For 30 years of practice in Florida, I have had hundreds of couples in my office with a similar complaint: “he/she doesn’t speak loud enough and he/she doesn’t hear.”

Since so much of my practice is devoted to serving people with Parkinson’s disease and related diagnosis, it is usually the case that the patient does not speak loud enough. But given the demographic here in SW Florida, it is also true that many of their spouses are hard of hearing, and either refuse to acknowledge it, or have hearing aids that they don’t wear. Patients too are guilty of not wearing their hearing aids, which are sometimes in their pocket or at home in a drawer.

It makes no sense to me, and in fact is almost counterproductive for a patient to be struggling to be heard and working hard to improve the loudness and clarity of their voice, while their partner has not committed to their hearing health. It also makes no sense to me that a patient with a medical diagnosis that has an association with dementia, would also choose not to wear their hearing aids, which contributes to cognitive decline and even dementia.

Global research suggests that hearing loss and dementia are linked.¹ Having mild hearing loss is thought to double your risk of developing dementia and the level increases the more severe your hearing loss. So the risk is three times as great if you have moderate levels of hearing loss and five times as great if you have severe hearing loss.

Hearing loss is associated with a decline in memory skills, probably as the effort required from the brain to make sense of sounds is much greater. With hearing loss, the information about sounds that the brain receives from the ear is degraded – it may be muffled, or blurred and sounds at some pitches may not reach the brain at all, so it has to work harder to figure out what it’s hearing.

The additional ‘listening effort’ reduces the resources that the brain has to do all the other things it needs to do and may accelerate or exacerbate cognitive decline. Individuals with Parkinson’s disease are already devoting cognitive resources to ambulation, speaking and sometimes even swallowing, and that constant demand along with hearing loss can add to the daily fatigue many complain of.

Finally, any communication impairment overtime can negatively impact relationships and quality of life. Struggling to speak and be understood or to hear and understand is like driving for miles with a radio that is stuck between stations only delivering a garbled message and static. Couples  often begin talking to each other less, losing one of the bonds that most likely initially drew them together.

If you suspect you have a hearing loss, ask your physician for a referral to an audiologist. If you have hearing aids that you haven’t worn for over a year, take them to an audiologist and request a current hearing test and re-programming if needed.

I have never met a person yet who would leave the house without their prescription glasses and spend the day walking into things, so, why leave home unable to hear well?

If you would like to learn some tips for how you and your partner could improve communicators in the face of Parkinson’s disease, visit my website and listen to the webinar: Parkinson’s & Care-Partner Communication: It Takes Two Baby! hosted by SmartXPD® Visit:



My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate  and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

Voice Aerobics the heART and Science of Voice Practice