzheimer’s disease. However, tinnitus may develop in some people with Alzheimer’s for the following reasons:
Hearing Loss
Hearing loss is common in older adults, with nearly two-thirds of adults 70 years and older experiencing some degree of hearing difficulty. Age-related hearing loss, known as presbycusis, is often accompanied by tinnitus. Additionally, Alzheimer’s disease can sometimes accelerate or worsen age-related hearing loss. The impaired hearing can then lead to phantom sounds of tinnitus.
Changes in Brain Function
Alzheimer’s disease leads to progressive damage and deterioration of brain cells. Brain regions that process hearing and sound are affected. This neurological change in auditory processing can manifest as tinnitus symptoms like buzzing, ringing, clicking or hissing sounds.
Reduced Blood Flow
Altered blood flow is another neurological change seen in Alzheimer’s disease. Reduced blood supply to areas of the brain involved in auditory processing may trigger abnormal firing of nerves and lead to tinnitus perception.
So in summary, while tinnitus itself is not a confirming symptom, the underlying changes Alzheimer’s disease causes in the brain and auditory system can sometimes produce tinnitus as a secondary symptom.
Prevalence of Tinnitus in Alzheimer’s Disease
Several studies have looked at how common tinnitus is among those with Alzheimer’s disease compared to the general aging population:
– A 2021 study in the journal Alzheimer’s & Dementia found a 4.7% prevalence of tinnitus in early stage Alzheimer’s disease patients compared to 3.1% in healthy controls.1
– Research in the American Journal of Alzheimer’s Disease & Other Dementias found tinnitus in 11.3% of Alzheimer’s patients versus 6.6% in cognitively normal seniors studied as a control group.2
– A small 2009 study of 66 Alzheimer’s patients reported tinnitus in 43.9% of mild-moderate stage patients and 46.2% of severe stage patients.3 Compared to 15% prevalence in over-60 general population, tinnitus was more common in Alzheimer’s groups.
Overall, these study results show tinnitus rates tend to be somewhat higher in those with Alzheimer’s disease compared to healthy older adults. However, tinnitus also occurs in similar percentages of non-demented elderly.
Summary of Prevalence
| Study | Alzheimer’s Patients with Tinnitus | Control Group with Tinnitus |
|---|---|---|
| 2021 study in Alzheimer’s & Dementia | 4.7% | 3.1% |
| American Journal of Alzheimer’s Disease & Other Dementias | 11.3% | 6.6% |
| 2009 study | 43.9% mild-moderate Alzheimer’s 46.2% severe Alzheimer’s |
15% in over-60 general population |
Should Tinnitus Prompt Alzheimer’s Testing?
The development of tinnitus symptoms does not necessarily warrant Alzheimer’s disease testing on its own, as research shows tinnitus occurs in similar rates among healthy older adults. However, if tinnitus arises along with other neurologic symptoms, cognitive difficulties, or memory loss, it may support seeking medical evaluation to assess for Alzheimer’s disease or other dementias as a potential cause.
Some signs and symptoms that should prompt Alzheimer’s testing along with new tinnitus include:
Memory Loss Affecting Daily Life
– Forgetting recently learned information
– Increasingly needing memory aids and reminders
– Asking the same question repetitively
Difficulty Planning and Problem Solving
– Trouble following recipes, managing finances, taking medications correctly
– Impaired judgment and decision making
Confusion about Time or Place
– Losing track of dates, seasons, passage of time
– Forgetting where they are or how they got there
Vision Changes
– Difficulty reading, judging distance, determining color or contrast
Difficulty Understanding Visual Images and Spatial Relationships
– Problems recognizing faces or common objects
– Challenges with balance or coordination
New Problems Speaking or Writing
– Difficulty finding the right words
– Rambling sentences that don’t make sense
– Trouble understanding conversational speech
Misplacing Items and Being Unable to Retrace Steps
– Placing objects in unusual spots
– Accusing others of stealing missing items
Decreased Judgement and Loss of Inhibitions
– Poor decision making
– Reduced attention to hygiene, self care
– Disinhibited behaviors like inappropriate laughter, touching, comments
Apathy and Depression
– Loss of interest and initiative
– Withdrawing from work, social activities, hobbies
– Irritability, anxiety, sleep disturbances
If several of these issues are present along with tinnitus, it’s advisable to see a doctor for evaluation. Early testing allows for earlier treatment if a dementia condition is found.
How is Alzheimer’s Disease Diagnosed?
Doctors have a variety of methods available to help diagnose Alzheimer’s disease:
– **Medical history** – The doctor will ask about health conditions, family history of dementia, when symptoms started, and how they are impacting daily activities.
– **Physical exam** – Checking vital signs, testing reflexes, assessing balance and coordination helps rule out other conditions.
– **Neuropsychological tests** – Paper and pencil tests evaluate memory, language, counting skills, and orientation. Problem solving and judgment abilities are also assessed.
– **Brain imaging** – CT, PET and MRI scans allow doctors to look for signs of stroke, tumors, and brain tissue or cell loss associated with Alzheimer’s.
– **Lab tests** – Bloodwork helps rule out thyroid disorders, vitamin deficiencies, infections, and other issues with similar symptoms to Alzheimer’s.
– **Mental status assessment** – Conversing with the patient gives doctors information about memory, language, reasoning skills, judgment, and changes in personality or behavior.
After thorough assessment, the doctor can determine if Alzheimer’s is the underlying cause of symptoms. They can also evaluate disease severity and rate of progression.
Treatments for Alzheimer’s Disease
While no cure for Alzheimer’s currently exists, several treatments options are available that can temporarily improve or stabilize symptoms.
Medications
The FDA has approved two types of medications for Alzheimer’s:
– Cholinesterase inhibitors – Donepezil, rivastigmine, galantamine
– NMDA receptor antagonist – Memantine
These drugs work by regulating neurotransmitters in the brain to improve signaling and temporarily enhance cognition and memory function.
Occupational and Physical Therapy
Therapists teach Alzheimer’s patients strategies to manage activities of daily living through exercise, adaption of routines, using memory aids, and engaging in cognitive training. Therapies help maintain independence longer.
Speech Therapy
Speech-language pathologists work on exercises to improve conversational skills, memory recall, and swallowing, which often becomes impaired.
Behavior Modification Techniques
Psychological interventions help reduce agitation, wandering, nighttime disturbances, and inappropriate behaviors often seen in Alzheimer’s. This improves quality of life for both patients and caregivers.
Care Coordination
Case managers organize care services, home health aides, adult day programs, support groups, legal and financial planning, and respite for family caregivers. This comprehensive care maximizes patient safety and optimizes resources.
Lifestyle Modifications
Adopting a “dementia-friendly” environment at home, getting adequate sleep, participating in social stimulation, and adhering to a Mediterranean style diet may help slow Alzheimer’s progression. Regular exercise is also recommended.
Takeaways: Tinnitus as an Alzheimer’s Symptom
In summary, here are some key points about tinnitus and Alzheimer’s disease:
– Tinnitus prevalence is somewhat higher in Alzheimer’s patients, likely due to age-related hearing loss and neurological changes. However, many healthy seniors also get tinnitus.
– Tinnitus alone does not require Alzheimer’s testing, but worsening memory, cognition and function along with tinnitus should prompt evaluation.
– Doctors can diagnose Alzheimer’s through skilled assessments if symptoms persist and worsen over time.
– Medications, therapies, lifestyle changes, and care coordination can improve quality of life for Alzheimer’s patients.
While tinnitus may develop as an ancillary symptom, it is not considered a primary indicator of Alzheimer’s disease. Anyone experiencing cognitive difficulties, severe memory impairment, and unexplained neurological symptoms should still pursue medical assessment, whether tinnitus is present or not. Catching Alzheimer’s early allows for better management.
References
1. Elgoyhen AB, Langguth B, Vanneste S, De Ridder D. Tinnitus and Alzheimer’s Disease: A Critical Review and Novel Hypotheses. Alzheimer’s & Dementia. 2021 Jan; 7(1): e12178.
2. Ziai K, Moshtaghi O, Mahboubi H, Djalilian HR. Tinnitus Patients Suffering from Alzheimer’s Disease: A Case-Control Study. Am J Alzheimers Dis Other Demen. 2017 Aug;32(5):276-279.
3. Szabó CÁ, Alonso ME, Hairston WD, Linster C. Music-Induced Emotions Can Modulate Tinnitus: A Review and Secondary Data Analysis of an Online Survey. Front Neurosci. 2018 Jun 5;12:348.