Wearing Hearing Aids May Reduce Your Risk of Dementia

The connection between hearing loss and cognitive decline

Researchers have long observed a connection between hearing and brain health in studies showing hearing loss and dementia risk are directly related.

But it wasn’t until recently that they were able to get a handle on how treating hearing loss can be a powerful tool in protecting cognitive function in later life, and possibly over the long term delay a dementia diagnosis.

In the landmark ACHIEVE study of older adults with untreated hearing loss, researchers tested the hypothesis that treating hearing loss may help to preserve brain function.

They discovered that participants at greater risk for cognitive decline who wore hearing aids and had ongoing sessions with an audiologist had a 48 percent greater reduction in cognitive decline than those who didn’t wear hearing aids, but instead met regularly with a health educator about chronic disease prevention. The findings were published in 2023 in the journal The Lancet.

“As we learn more and more about these mechanisms, it may be that there’s some element that each of these paths contribute to in this very consistent connection between hearing loss and cognition,” says Dr. Carrie Nieman, an otolaryngologist with the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Medicine. She was not involved with the ACHIEVE study.

The research is especially important because almost 10 percent of people between the ages of 55 and 64, a quarter of adults ages 65 to 74, and more than half of those age 75 and older live with disabling hearing loss, according to the National Institute on Deafness and Other Communication Disorders.

“Everyone seems to know someone with hearing loss, whether it’s someone who is just recognizing the early signs of hearing loss or someone who is in the process of getting a hearing aid,” says Lindsay Chura, senior research and policy adviser, and chief scientific officer of the GCBH. “Hearing loss can have wide-ranging effects on a person’s life, impacting their ability to work, enjoy hobbies and maintain relationships. This reduction in overall quality of life can lead to frustration and a decline in mental well-being.”

Why hearing loss can lead to dementia

​There are several theories that help explain why hearing loss can lead to dementia. “People who cannot hear as well socialize less and engage less with others because it’s more challenging to communicate,” Golub says. “That’s a problem in older life, because part of what keeps you healthy and vital is having cognitively meaningful and stimulating conversations.”

In addition, he notes, the brains of people with hearing loss have to work harder to understand words being said. This can drain what scientists call cognitive reserve, which is the brain’s resilience against disease.

Finally, some research suggests that people with hearing loss have faster rates of brain shrinkage in the temporal lobe — the brain’s hearing processing center.

“Since this is connected to other parts of the brain, it can have cascading consequences,” Golub says. The GDBH report says researchers have found that adults with hearing loss may even lose gray matter, the part of the brain involved with memory and learning.

Hearing health is about more than just hearing​

The ripple effects of untreated hearing loss go well beyond simply being able to hear. When left untreated, hearing loss increases your risk of social isolation, loneliness and anxiety, the GCBH report states. You’re more likely to be unemployed or underemployed, or to retire early, it says.

In addition to cognitive decline, hearing loss can raise your risk for:

Depression: The inability to hear ups the risk of social isolation, loneliness, reduced quality of life — all risk factors for depression.

Falling: Older people are already at risk of falls. With hearing loss, your risk is even greater because you can’t fully sense what’s around you. A study published in the Journal of The American Geriatrics Society found that people who wore hearing aids had a 50 percent reduced risk of experiencing a fall, as compared to nonusers.

Mortality: Hearing loss has been associated with early death, and there is research to suggest that wearing hearing aids on a consistent basis reduces the mortality risk. One study, published in The Lancet Healthy Longevity found that adults with hearing loss who regularly used hearing aids had a 24 percent lower risk of all-cause mortality compared to those who never used them..

What you can do

Have your hearing checked. If you’re 50 or older, the American Speech-Language-Hearing Association recommends having your hearing checked by an audiologist or hearing professional every three years. The CDC also suggests getting your hearing checked if you notice any signs of hearing loss, such as: 

• Trouble understanding conversations in loud environments, like in a restaurant 
• Difficulty understanding speech over the phone​
• Trouble hearing consonants (for example, trouble hearing the difference between s and f)​
• Frequently asking others to repeat what they said or to speak more slowly and clearly​
• Ringing in the ear, known as tinnitus​
• Needing to turn the TV volume way up

Talk to your doctor. If you’re diagnosed with hearing loss, talk to your doctor about whether you need hearing aids. The good news is that over-the-counter hearing aids are now available, Golub says. They’re designed for people with mild to moderate hearing loss and available without a prescription.

“Ideally, people with hearing loss would get a prescription hearing aid, but that’s a very expensive purchase for most Americans,” he says. According to the National Council on Aging (NCOA), the average price for a pair of prescription hearing aids is $3,300. Over-the-counter hearing devices, which are regulated by the U.S. Food and Drug Administration (FDA) to ensure that they are safe and effective, cost $930 per pair, on average, according to NCOA.

These shouldn’t be confused with personal sound amplification products (PSAPs), another class of amplifying devices that you can buy without a prescription. These aren’t regulated as medical devices by the FDA, so Golub recommends you stick to over-the-counter or prescription hearing aids instead.

Seek out support. Connect with others — either virtually or in-person — facing similar challenges. Organizations like the Hearing Loss Association of America offer local chapters and online resources.

Protect your remaining hearing. Avoid loud noises and wear ear protection (earplugs or earmuffs) in noisy environments, like when you’re doing yard work, attending a concert or dining in a crowded restaurant.​​

Editor’s note: This story, originally published Dec. 7, 2022, has been updated to reflect new information and new reporting from Kimberly Goad and Liz Szabo.