Summary of Council decision:
Two issues were investigated, both of which were Not upheld.
A press ad for hearing aid company Hidden Hearing, seen on 1 July 2017, stated in a newspaper-style headline along the top of the ad “Hearing loss linked to dementia”. Text below stated “Shocking research in France has revealed that hearing loss is linked to dementia. A 25 year study has identified that as you age and struggle to hear clearly, social isolation and depression are more likely. This leads to less stimulation of the brain which in turn can lead to cognitive decline. However, the rate of cognitive decline is reduced when the hearing loss is treated by the use of hearing aids”.
The complainant challenged whether:
1. the claim that hearing loss was linked to dementia and could lead to cognitive decline was misleading and could be substantiated; and
2. the claims “as you age and struggle to hear clearly, social isolation and depression are more likely” and “hearing loss is linked to dementia” could cause fear and distress without justifiable reason.
Hidden Hearing said that all the claims were supported by research published by The American Geriatrics Society which appeared in 2015 entitled “Self-Reported Hearing Loss, Hearing Aids, and Cognitive Decline in Elderly Adults: A 25-Year Study”. Hidden Hearing also provided a report by The Lancet regarding dementia and the variables associated with its development, and referred to an NHS Choices online article entitled “Nine lifestyle changes may reduce risk of dementia”.
1. Not upheld
The ASA considered consumers would understand from the ad, in particular the claims “Hearing loss linked to dementia”, “this leads to less stimulation of the brain which in turn can lead to cognitive decline” and “the rate of cognitive decline is reduced when the hearing loss is treated”, that hearing loss was associated with, and could contribute to, dementia and cognitive decline.
The ad referred to a recently published study by The American Geriatrics Society, which was conducted among a cohort of 3,675 individuals, aged 65 and older with varying degrees of hearing loss. Cognitive decline was measured using the Mini-Mental State Examination (MMSE), a widely-recognised and widely-used screening tool for dementia and administered at follow-up visits across 25 years. The research found self-reported hearing loss was significantly associated with lower baseline MMSE score and greater cognitive decline during the 25-year follow-up period. Subjects with hearing loss who used a hearing aid were also found to have no difference in cognitive decline from controls. While the study reported a link between cognitive decline and hearing loss, it did not explicitly find that hearing loss was linked to dementia.
However, Hidden Hearing also provided a report by the Lancet Commission, which carried out a systematic review of relevant studies on the link between dementia and hearing loss. We noted that the paper’s authors consulted experts to identify relevant studies and used the established Quality in Prognosis studies tool to identify those studies which were of high quality. Studies were only included if they involved a cohort of cognitively healthy people for at least five years, had an objective measure for peripheral hearing, measured incident dementia as an outcome and had adjusted for age and cardiovascular risk factors as potential confounding factors. Three studies met the criteria, and each study found peripheral hearing loss was a significant risk factor for dementia. We noted that a meta-analysis of data from all three studies found that, with a 95% confidence level, the risk of developing dementia was 1.94 times greater among those with hearing loss than those who did not have it. We considered that the paper established that there was a link between dementia and hearing loss.
Although the specific study referenced in the ad did not report a link between dementia and hearing loss, we concluded that because the evidence provided showed that hearing loss was linked to dementia and cognitive decline, the ad was unlikely to mislead consumers.
On this point, we investigated the ad under CAP Code (Edition 12) rule 3.1 3.1 Marketing communications must not materially mislead or be likely to do so. (Misleading advertising) and 3.7 3.7 Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation. (Substantiation), but did not find it in breach.
2. Not upheld
We noted that dementia, depression, and social isolation were less commonly associated with hearing loss and therefore might cause fear or distress to some readers who were unaware of the link. Nonetheless, because we had seen evidence that hearing loss could lead to dementia, depression and social isolation, we concluded the claims were unlikely to cause fear or distress without justifiable reason.
On this point, we investigated the ad under CAP Code (Edition 12) rule 4.2 4.2 Marketing communications must not cause fear or distress without justifiable reason; if it can be justified, the fear or distress should not be excessive. Marketers must not use a shocking claim or image merely to attract attention. (Harm and offence), but did not find it in breach.
No further action necessary.