Hearing loss does not directly cause dementia. However, untreated hearing loss is associated with a higher risk of cognitive decline. Treating hearing loss may reduce listening strain, improve social engagement, and support overall brain health as you age.
Many of our patients ask a version of the same question:
“I’ve heard hearing loss can lead to dementia. Is that true?”
It’s an understandable concern. Headlines over the past decade have drawn attention to the connection between hearing loss and cognitive decline. But the story is more nuanced than many articles suggest.
Here’s what we actually know, what we don’t know, and what it means for you.
Over the past 15 years, several large longitudinal studies have examined the relationship between hearing loss and cognitive decline.
In a landmark study published in Archives of Neurology, researchers followed older adults for nearly 12 years and found that greater levels of hearing loss were associated with progressively higher risk of developing dementia over time. In this 2011 study, individuals with moderate hearing loss had roughly three times the risk of developing dementia compared to those with normal hearing.
In a separate study published in JAMA Internal Medicine, hearing loss was associated with accelerated rates of cognitive decline compared to normal hearing.
It’s important to emphasize that these studies show an association, not direct causation. Hearing loss does not “cause” dementia in a simple, linear way. Instead, untreated hearing loss is considered a potentially modifiable risk factor for cognitive decline.
That distinction matters.
There are several leading theories.
When hearing becomes more difficult, the brain has to work harder to fill in missing sounds. Instead of effortlessly understanding speech, your brain diverts extra resources just to decode conversation.
Over time, that increased listening effort may reduce the cognitive resources available for memory, comprehension, and processing speed.
Patients often describe this as:
The brain is compensating, but it’s working overtime.
Hearing loss decreases the amount of sound information reaching the brain. When certain auditory pathways are under-stimulated for long periods, structural and functional changes can occur.
Just like muscles weaken when not used, neural pathways can also change when they are not regularly engaged.
This may be the most powerful factor.
Untreated hearing loss often leads people to withdraw from social situations. Conversations become frustrating. Group settings feel overwhelming. Many people slowly participate less.
Social isolation itself is a well-established risk factor for cognitive decline.
So hearing loss may indirectly affect brain health by reducing meaningful engagement.
This is where things get especially interesting.
The recent ACHIEVE study, a large randomized controlled trial, examined whether treating hearing loss with hearing aids could influence cognitive outcomes.
The results showed that among individuals at higher risk for cognitive decline, those who received hearing intervention had significantly less cognitive decline over three years compared to those who did not. The greatest benefit was observed in individuals already at higher risk for cognitive decline.
That does not mean hearing aids “prevent dementia.” But it does suggest that treating hearing loss may play a meaningful role in supporting long-term brain health.
Hearing care is not just about volume. It may be part of a broader healthy aging strategy.
Here’s the practical takeaway:
Even mild hearing loss is worth evaluating. Many patients assume they should “wait until it gets worse.” But waiting may increase listening strain and reduce quality of life in the meantime.
Addressing hearing concerns early allows for:
That’s proactive care.
Yes, even mild hearing loss can be a very big deal, for both your overall health, your social-emotional well-being, and cognition.
Many people with mild hearing loss still function relatively well in quiet environments, but the difficulty often appears in:
Because it’s situational, it’s easy to dismiss. But mild loss still increases listening effort. Over years, that strain adds up.
A baseline hearing test provides clarity and allows us to track changes over time.
For adults over 60, hearing evaluations are recommended annually, especially if:
Hearing health is part of overall health, and it should not be an afterthought, especially if you are concerned about your cognitive health.
No. Hearing loss does not directly cause dementia. However, untreated hearing loss is associated with an increased risk of cognitive decline. It is considered a modifiable risk factor.
Yes, untreated hearing loss is associated with a higher risk of cognitive decline, but it does not directly cause dementia. Treating hearing loss may support better long-term brain health.
Hearing aids do not prevent dementia. However, research suggests that treating hearing loss may reduce cognitive decline in certain populations and supports healthier brain engagement.
No. Early treatment often reduces listening fatigue and improves communication. Waiting until hearing loss becomes severe may increase social withdrawal and cognitive strain.
No. A comprehensive hearing evaluation is painless and typically takes less than an hour. It provides valuable insight into your hearing and communication function.
The connection between hearing and brain health is real, but it is not something to fear. It is something to act on.
If you are concerned about your hearing, scheduling a comprehensive hearing evaluation provides clarity, establishes a baseline, and helps you make informed decisions about your long-term health.
Our audiology team at Live Better Hearing + Balance is here to help you understand your hearing and make informed decisions about your long-term health.
