Highlights
- Hearing loss is one of the largest modifiable risk factors for dementia.
- Observational studies link hearing aid use with lower dementia risk.
- The ACHIEVE trial found benefits mainly for people at higher risk.
- Hearing aids improve communication, confidence, and social life.
Hearing loss creeps up on many of us. At first, it's just turning up the TV a little, or asking people to repeat themselves in noisy restaurants. Over time, conversations become tiring, social events lose their appeal, and it's easier to nod along than to admit you didn't catch what was said.
For years, hearing loss was seen as a frustrating but harmless part of getting older. Now researchers know it's closely linked to brain health. In fact, hearing loss has been identified as one of the largest modifiable risk factors for dementia. That raises an important and hopeful question: can treating hearing loss with hearing aids help protect the brain? This article explores what the research shows.
Hearing Loss and Dementia: The Connection
The 2024 Lancet Commission on dementia prevention identified hearing loss as one of the biggest modifiable risk factors for dementia, estimating that it accounts for around 7 percent of dementia cases worldwide. Studies have found that people with untreated hearing loss tend to experience faster cognitive decline than people with normal hearing, and the risk rises with the severity of hearing loss.
Because hearing loss is so common, affecting roughly two-thirds of adults over 70, even a modest effect on dementia risk adds up to a large impact across the population.
Why Might Hearing Loss Affect the Brain?
Researchers have proposed several explanations, and more than one may be true.
Cognitive Load
When hearing is poor, the brain has to work harder to make sense of sounds. This extra effort may take resources away from other thinking tasks, such as memory and attention. Many people with hearing loss describe feeling mentally exhausted after conversations.
Social Isolation
Struggling to hear often leads people to withdraw from social situations. Social isolation and loneliness are themselves risk factors for dementia, and conversation is one of the best forms of mental stimulation.
Reduced Brain Stimulation
When the brain receives less sound input, the areas responsible for processing sound may become less active. Some studies have found faster shrinkage in certain brain regions in people with hearing loss.
A Shared Cause
It's also possible that hearing loss and cognitive decline share some underlying causes, such as blood vessel problems or aging processes affecting both the ear and the brain.
What Research Shows About Hearing Aids
Observational Studies
Large studies following people over time have generally found that people with hearing loss who use hearing aids have a lower risk of dementia than those who don't. A large 2023 study published in The Lancet Public Health, using data from the UK Biobank, found that people with hearing loss who didn't use hearing aids had a higher risk of dementia, while those who used hearing aids had a risk similar to people without hearing loss.
A 2023 review and analysis in JAMA Neurology, combining data from many studies, found that hearing aids and cochlear implants were associated with a lower risk of long-term cognitive decline.
These studies are encouraging, but they show associations rather than proof of cause and effect. People who use hearing aids might also differ in other ways, such as being healthier or wealthier.
The ACHIEVE Trial
To get clearer answers, researchers ran a randomized controlled trial called ACHIEVE, published in The Lancet in 2023. Nearly 1,000 adults aged 70 to 84 with untreated hearing loss were given either a hearing intervention, including hearing aids and support from an audiologist, or a health education program.
Over three years, the hearing intervention did not significantly slow cognitive decline across the whole group. However, among participants who were at higher risk of cognitive decline, those drawn from a long-running heart health study, the hearing intervention slowed the rate of decline by almost half.
Researchers concluded that hearing intervention may be most helpful for older adults at greater risk of cognitive decline, and that longer follow-up is needed. The trial also showed benefits for communication, social engagement, and loneliness.
The Bottom Line
The evidence isn't yet definitive, but it's promising. Hearing aids are safe, they improve quality of life, and they may help protect the brain, particularly for people at higher risk. Given all this, experts widely recommend treating hearing loss as part of a brain-healthy lifestyle.
It also helps to think of hearing care as a long-term habit rather than a one-time fix. Hearing can change over the years, so regular checkups and adjustments keep your hearing aids working as well as possible.
Other Benefits of Treating Hearing Loss
Even setting dementia aside, hearing aids can make life better:
- Easier, less tiring conversations
- More confidence in social situations
- Less loneliness and isolation
- Better safety, such as hearing alarms and traffic
- Greater enjoyment of music, films, and nature
- Improved relationships with family and friends
Signs You May Need a Hearing Test
- Often asking people to repeat themselves
- Turning up the TV or radio louder than others like
- Struggling to follow conversations in noisy places
- Thinking others are mumbling
- Difficulty hearing on the phone
- Ringing in the ears
- Family or friends mentioning your hearing
Experts suggest adults have their hearing checked regularly from midlife onward, and sooner if you notice any signs.
Getting the Most From Hearing Aids
Wear Them Consistently
Hearing aids work best when worn throughout the day. It can take a few weeks for your brain to adjust to new sounds, so be patient.
Get Professional Fitting
An audiologist can fit and adjust your hearing aids for your specific hearing loss. Follow-up appointments help fine-tune settings.
Consider Over-the-Counter Options
In the US, over-the-counter hearing aids became available in 2022 for adults with perceived mild to moderate hearing loss. They can be a more affordable starting point, though a professional assessment is still valuable.
Use Your Hearing
Once your hearing is improved, put it to use. Rejoin social activities, have conversations, listen to music, and engage with the world.
Combine With Other Brain-Healthy Habits
Treating hearing loss works best alongside other steps:
- Regular physical activity
- Social connection
- Mental challenges such as learning, reading, and brain games
- Managing blood pressure, blood sugar, and cholesterol
- Good sleep and a healthy diet
- Getting your vision checked too
Frequently Asked Questions
Do hearing aids prevent dementia?
They haven't been proven to prevent dementia, but research suggests they may lower risk, especially for people at higher risk of cognitive decline.
Is it ever too late to get hearing aids?
No. Hearing aids can improve quality of life at any age.
How long does it take to get used to hearing aids?
Most people adjust within a few weeks to a few months of regular wear.
Are over-the-counter hearing aids effective?
For adults with mild to moderate hearing loss, they can be helpful. A hearing test can confirm whether they're suitable.
Key Takeaways
- Hearing loss is one of the largest modifiable risk factors for dementia.
- Observational studies link hearing aid use with lower dementia risk.
- The ACHIEVE trial found benefits mainly for people at higher risk.
- Hearing aids improve communication, confidence, and social life.
- Regular hearing checks are a simple, valuable step for brain health.
Your ears and your brain work as a team. Looking after your hearing is one of the easiest ways to stay connected, engaged, and mentally sharp. If you've been putting off a hearing test, now is a great time to book one.
This article provides general educational information and is not medical advice. A qualified healthcare professional can help you evaluate choices in relation to your health history, medications, and individual needs.