Your Hearing and Your Brain
Hearing happens in the brain. When it gets harder to follow conversations, your brain works harder too. Here's what the research says, and the simple step you can take this month.
Booking for a parent or spouse? Here's how we can help.
The short version
- Hearing loss is common: about two in three adults over 70 have some.
- In long-term studies, people with untreated hearing loss had faster declines in memory and thinking.
- Hearing loss is one of the leading risk factors for dementia that a person can actually do something about.
- Treating it won't guarantee anything. But it's one of the few steps that's in your hands, and it helps you stay in the conversation now.
How hearing and the brain are connected
Researchers point to three likely reasons:
- Your brain works overtime. When sound comes in unclear, your brain spends extra effort decoding words. That leaves less for remembering and thinking.
- The hearing parts of the brain get less to do. Brain scans show faster shrinking in the areas that process sound and speech when hearing loss goes untreated.
- Conversations get harder, so people pull back. Skipping dinners, the bridge club or family calls leads to isolation, a known risk to brain health.
What the research found
Johns Hopkins, 2011 · Archives of Neurology · 639 adults followed about 12 years
2× · 3× · 5×
The risk of developing dementia was about twice as high with mild hearing loss, three times with moderate, and five times with severe.
Johns Hopkins, 2013 · JAMA Internal Medicine · 1,984 adults in their 70s and 80s, 6 years
30–40% faster
Thinking and memory scores declined 30 to 40 percent faster in people with hearing loss.
Johns Hopkins, 2014 · NeuroImage · yearly MRI scans for up to 10 years
Extra brain tissue loss
People with hearing loss lost more than an extra cubic centimeter of brain tissue each year, mostly in the regions that handle sound and speech.
Lancet Commission on Dementia, 2024 · international expert panel
Tied for #1
The Commission named 14 risk factors that together account for about 45% of dementia. Hearing loss is tied for the largest single one, at 7%.
ACHIEVE trial, 2023 · The Lancet · 977 adults aged 70–84, 3 years
48% slower decline
Hearing aids plus ongoing audiologist care slowed decline in thinking by 48% in older adults already at higher risk. Healthy volunteers showed no difference in 3 years, but both groups communicated better and felt less lonely.
Review of 19 studies, 2023 · JAMA Neurology · more than 126,000 people
19% lower risk
People who used hearing aids had a 19% lower risk of long-term cognitive decline than people who left hearing loss untreated.
What this does and doesn't mean
- These studies show a strong link. Most can't prove that hearing loss causes memory problems.
- No one can promise that hearing aids will prevent dementia, and we won't.
- What the research does support: hearing loss is common, treatable and worth taking seriously. The Lancet Commission lists treating it as a key step for brain health.
- If you're noticing memory changes, talk with your doctor. A hearing test is a good place to start, and we'll send your results to them.
Why how you're treated matters
In the ACHIEVE trial, people didn't just get hearing aids. They got fittings, coaching and follow-up from an audiologist over three years. That's the kind of care our practice is built around:
- A full evaluation in a sound-treated room, including how well you understand words, not just beeps.
- A verified fitting. We measure what your hearing aids actually deliver in your ear and fine-tune them to proven targets.
- LACE auditory training to help your brain get back in practice understanding speech.
- Follow-ups and yearly checks, because your hearing changes over time.
For families: how to help someone you love
You're often the first to notice. Common signs:
- The TV is louder than it used to be
- They ask people to repeat themselves, or answer the wrong question
- They avoid restaurants, phone calls or group gatherings
- They say people mumble
- They seem tired or withdrawn after social time
How to bring it up: Start with what you've noticed and why it matters to you ("I miss our phone calls"). Hold off on the memory research at first. Suggest a hearing test as a simple check, like an eye exam.
You can book for them. Call us and we'll find a time that works. You're welcome to come to the appointment.
Your first visit
- What happens: a conversation about what you're noticing, a look in your ears, and a full hearing evaluation. We go over your results with you.
- Cost: $0 to $45. Hearing tests with a doctor's referral are free.
- No pressure: if you don't need hearing aids, we'll tell you. If you do, we'll walk through options at your pace.
- Your doctor stays informed: with your permission, we send your results to your physician.
Questions people ask
Will hearing aids prevent dementia?
No one can promise that. The best evidence so far shows treating hearing loss may slow decline in people at higher risk, and it clearly helps with communication and loneliness.
My hearing isn't that bad. Should I still get tested?
Yes. In the studies, even mild hearing loss was linked to higher risk. A baseline test also gives you something to compare against later.
Do I need a referral?
No. But if your doctor refers you, the hearing test is free.
I already have hearing aids I don't wear. Can you help?
Often, yes. Many people stop wearing hearing aids because they were never verified or adjusted. Bring them in.
Sources
- Lin FR, Metter EJ, O'Brien RJ, et al. Hearing loss and incident dementia. Archives of Neurology. 2011;68(2):214-220.
- Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Internal Medicine. 2013;173(4):293-299.
- Lin FR, Ferrucci L, An Y, et al. Association of hearing impairment with brain volume changes in older adults. NeuroImage. 2014;90:84-92.
- Livingston G, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet. 2024.
- Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE). The Lancet. 2023.
- Yeo BSY, et al. Association of hearing aids and cochlear implants with cognitive decline and dementia: a systematic review and meta-analysis. JAMA Neurology. 2023;80(2):134-141.
This page is for general education and isn't medical advice. Talk with your doctor about any memory concerns.