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Hearing Aids May Reduce Dementia Risk by Half

New study finds hearing aids slowed memory loss in those at risk for dementia


spinner image close-up of woman putting in an over-the-counter hearing aid
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New research finds that treating hearing loss may be critical for helping to prevent dementia in those at risk for cognitive decline. The study, with nearly 1,000 older adults, adds to growing evidence that getting tested for hearing loss and getting hearing aids for those who need them can slow decline in memory and thinking skills. The study was published in The Lancet and presented at the Alzheimer’s Association International Conference.

The study involved 977 adults ages 70 to 84 with untreated hearing loss. Participants came from two study groups: one group of adults who were already participating in a heart health study and a group of healthy volunteers who were recruited from the community. The participants who came from the heart health study were, on average, older and had more risk factors for cognitive decline than the new healthy volunteers.

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Half the group received counseling from an audiologist and hearing aids if they needed them. The other half, the control, got advice on healthy aging from a health educator. Researchers followed the study participants for three years and tested their memory and thinking skills.

The researchers found that hearing aids did not reduce cognitive decline in the total group. But when the researchers analyzed results for the older group who were at higher risk for dementia, those who got the hearing interventions had a 48 percent greater reduction in cognitive decline than the control.

“These results provide compelling evidence that treating hearing loss is a powerful tool to protect cognitive function in later life, and possibly, over the long term, delay a dementia diagnosis,” says professor Frank Lin, M.D., of the Johns Hopkins University School of Medicine and Bloomberg School of Public Health.

The research is the first randomized controlled trial to study whether hearing intervention makes a difference in preventing cognitive decline. Cognitive decline is a decline in abilities severe enough to interfere with daily life and can range from mild cognitive impairment to dementia, according to the Centers for Disease Control and Prevention (CDC). Alzheimer’s is the most common form of dementia.

This study builds on evidence of the link between dementia and hearing loss. In 2020 the Lancet Commission on Dementia said that hearing loss contributed to about 8 percent of dementia cases worldwide, which is equivalent to 800,000 of the nearly 10 million new cases of dementia diagnosed every year. “We’re much more confident that there is a good association between hearing aid use and reversing chance of cognitive decline,” says Justin Golub, M.D., an associate professor of otolaryngology, neurotology and skull base surgery at the New York-Presbyterian/Columbia University Irving Medical Center in New York City.

What earlier research has found

Research has long associated hearing loss with dementia. However, what hasn’t been clear is whether treating the hearing loss will also help prevent or slow down memory loss. But recent studies are finding that treating hearing loss does make a difference in brain health. This research is especially important because almost 10 percent of people between the ages of 55 and 64, a quarter of people ages 65 to 74, and half of those age 75 and older live with disabling hearing loss, according to the National Institute on Deafness and Other Communication Disorders.

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In an earlier JAMA Neurology study, for example, researchers analyzed 31 studies, both observational and clinical trials, and looked at the link between hearing restoration devices, such as hearing aids and cochlear implants, and cognitive decline. They found that the use of these devices was associated not only with a 19 percent decrease in long-term cognitive decline but also with a 3 percent improvement in cognitive test scores in the short term — anywhere from three months to a year. This is a significant improvement, notes Douglas Hildrew, M.D., an assistant professor at the Yale School of Medicine in the Section of Otolaryngology — Head and Neck Surgery. “It’s something we would hope to see — but not necessarily expect to,” he says.

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'Hearing Loss for Dummies'

Authors Frank Lin and Nicholas Reed at the Johns Hopkins School of Medicine lay out the steps to hearing health, including the benefits for your cognitive, emotional and physical well-being.

There are several theories about the connection between hearing loss and cognitive decline, says Golub. “People who cannot hear as well socialize less and engage less with others because it’s more challenging to communicate,” he 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.

“Scientists estimate that hearing loss may be the biggest potentially treatable risk factor for dementia, accounting for more cases of dementia in the world than other risk factors such as high blood pressure, smoking or low education,” write Lin and audiologist Nicholas Reed in Hearing Loss for Dummies.

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Lin and other researchers are now interested in analysing the social engagement data from the new study to better understand the ways in which hearing aids may delay cognitive decline.

“Social engagement has long been known to help promote brain health. There are many reasons for why this may be the case — increased cognitive stimulation, less stress and loneliness, promoting better health habits, among others,” Lin says.

What to do

While hearing loss is associated with cognitive decline, it can be corrected. Hildrew recommends that everyone over the age of 60 get their hearing checked once a year.

“Everyone should know what their hearing is and consider addressing any hearing loss that may be present,” Lin says. “Getting tested could involve seeing an audiologist or other hearing care professional. Importantly, it’s also possible to do this yourself now with your smartphone.”

The CDC also recommends 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
  • Needing to turn the TV volume way up

If you are diagnosed with hearing loss, talk to your doctor about whether you need a hearing aid. The good news is that over-the-counter hearing aids are now available, says Golub. These are designed for people with mild to moderate hearing loss and can be purchased 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. The average price for a pair of prescription hearing aids is $4,600. The new over-the-counter hearing devices, which are regulated by the FDA to ensure that they are safe and effective, currently range in price from around $200 to $1,000 a pair.

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 “it’s like the Wild West,” Golub says. He recommends that you stick to over-the-counter or prescription hearing aids instead.

Editor’s note: This story, originally published December 7, 2022 has been updated to include new information. Betsy Agnvall contributed additional reporting to this update.

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