Hearing Loss is a modifiable risk factor of dementia. This article explores the connection between the two and provides a deeper understanding of hearing loss, its signs and symptoms and what can be done to prevent and treat potential hearing loss.
Introduction
By 2050, nearly 2.5 billion people are projected to have some form of hearing loss.1 According to the Lancet study (2020), hearing loss has been identified as a risk factor for dementia.2 The Lancet study (2024), found that hearing loss is estimated to account for 7% of dementia-related cases globally.3 Although it is highly prevalent among seniors, hearing loss is not commonly or well diagnosed, making it an important issue in dementia prevention and care.
What is the Connection of Hearing Loss and Dementia
Hearing loss as a potential risk factor for dementia has gained more prominence in recent years. The 2017 Lancet report found that hearing loss had the highest Population Attributable Fraction (PAF) — a measure that estimates how many cases of a disease could be prevented if a specific risk factor were eliminated. In this case, hearing loss accounted for 23% of potentially preventable dementia cases, more than any other individual risk factor such as depression (10.1%), smoking (13.9%), social isolation (5.9%), high blood pressure (5.1%), or diabetes (3.2%). 4
Untreated hearing loss could lead to increased social isolation and changes in one’s brain structure. This is because two main regions of the brain are affected by hearing loss: the temporal lobe and the frontal cortex:
- The temporal lobe: Involved with sound processing, and other functions.
- The frontal cortex: Involved with attention and executive function, such as decision making and planning.
Hearing loss slows down these functions leading to a rapid deterioration of the brain’s cognitive function in these areas.
Increased Social Isolation
Older adults with hearing loss have trouble in communication, leading to withdrawal from social situations. 5 Other studies have also found that poorer social networks, reduced social support and loneliness can increase the risk of dementia in individuals who were initially disease-free, even after modifying other risk factors. 6
The link between hearing loss and social isolation reduces opportunities for cognitive stimulation. When individuals are less engaged in conversations they process less stimulating information, which can affect their brain function.
Over time, this reduced cognitive engagement, coupled with declining communication skills, may contribute to cognitive loss and ultimately lead to dementia.
Changes in Brain Structure
Hearing loss has also been related to lead to decreased stimulation of cognitive processing. 7 This results in a lack of speech and language input, which can negatively impact brain structure and function, ultimately causing brain tissue to shrink.
Additionally, hearing loss can accelerate subtle cognitive decline such as working memory by increasing the cognitive load on the brain. Specifically, it appears to weaken areas commonly associated with Alzheimer’s disease. 8
Types of Hearing Loss
Hearing loss is a condition that affects the way we hear sounds, and it can happen for many reasons.
There are three types of hearing loss (a) Conductive hearing loss and (b) Sensorineural hearing loss and (c) Mixed hearing loss.9
Early Signs of Hearing Loss
Hearing loss can occur suddenly or gradually, and it can affect one or both ears. Symptoms include:
- Difficulty understanding speech in noisy environment
- Feel like people are mumbling
- Need to repeat themselves for you
- Difficulty understanding someone if you are not looking at them
- Withdrawal from conversations
- Associated ear symptoms, such as earache and ear discharge due to ear infections
- Tinnitus (ringing in the ears)
- Vertigo (spinning sensations)
Do consult a doctor should you experience these symptoms.
Tips for Prevention and Intervention
The best way to reduce the risk of dementia from hearing loss is to have frequent and regular hearing checkups. It is recommended that seniors should attend a health screening every 1-2 years to stay proactive about their health. 12
Prevention
Health Hub functional screening platforms
Project Silver Screen is an affordable, nationwide functional screening programme for Singaporeans aged 60 and above. The Health Hub platform provides a comprehensive list of upcoming functional screenings.
Click on this link to sign up for your health screening: functional screening platforms
Practicing safe listening strategies can also reduce the risk of hearing loss.13
Here are some tips to prevent hearing loss:
- Keep the volume down. Set your device’s volume level to no more than 60% of the maximum volume.
- Use well-fitted and noise cancelling headphones/earpieces.
- In noisy places, use ear protectors such as earplugs.
- Always stay away from sources of loud sound, such as loudspeakers, noisy machinery etc.
- Limit time spent engaged in noisy activities. Give your ears a break frequently from loud sounds. This helps the sensory cells inside the ears recover.
- Monitor sound levels. Choose devices with built-in safe listening features that allow you to monitor your exposure.
Tip
Maintain a sound below 70dB as sounds above 70 dB can damage hearing over time.15
Intervention
Additionally, one can ensure that hearing loss is dealt with quickly through treatment.
These are some treatment and alternative options for managing hearing loss:
- Hearing Aids: a small electronic device to wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate fully in daily activities.
- Cochlear Implants: a surgically implanted neuro-prosthetic that provides a person with moderate-to-severe sensorineural hearing loss with sound perception.
It is best to consult an audiologist to decide which is the best option for you or your loved one.
Conclusion
Addressing hearing loss can help reduce the risk of dementia. If you are concerned that someone you know or yourself may be at risk of developing hearing loss, please approach your GP (General Practitioner) or family doctor for a referral.
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World Health Organization. (2025, 26 February). Deafness and hearing loss. https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., … K. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. The Lancet, 403(10300), 1-40. https://doi.org/10.1016/S0140-6736(24)00345-6
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., … & Mukadam, N. (2017). Dementia prevention, intervention, and care. The lancet, 390(10113), 2673-2734.
Bott, A., & Saunders, G. (2021). A scoping review of studies investigating hearing loss, social isolation and/or loneliness in adults. International Journal of Audiology, 60(sup2), 30–46. https://doi.org/10.1080/14992027.2021.1915506
Chern, A., & Golub, J. S. (2019). Age-related Hearing Loss and Dementia. Alzheimer disease and associated disorders, 33(3), 285–290. https://doi.org/10.1097/WAD.0000000000000325
Griffiths, T. D., Lad, M., Kumar, S., Holmes, E., McMurray, B., Maguire, E. A., Billig, A. J., & Sedley, W. (2020). How Can Hearing Loss Cause Dementia?. Neuron, 108(3), 401–412. https://doi.org/10.1016/j.neuron.2020.08.003
Ford, H. A., Hankey. J. G., Yeap. B. B., Golledge, J., Flicker, L. & Almeida, P. O. (2018). Hearing loss and the risk of dementia in later life. Maturitas Vol (112), pg 1-11. https://doi.org/10.1016/j.maturitas.2018.03.004
Cleveland Clinic. (2023, August 24). Hearing loss: Types, symptoms, causes & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17673-hearing-loss
NHS 24. (2024). What does tinnitus sound like? Ringing, crackling, buzzing examples [Video]. Youtube. https://www.youtube.com/watch?v=kgIrfiyK4x8
FreeMedEducation. (2017). What is Vertigo? [Video]. Youtube. https://www.youtube.com/watch?v=j04qNXaCm0Y
World Health Organization. (2025, 21 March). Deafness and hearing loss: Safe listening. https://www.who.int/news-room/questions-and-answers/item/deafness-and-hearing-loss-safe-listening
CPF Board. (2025, March 25). How often should you go for a health screening? CPF. https://www.cpf.gov.sg/member/infohub/educational-resources/how-often-should-you-go-for-a-health-screening
International Noise Awareness Day (n.d). Common Noise Levels- How Loud Is Too Loud?. https://noiseawareness.org/info-center/common-noise-levels/
Hearing Health Foundation. (n.d.). What are safe decibels? Hearing Health Foundation. https://hearinghealthfoundation.org/keeplistening/decibels
