Hearing Loss and Dementia: Understanding the Link and What You Can Do

older Asian man cupping his ear to hear

Hearing loss has been linked to cognitive decline and to dementia, and the call to treat hearing loss is growing more urgent.

A Johns Hopkins Medicine article reports: “In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D., and his colleagues found that mild hearing loss doubled dementia risk. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.”

Thus, researchers are also looking at the link between cognitive decline and wearing hearing aids. Multiple studies, though not all, appear to indicate that use of hearing aids has a positive impact on cognitive decline; however, researchers believe that more research is needed.

The Johns Hopkins ACHIEVE study

In July 2023, the results of the ACHIEVE Study, funded by NIH and co-led by Dr. Frank Lin, were released. Researchers compared the rate of cognitive decline over a three-year period between people who did and people who did not receive hearing aids.

A National Institute on Aging article in September 2023 explained that, in looking at all the participants, there was “no difference in the rate of change in cognitive functioning between people who received the hearing aids and those who didn’t. However, when the analysis focused on people from the heart-health study who had a higher risk of dementia, the benefit of the hearing aids was substantial. Those who received hearing aids had an almost 50 percent reduction in the rate of cognitive decline compared with people in the health-education group.”

Organizations taking note

Last year, the American Speech-Language-Hearing Association (ASHA) published “The Value of Audiology: Hearing Loss  and Cognitive Decline/Dementia,” research and statistics that they believe support their conclusion that “treating hearing loss with amplification reduces the likelihood of developing dementia and improves cognitive function.”

The National Plan to Address Alzheimer’s Disease, 2023 Update states, “Hearing loss has been identified as a risk factor for AD/ADRD [Alzheimer’s Disease/Alzheimer’s Disease Related Dementias], and recent research has demonstrated that hearing aid use is associated with reduced dementia risk.”

Why can hearing loss harm our brains?

While the reasons aren’t entirely clear, three factors may play a role in why and how hearing loss is linked to dementia. First, when we can’t hear well, we sometimes lose the desire to socialize and engage in our hobbies. Perhaps we’re embarrassed, frustrated, or we simply can’t enjoy those activities in the same way. That can lead to loneliness and/or isolation, which itself is linked to an increased risk of dementia.

Second, when we’re striving hard to hear, our brain is directing our mental resources toward listening and understanding the words. Thus, our brains may not have enough power to also focus on thinking and memory.

Finally, hearing loss may actually damage our brains, contributing to a faster rate of atrophy in the brain, according to Dr. Frank Lin.

It’s important to understand that hearing loss can be exhausting. Striving to hear while you have a hearing loss is like riding a bike uphill—it requires a lot more effort, and it tires you more quickly. In “How to Explain Hearing Loss So Others Can Understand It” (Psychology Today), Shari Eberts talks about how hearing loss is like playing Wheel of Fortune—key letters are missing, and we have to watch for cues in context, lipreading, and body language in order to understand speech.

What you can do next

Making hearing health and communication a priority can be a good start.

Watch for signs of hearing loss. Are you struggling to hear the television, or conversations on the phone? Are you asking people to repeat themselves, or are friends and family telling you that you may have a hearing loss?

Even if the science isn’t yet definitive, practice healthy aging by seeing an audiologist and by purchasing hearing aids if you need them. If you’re new to working with an audiologist, the Hearing Loss Association of Washington (HLAA-WA) has some  excellent tips.

Hearing aids can change lives

Many people report that hearing aids have changed their lives dramatically and for the better. At HLAA-WA, we hear glowing testimonials about the power of a simple hearing aid. “It was as if my mother suddenly entered the room—she became alive and actively engaged in the conversation,” one member told us.

Thankfully, the stigma surrounding hearing aids and hearing loss is fading. More people are talking about their hearing loss, and hearing aids and “hearables” are becoming more common—and even more stylish.

Hearing aids: a sound investment

Hearing aids are covered under Washington State Medicaid, some Medicare Advantage plans and, thanks to recent legislation, many private group insurers. But if you have concerns about how to afford hearing aids, visit HLAA-WA’s Financial Help for Buying Hearing Aids webpage. Another option may be over-the-counter hearing aids as they are often more affordable and may work well if you have mild to moderate hearing loss.

As Dr. Frank Lin has said, there’s really no downside to getting hearing aids. Hearing aids can be an investment in your mind, body, and spirit, and they just might help protect your brain.

Contributor Diana Thompson is a retired lawyer who serves on the Seattle-King County Advisory Council on Aging & Disability Services and lends her expertise to HLAA-WA’s advocacy efforts. Diana serves as liaison to many community groups, advocating for the needs of people with hearing loss, including the Washington State Dementia Action Collaborative and the Bellevue Network on Aging.

This article appeared in the February 2024 issue of AgeWise King County. It is the third of a three-part series on hearing loss and aging from the Hearing Loss Association of America—Washington State (HLAA-WA). Read “New Legislation Helps Older People with Hearing Loss in Washington State” (November 2023) and “Are Over-the-Counter Hearing Aids Right for You?” (December 2023).