Considering hearing loss as a modifiable risk factor for dementia

ABSTRACT

Introduction

Accumulating evidence links hearing loss to impaired cognitive performance and increased risk for dementia. Hearing loss can lead to deafferentation-induced atrophy of frontotemporal brain regions and dysregulation of cognitive control networks from increased listening effort. Hearing loss is also associated with reduced social engagement, loneliness, and depression, which are independently associated with poor cognitive function.

Areas Covered

We summarize the evidence and postulated mechanisms linking hearing loss to dementia in older adults and synthesize the available literature demonstrating beneficial effects of hearing remediation on brain structure and function.

Expert Opinion

: Further research is needed to evaluate whether treatment of hearing loss may reduce risk of cognitive decline and improve neural consequences of hearing loss. Studies may investigate the pathologic mechanisms linking these late-life disorders and identify individuals vulnerable to dementia, and future clinical trials may evaluate whether hearing treatment may reduce the risk for dementia.

Plain Language Summary

Evidence suggests that hearing loss is associated with impaired cognitive performance, increased risk for dementia, and poor brain health in older adults. Fortunately, preliminary studies have shown positive effects of hearing treatment on cognitive outcomes and reversal of adverse neural effects of hearing loss. In the following, we review the available evidence providing support for hearing loss as a modifiable risk factor for dementia. However, there are important limitations to such findings, and further research is needed to definitively evaluate whether hearing treatment may protect cognitive and brain health in older adults. If future studies demonstrate that hearing treatment has beneficial effects on cognitive and neural outcomes, such results may take advantage of the recent widespread efforts to improve access to hearing treatment in the United States.

KEYWORDS:

• Cognitive decline
• dementia
• hearing loss
• hearing aids
• modifiable risk factor

Article highlights

• Historically considered a benign component of aging, hearing loss in recent years has been associated with cognitive decline, dementia, and poor brain health in older adults

• Hearing loss can have adverse effects on brain structure and function and can lead to loneliness and late-life depression

• Accumulating evidence suggests that hearing treatment may improve cognitive outcomes in older adults, though there are important limitations to such findings

• Preliminary studies also provide evidence that hearing treatment may reverse specific neuroplastic changes associated with chronic hearing loss

• Further research is needed to determine whether hearing treatment is effective for the prevention and/or treatment of current cognitive decline

• Given the potential benefits of hearing treatment on cognitive and neural outcomes, there is an urgent need to provide increased access to hearing care

Declaration of interest

FR Lin receives financial support from the Scientific Advisory Board for Fondation Pour L’Audition and Frequency Therapeutics. FR Lin is also the director of a public health research center funded in part by a philanthropic donation from Cochlear Ltd to the Johns Hopkins Bloomberg School of Public Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded by the National Institute of Mental Health (NIMH – T32)