New Research Suggests Hearing Aids Could Delay Dementia

A recent study suggests that hearing aids could be a useful tool for improving cognition and even delaying dementia.

The meta-analysis of more than 31 studies that included 137,484 participants found that using a hearing aid or cochlear implants was linked to a 19% decrease in long-term cognitive decline and a 3% increase in short-term cognitive test scores.

While researchers are still trying to understand the connection and hearing aids alone are not enough to prevent dementia, there is compelling evidence that hearing loss is a key dementia risk factor—and one that can be changed.

How Hearing Loss and Dementia Are Connected

While hearing loss and dementia often occur in the same later stages of life, there’s little concrete evidence proving how the two diagnoses are linked.

A 2011 study suggested that straining to hear and decode sounds like speech may overwhelm the brain. For people predisposed to dementia, the strain could speed cognitive decline.

Karen D. Sullivan, PhD, ABPP, a board-certified neuropsychologist at I Care For Your Brain told Verywell that social isolation caused by the inability to hear and strain can also make dementia worse.

“Neurons in the auditory cortex are finely tuned to things like pitch, tone, and the human voice,” said Sullivan. “Their primary job is to perceive specific sounds, and when they don’t serve a function anymore, they are no longer stimulated. Brain cells that lack stimulation have a metabolic shutdown and undergo a process of apoptosis which basically means self-destruction.”

Once those neurons have started to decay and a person has hearing loss, they can become socially withdrawn. When it’s hard to hear in social situations like crowded rooms, many people will choose to self-isolate. According to Sullivan, that isolation may contribute to cognitive impairment.

How Can Hearing Aids Help?

Sullivan pointed to a 2021 study that showed that older adults who had been diagnosed with mild cognitive impairment and who used hearing aids were at significantly lower risk for developing all-cause dementia compared to people who were not using hearing aids.

Does that mean that any person who is starting to have hearing trouble should get hearing aids?

Like many progressive conditions, hearing loss happens slowly. Brian Kaplan, MD, chairman of the Department of Otolaryngology and Director of the Cochlear Implant Program at the Greater Baltimore Medical Center, told Verywell that if you think you’re experiencing hearing loss, the first step is to see an audiologist.

“There are five degrees of hearing loss: mild, moderate, moderately severe, severe, and profound,” said Kaplan. “Each level considers where sounds fall in loudness level and frequency scale for what you can and cannot hear.”

Rachel Raphael, MA, CCC-A, an audiologist at Alan E. Oshinsky, MD, PA, told Verywell that common signs of hearing loss can include:

• Turning the TV volume up high
• Asking people to repeat themselves
• Accusing people of mumbling or whispering
• Experiencing ringing in the ears (tinnitus)

In terms of risk factors, it’s also common for people to have a history of working in a loud noisy environment, such as in a factory, on construction sites, or near firearms.

According to Raphael, screening tests can also detect strokes and measure cognition by assessing four domains: visuospatial, problem-solving, speed reaction time, and processing speed.

Based on the combined results of these tests, providers are often able to recommend hearing aids much sooner than a patient would recognize that they need them.

What About OTC Hearing Aids?

In the United States, hearing aids can be purchased over the counter (OTC) without the need for screening. However, both Kaplan and Raphael still recommend visiting an audiologist to figure out which hearing aid or cochlear implant is best for you.

“OTC can be affordable and helpful for some people with mild to moderate losses,” said Raphael. “But they will not address the complexity of many asymmetric losses, more severe losses, physically and mentally challenged patients, etc., for whom a prescriptive fit and lots of guidance and troubleshooting will be needed.”

Kaplan said they hope the study and others like it will push more people to find out if they are starting to experience hearing loss and get the support they need as soon as possible.

“The biggest thing is we want aging adults to understand they need to take their hearing seriously,” said Kaplan. “Just as you wouldn’t dismiss hypertension, you should not dismiss hearing loss. As a society, we should be treating hearing health with as much importance as eye health and orthopedic health as we age.”