Up to 32% of Dementia Cases May Be Attributable to Hearing Loss, Study Finds
In a significant new study published in JAMA Otolaryngology–Head & Neck Surgery, researchers report that nearly one in three dementia cases over an eight-year period could be attributed to hearing loss, based on data from a large, diverse cohort of older adults.
The findings suggest that addressing clinically significant hearing loss in later life may represent a powerful—and underused—tool in dementia prevention strategies.
Objective Hearing Measures Reveal Stronger Link
The study, conducted as part of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), followed nearly 3,000 adults aged 66 to 90 who did not have dementia at the study’s outset. Participants underwent both objective (audiometric) and subjective (self-reported) hearing assessments, and their cognitive health was tracked for up to eight years.
The results showed that 32% of dementia cases could be attributed to any degree of audiometric hearing loss, with mild and moderate-or-greater hearing loss each contributing roughly half of that fraction. In contrast, self-reported hearing loss showed no association with increased dementia risk, highlighting the importance of using objective clinical assessments when evaluating hearing-related dementia risk.
The researchers noted that self-reported hearing difficulties likely underestimate clinically significant hearing loss in older adults, particularly those over 70. They explained, “Self-report substantially underestimated HL prevalence and was not associated with any dementia incidence. Future studies should prioritize objective measures of hearing over subjective measures to quantify its preventative potential on dementia risk.”
Greater Risk Identified Among Older Adults and Women
Further analysis revealed that the proportion of dementia attributable to hearing loss varied by demographic factors. Population attributable fractions (PAFs)—a metric that quantifies how much of a disease burden is linked to a given risk factor—were generally higher among participants aged 75 and older, women, and White individuals, compared to their younger, male, or Black counterparts.
These differences were largely driven by variations in the prevalence of hearing loss across groups, though the researchers cautioned that smaller subgroup sizes may limit the precision of these estimates. Despite this, the trend aligns with prior studies indicating higher rates of hearing loss among older and female populations.
Notably, among participants with moderate or greater hearing loss, only about 56% reported using hearing aids, and the protective effect of hearing aid use on dementia risk appeared modest in this cohort. However, the researchers pointed out that longer-term studies may be needed to fully capture the cognitive benefits of consistent hearing aid use.
A Larger Public Health Role for Hearing Care
Previous estimates of the contribution of hearing loss to dementia in the U.S. population have varied widely—from 2% to 19%—in part due to differences in how hearing loss was measured. The 32% estimate reported in this study represents one of the highest to date and underscores the importance of accurate, audiometric testing.
“This cohort study suggests that treating hearing loss might delay dementia for a large number of older adults. Public health interventions targeting clinically significant audiometric hearing loss might have broad benefits for dementia prevention.”
Their findings also reinforce the importance of late-life interventions. While midlife risk factors such as obesity, physical inactivity, and low educational attainment have long been targeted for dementia prevention, this study highlights that late-life hearing care may offer comparable—if not greater—preventative potential.
Importantly, the study builds on prior research from the ACHIEVE randomized clinical trial, which found that hearing intervention reduced cognitive decline by 48% in high-risk older adults over a three-year period. The ARIC participants in the current study, who formed part of the ACHIEVE trial’s population base, were followed for a much longer duration—up to eight years—providing a broader picture of long-term dementia risk.
A Call for Objective Screening and Broader Access
The findings carry significant implications for clinicians, researchers, and policymakers. With hearing loss affecting more than two-thirds of older adults in the U.S., the study argues for a shift toward routine objective hearing screenings as part of standard preventive care in aging populations.
At the same time, the authors noted that broader access to affordable and effective hearing interventions, including hearing aids and cochlear implants, is essential to maximizing the public health impact of these findings.
While additional research is needed to better understand subgroup variations and the potential cumulative effects of untreated hearing loss, this study strengthens the case for hearing care as a key component of healthy aging.
As the researchers concluded, “Interventions for sensory health in late life might be associated with a broad benefit for cognitive health.”
Reference
- Ishak EBurg EAPike JR, et al. Population Attributable Fraction of Incident Dementia Associated With Hearing Loss. JAMA Otolaryngol Head Neck Surg. Published online April 17, 2025. doi:10.1001/jamaoto.2025.0192
Article from: hearinghealthmatters.org