According to Emily Cooper, AuD, a clinical audiologist and audiology supervisor with OSF HealthCare Illinois Neurological Institute, researchers continue to learn more about the relationship between hearing loss and dementia.

"Over the last 10 years, there have been more and more studies linking hearing loss with dementia. There's a growing body of research showing that not only is there a link, but that untreated hearing loss is more of a risk for cognitive decline," Dr. Cooper says.

While researchers are still working to understand exactly why hearing loss and dementia appear to be connected, Dr. Cooper emphasizes that hearing loss alone does not cause dementia. Instead, untreated hearing loss may contribute to factors that increase the risk of cognitive decline over time.

One possible reason is the impact hearing loss can have on a person's social life. Individuals who struggle to hear often withdraw from conversations, social gatherings and activities they once enjoyed.

"Your brain needs to be active and used," Dr. Cooper stresses. "Hearing loss also takes a lot of brain power. Your brain is having to do a lot more processing to understand the world." Over time, that increased effort may contribute to cognitive decline.

Recognizing the signs of hearing loss

Hearing loss can develop gradually, making it difficult for people to recognize when their hearing has changed. Dr. Cooper says some common warning signs include:

• Turning up the television louder than usual
• Frequently asking others to repeat themselves
• Saying "what?" or "huh?" more often during conversations
• Having more difficulty hearing in noisy environments, such as restaurants or crowded events
• Experiencing ringing in the ears, known as tinnitus

Because these changes often happen slowly, family members are sometimes the first to notice them.

Dr. Cooper says loved ones can play an important role by encouraging hearing evaluations in a supportive way. Rather than focusing on the hearing loss itself, she recommends emphasizing quality of life and participation in important moments.

For example, family members might say they want their loved one to fully participate in family gatherings or clearly hear conversations during medical appointments.

Don't wait to get your hearing checked

Many people postpone hearing evaluations for years, assuming hearing loss is inevitable or waiting until their golden years.

"Getting treated early is going to be the most beneficial in preventing cognitive decline as it relates to hearing loss," Dr. Cooper says. "That means getting your hearing tested early, not waiting until you're 65 and on Medicare to do so. Even in your 40s and 50s, there's research that shows even mild hearing loss in your 40s and 50s can lead to cognitive decline later in life."

She encourages adults to establish baseline hearing assessments as they age, just as they monitor other aspects of their health.

A good first step is discussing hearing concerns with a primary care provider, who can then provide a referral to an audiologist for a comprehensive hearing evaluation.

A growing concern for an aging population

The importance of hearing health is becoming even more significant as the nation's population ages.

By 2030, all Baby Boomers will be over the age of 65 according to the United States Census Bureau. Dr. Cooper says this creates a larger risk for both hearing loss and dementia.

"We're looking at massive numbers of an aging population and people who could be at a risk for dementia and hearing loss," Dr. Cooper says. "As a field, we are looking at educating people to get their hearing tested early and getting treated early."

Research in Oxford Academic’s Age and Ageing journal suggests that individuals who receive treatment for hearing loss may have a lower risk of cognitive decline than those who leave hearing loss untreated.

Treatment options vary based on the severity of hearing loss and may include hearing aids or cochlear implants. While Medicare does not currently cover hearing aids, cochlear implants are covered by Medicare and many other insurance plans.

For Dr. Cooper, the message is straightforward: hearing loss should not be viewed as something people simply have to accept. Identifying hearing loss early and seeking treatment may help individuals stay engaged, connected and cognitively healthy as they age.

If you have concerns about your hearing, speak with your primary care provider who can help talk through options with you.

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Hearing loss can affect anyone. According to some studies, about 23% of Americans ages 12 and older experience hearing loss. While it can be mild or severe, hearing loss can also increase the odds of developing dementia later in life.

That’s according to a study published in JAMA that focused on people ages 70 and older.

While the reasons aren’t clearly understood, it’s important to note that there is a causal effect between hearing loss and dementia, according to Christopher Workman, Au. D., an audiologist with OSF HealthCare.

“There's enough research out there that shows some link to it," says Dr. Workman. "Some of that may be related to the hearing loss itself. Some of it may be related to the effects of hearing loss, which could include loneliness, depression, or lack of social interaction. There may be a direct and indirect cause to dementia, Alzheimer’s, and those type of things.”

In the past 30 years Dr. Workman has seen several patients with cognitive issues including dementia, and that number is growing. Some of their symptoms are significant, which he says raises concerns about their cognitive capabilities.

He adds that one way to prevent feelings of loneliness, depression and to stay socially active is by wearing hearing aids.

“I've read a number of these studies over the past several years and there's some debate as to exactly what's happening or what's causing it," he says. "But I think that hearing aids can play a role in minimizing the potential for dementia occurring. Obviously, you could still have dementia without and have good hearing. You could also have dementia and have hearing aids early on and still have dementia. It's not a cure, but it can help minimize some of the factors that may lead to dementia.”

But getting someone to wear hearing aids isn’t always easy. Some people cite the cost of the devices, while others have issues with sound quality. Other reasons are more of a social stigma – hearing aids are associated with becoming older, and some people have a difficult time with that reality.

A new Illinois law was signed in August, which requires all insurers to provide coverage to Illinois residents if their doctor prescribes a hearing instrument. This expands on a bill in 2018 that required insurers to cover hearing aids for children under the age of 18.

“When we see a patient, I try to kind of screen where they're at mentally, as far as the acceptance of the idea of hearing aids and sometimes I'll recommend they wait if they're not mentally ready, because the last thing we want as people buying hearing aids and they sit in a drawer, so the key is mental acceptance," says Dr. Workman. "And then the second key is committing to the idea of wearing them and wearing them all day. Because if you only wear them for an hour a day, they're not providing the benefit that they need. We want to keep stimulating the auditory pathway to prevent any atrophy from occurring.”

The goal is to treat the patient’s hearing loss as soon as possible before they experience any signs of dementia or cognitive decline. Many times, if an audiologist does suspect some cognitive decline, he or she will refer the patient back to their primary care provider for further evaluation.

Dr. Workman stresses that not everyone who experiences hearing loss is going to get dementia. But he encourages patients and family members to pay close attention to potential warning signs such as asking people to repeat themselves, accusing people of mumbling or turning up the volume on the TV, for example.

“When you start realizing you're withdrawing or the spouse or children recognize that they're withdrawing, then it's time to have something done," he adds. "Get it checked out, find out what's going on and then address it before it continues to lead to further isolation, depression and loneliness.”

Dr. Workman is optimistic that the medical community will have a better understanding of the connection between hearing and dementia in the next several years as more data is compiled and further research is conducted.
 

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