Patient Health Insights: Hearing Loss and Cognitive Impairment

Key takeaways:

• Hearing loss appears to negatively affect cognition and has been associated with structural changes in the brain.
• The risk of dementia increases with worsening hearing loss.
• Hearing loss is a modifiable risk factor against cognitive decline.

Recent research demonstrates an association between hearing loss and cognitive decline (Loughrey et al., 2018), incident cognitive impairment (Yu et al., 2024), and structural brain damage (Wang et al., 2022), making it imperative to identify and treat hearing loss as soon as possible. The risks of cognitive decline and cognitive impairment due to hearing loss may motivate patients to seek treatment with hearing aids.

“Older adults with hearing loss are more likely to develop problems thinking and remembering than older adults whose hearing is normal,” notes Frank Lin, M.D., Ph.D., an assistant professor at Johns Hopkins University School of Medicine and the university’s Bloomberg School of Public Health.

Lin’s past research from 2010–2014, which instituted the link between untreated hearing loss and cognitive decline and dementia, continues to be supported by recent studies that underscore the urgency to treat hearing loss sooner rather than later.

Recent evidence has shown that older adults who develop hearing loss are more likely to develop dementia than peers without hearing problems (Loughrey et al., 2018). This includes incident cognitive decline, meaning a decrease in cognitive abilities (such as thinking and language) in people without any previous related impairments (Yu et.al, 2024).

Furthermore, the more severe the hearing loss, the greater the risk of cognitive decline: For each 10-decibel worsening of hearing, the risk of dementia increases by 16%, according to current investigations (Yu et al., 2024).

These findings are strengthened by continued research to support the correlation between untreated hearing loss and structural changes in the brain.

A recent study published in the Lancet’s eBioMedicine publication (2022) confirmed the association between poor hearing performance and decreased volume of the brain’s temporal cortex, hippocampus, inferior parietal lobe, and precuneus. Together, these brain structures are responsible for thinking, memory, and processing sound and speech.

“If you want to address hearing well,” says Lin, “you want to do it sooner rather than later…before these brain structural changes take place.”

The Lancet Commission of Dementia Prevention, Intervention, and Care (2022) named hearing loss the single most modifiable risk factor against cognitive decline, and the most common treatment for hearing loss today is properly fitted hearing aids.

Johns Hopkins Medicine (2025) points out that, on average, people wait 10 years before getting help for their hearing loss. However, the association of hearing loss with both cognitive decline and cognitive impairment may provide a powerful motivational force for patients to follow treatment plans for hearing loss—sooner rather than later.

References

1. Johns Hopkins Bloomberg School of Public Health. “Frank R. Lin, MD, PhD: Bio.” Accessed July 2, 2025. https://jhucochlearcenter.org/about/team/frank-r-lin-md-phd

2. Johns Hopkins Medicine. “The Hidden Risks of Hearing Loss.” Last modified 2025. https://www.hopkinsmedicine.org/health/wellnessand-prevention/the-hidden-risks-of-hearing-loss

3. Livingston, G., Huntley, J., Sommerlad, A., et. al. (2020, August). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. THE LANCET COMMISSIONS, 396, Issue 10248, 413–446. Doi: 10.1016/S0140-6736(20)30367-6

4. Loughrey, D., Kelly, M., Kelley, G. et al. (2018). Association of Age-Related Hearing Loss Function, Cognitive Impairment, and Dementia. JAMA Otolaryngol Head Neck Surg, 144(2),115–126. Doi:10.1001/jamaoto.2017.2513

5. Wang, H., Zhang, W., Rolls, E., et al. (2022, Dec.). Hearing impairment is associated with cognitive decline, brain atrophy and tau pathology. eBioMedicine, 86:104336. Doi: 10.1016/j. ebiom.2022.104336

6. Yu, R., Proctor, D., Soni, J., Pikett, et al. (2024, May). Adult-onset hearing loss and incident cognitive impairment and dementia – a systematic review and meta-analysis. Ageing Res Rev, 98,102346. Doi: 10.1016/j.arr.2024.102346