Middle-Ear Hearing Loss Linked to Dementia Risk—Can Hearing Aids Help Protect Your Memory?
Plus learn which factors have an even bigger impact on your risk of cognitive decline
Key Takeaways
- New study links certain middle-ear hearing loss to increased dementia risk
- Other factors, like smoking and loneliness, are more closely linked to memory loss.
- While hearing aids can’t prevent dementia, they foster social ties, which boost brain health.
What if hearing loss and the risk of dementia were more closely linked than you thought? A new study in the Journal of Otolaryngology–Head and Neck Surgery found that certain middle-ear conditions—cholesteatoma (an abnormal skin growth) and eardrum perforation—both of which can lead to hearing, are linked to a higher risk of dementia. To better understand this surprising connection, including whether hearing aids might help, we spoke with leading researchers in the field.
The link between dementia and hearing loss
“Research has established a strong connection between hearing loss and cognitive decline, including dementia,” says study coauthor S. Dillon Powell, Dean’s Research Fellow in the Golub Lab at Columbia University. “The why and how is still being understood. There is not a lot of very strong evidence for causality, so we can’t say for certain that hearing loss is causing dementia, but we can fairly confidently say there is a relationship between the two. If hearing loss does contribute to dementia, it’s likely through a combination of factors: decreased cognitive input, increased cognitive strain and worse socialization are among the leading theories, but there may be more to discover.”
This connection raises important questions, adds Nicholas S. Reed, AuD, PhD, vice president of audiology research and innovation at Amplifon and adjunct faculty in the Department of Epidemiology at the Johns Hopkins University Bloomberg School of Public Health. Is this simply a consequence of aging? Is there a specific mechanism at work? And could dementia actually cause hearing loss, rather than the other way around?
Woman's World Answers
Even mild hearing loss can affect your memory
Reed explains that untreated hearing loss may simply tax the brain to the point where it becomes a cognitive load issue. “It’s like constantly listening to a bad stereo signal or having a bad cell phone signal,” he says. “If you do that long enough, you get frustrated and tired.” Your brain works overtime to fill in the blanks, eventually taking a toll on cognitive function.”
That extra effort eventually comes at the expense of other important brain functions, like working memory. “We like to use phrases like ‘I only use 10 percent of my brain,’ but the truth is we use every ounce of brain power that’s available to us already,” Reed explains. “We’re always operating at 100 percent, so extra energy comes at the expense of something else.” In other words, when our brain is straining overtime to help us hear, it has less energy left for memory and problem-solving.
As for the backwards mechanism: dementia leading to hearing loss? “The truth is, there’s very little evidence for that when you think about hearing loss as studied by pure-tone audiometry, meaning you hear a tone, you raise your hand,” Reed explains. “That’s the bread and butter of hearing measurement. Speech understanding is a different story, as it involves complex cognitive tasks to decode a signal.”
The surprising way relationships reduce cognitive decline
Another mechanism linking hearing loss and dementia may be one most of us intuitively understand, says Reed. “Hearing really is important for our connection to other people,” he explains. “In the research on hearing loss and dementia—we’re not talking about congenital hearing loss, where sign language is a potential mode of communication—we’re talking about people who’ve spent their lives relying on spoken language and are now losing that ability.”
This group is especially vulnerable to social isolation and loneliness as their hearing declines. And the consequences, especially for older adults, are substantial: Social isolation is strongly associated with cognitive decline and dementia and is one of the largest drivers of Medicare spending, Reed notes.
Can hearing aids reduce the risk of dementia?
What’s the bottom line on hearing aids and dementia prevention? The science is promising but still evolving. “We’re starting to see evidence that the link between dementia and hearing loss may go beyond simple association towards a real relationship—though I’m careful with that language,” notes Reed. “In epidemiology and public health, calling something a ‘relationship’ means there’s strong collective confidence and substantial evidence of causality that takes decades to build.”
Here’s what makes this tricky: The research looks at large groups of people, not individuals. Other factors—like smoking or sleep—may have a clearer, stronger impact on your personal dementia risk, Reed explains. “That distinction between individual and population risk really matters.”
“So if someone asks, ‘Should I get hearing aids to prevent dementia?’ the honest answer is: probably not in any guaranteed, individual sense. There are many factors at play. Hearing aids offer multiple benefits with little downside, but few, if any, single interventions would prevent a multifactorial condition like dementia in isolation.”
“That’s why I’m cautious about saying ‘hearing aids prevent dementia,’ he says. “The relationship is likely real, but it’s not that simple.”
The bottom line on hearing loss and dementia
Will treating hearing loss single-handedly prevent dementia? No, says Reed—it’s a multifactorial condition. But can hearing care hurt? Absolutely not. “There are mostly only potential benefits,” he explains. “Unlike medications, which can come with significant side effects, hearing care carries minimal risk beyond the time and cost involved.” That’s why Reed encourages people to explore their options when it comes to managing hearing loss. “Talk to a hearing care professional, and start by understanding what’s available to you.”
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