Hearing Loss One of the Most Treatable Risk Factors for Dementia

New report suggests hearing aids may help preserve memory, improve social connections, but hearing loss often goes untreated

Liz Szabo,

AARP

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En español

Published June 28, 2024

illustration of a brain connected to an ear with an orange thread

AARP (Source: Shutterstock (2))

Of all the risk factors that contribute to dementia, hearing loss is one of the most treatable, according to a special report from AARP’s Global Council on Brain Health (GCBH).

While people can’t change risk factors such as their family history, genetics or early-life education, studies now suggest that wearing hearing aids can slow the rate of cognitive decline, the report notes. “Addressing a loss in hearing is a practical and achievable way for aging adults to reduce the risk of cognitive decline,” the report states.

Studies suggest it’s important to address hearing loss early.

“Greater levels of hearing loss are associated with increased risk of cognitive decline and dementia over time,” said Frank Lin, M.D., a professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore, who was interviewed for the special report.

He said it’s encouraging that studies show that people who use hearing aids “actually do somewhat better than people who don’t use hearing aids” in cognitive function.

Lin led a randomized, controlled trial of hearing aids that was published last year in The Lancet. He and his colleagues found that older people at risk of dementia who wore hearing aids experienced 48 percent less cognitive decline over three years than peers who did not, as measured by annual assessments.

5 Signs That You May Be Losing Your Hearing

Answering yes to these questions may indicate you have hearing loss.

Are you having trouble following conversations?
Do you find yourself asking people to repeat things more often?
Does it seem like other people “mumble too much?”
Do you find the need to turn up the volume on the TV or radio? Do others complain that the volume is too loud?
Do you avoid talking on the phone because it’s exhausting trying to make out what the other person says?

While hearing aids won’t make people smarter, Lin said, “the goal is to maintain the function you have for as long as possible.”

Hearing loss contributes to about 8 percent of global dementia cases, according to a report published in 2020 from the Lancet Commission on Dementia Prevention. Authors of that report singled out hearing loss as “the largest potentially modifiable risk factor” for dementia in the world.

A silent epidemic

Hearing loss is a common problem, especially as people age: 1 in 3 people age 65 to 74 has age-related hearing loss, along with 1 in 2 people age 75 and older, according to the report.

“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,” said 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.”

Left untreated, hearing loss increases the risk of social isolation, loneliness, depression and anxiety, the report states. Hearing loss also increases the risk of falls by preventing people from picking up on subtle sound cues in the environment that can help with balance. People with untreated hearing loss are more likely to be unemployed or underemployed, or to retire early, according to the special report.

Ignoring an important area of health

The World Health Organization recommends that adults be screened for hearing loss every five years from age 50 to 64 and every one to three years beginning at age 65.

According to a survey conducted by AARP last year, most Americans over age 40 recognize the importance of hearing to health, but few take steps to protect their hearing — such as wearing ear protection when mowing the lawn or attending a concert with loud music.

Forty-one percent of adults age 50 and older reported having had their hearing checked in the past five years, according to an AARP survey conducted in June. In the survey, 38 percent reported having excellent hearing. Among those who reported hearing difficulties, 66 percent said their hearing “isn’t as good as it could be,” but that they don’t think they need hearing aids.

infographic of a cartoon brain with statistics about hearing loss and cognitive health

Data from a 2024 AARP poll on hearing of 817 people age 50 and older.

AARP Poll on Hearing

Studies suggest that adults who hear better also live better. Adults who describe their hearing as excellent also have higher mental well-being scores and lower depression and anxiety scores, according to the special report.

Yet hearing loss often goes untreated.

People who suspect they’re losing their hearing wait an average of seven years before they seek treatment. A study of Medicare participants cited in the report found that only 29 percent of those with hearing loss used hearing aids.

The United States has made progress in making hearing aids more accessible. The Food and Drug Administration has allowed hearing aids to be sold without a prescription since 2022. In the June AARP survey, 45 percent of respondents said they are more likely to use hearing aids that are available over the counter.

Yet hearing aids, which can cost thousands of dollars, remain unaffordable for many people. Health insurance usually doesn’t cover hearing aids, and neither does traditional Medicare, although some Medicare Advantage plans do. (Read Does Medicare Cover Hearing Aids? for more information.)

In August 2022, the Food and Drug Administration approved over-the-counter hearing aids. These devices, designed for those with mild to moderate hearing loss, are sold in stores and online without a prescription or special fitting from an audiologist. They are often much less expensive than traditional hearing aids. (For more information, read How to Shop for an Over-the-Counter Hearing Aid.)

Even when people have hearing aids, only 63 percent use them regularly, according to the June AARP survey. While some people find hearing aids uncomfortable or inconvenient, many simply forget to wear them, according to an online survey designed by AARP in 2023. Others say they avoid wearing hearing aids because of perceived stigma, according to the special report. Some people remain embarrassed by their hearing loss or worry that wearing a hearing aid will make them look weak.

Many unaware of link between hearing and brain health

Fewer than half of adults surveyed in 2023 know that hearing loss can contribute to dementia.

Education makes a difference, research shows.

Nearly 80 percent of adults surveyed said knowing that hearing loss increases their risk of dementia, falls and other dangers would make them “extremely likely” or “very likely” to address any current or future hearing issues, according to the June 2024 AARP survey.

Kristine Yaffe, M.D., chair of the GCBH and professor and vice chair of psychiatry, neurology and epidemiology at the University of California, San Francisco, said she hopes the special report will increase “people’s awareness of the connection with hearing loss, how common it is and how it could have downstream associations with brain health.”

Home Hearing Tests

Can you hear me now? How to test your hearing at home.

AARP members can take the National Hearing Test for free once a year. The National Hearing Test is an independent and scientifically validated hearing screen test developed with funding from the National Institutes of Health. Find out more about the free at-home hearing test.

The World Health Organization has created a free app that allows people to test their hearing, called hearWHO.

People also can download commercial mobile apps to assess their hearing. Some provide a “hearing number” from 10 to 100 decibels, with higher numbers reflecting greater hearing loss.

Lin and his colleagues at the Johns Hopkins Cochlear Center for Hearing and Public Health plan to launch a free app this fall that will allow people to learn their hearing number and track it over time. Lin said he’d like people to monitor their hearing number just as they track their weight, blood pressure and cholesterol levels.

How hearing loss leads to dementia

Hearing loss may contribute to dementia in three major ways.

“If you can’t hear as well, you probably don’t go out as much,” Lin said. “Social isolation can have direct effects on inflammation, and inflammation is a common pathway for the aging process. Remaining cognitively and socially stimulated, so you’re constantly exercising the brain, is important too.”

Hearing loss also increases “cognitive load,” or the amount of work that the brain is asked to do, Lin said. When someone can’t hear well, the brain must work harder to make sense of garbled sounds and convert them into meaningful words. That means the brain has less “cognitive reserve” to deal with other tasks, such as thinking and remembering.

Last, hearing loss can deprive the parts of the brain involved in hearing and communication of stimulation, leading them to atrophy, Lin said. According to the special report, researchers have found that adults with hearing loss lose gray matter, the part of the brain involved with memory and learning.

The good news, Lin said, is that “hearing loss is highly treatable, with technology that comes at absolutely no risk.”