Do Hearing Aids Stop Me from Getting Dementia?
Since the discovery of the increased incidence of dementia in the hearing loss population, this has been a prominent question in audiology. To be able to answer this question, we need to take a step back and look at the hearing loss/cognitive decline link.
Just because there is an increased incidence of dementia, it does not necessarily mean that there is a causal link between the two conditions. In short, correlation does not mean causality. A paper published in The Lancet investigated the population attributable fraction of potentially modifiable risk factors for dementia and concluded that 60% was unknown, 8% hearing loss, 7% was less education in early life, and a multitude of other causes made up the rest (Livingston et al., 2020). Even though hearing loss makes up the largest modifiable factor to reducing dementia risk, it is only part of the overall picture.
A review of hearing aid usage and dementia by Dawes and Munro (2024) showed that evidence was mixed. Regarding cognitive impairment, four studies showed lower dementia incidence among hearing aid users, while five found no difference. For cognitive decline, four studies reported lower rates among users, and three found no difference. Overall, eight studies indicated positive effects of hearing aids, and eight did not. All studies were observational, highlighting challenges like confounding factors. Hearing aid users often differ from nonusers in education, affluence, and ethnicity, which can influence cognitive outcomes, making it difficult to attribute positive results solely to hearing aid use.
Hearing aid manufacturers and audiologists often link hearing loss to dementia risk to motivate people to seek help, but this approach may backfire. Scare tactics, commonly used in public health campaigns, can sometimes discourage people from engaging with the message. Associating hearing loss with dementia might reinforce stigma and lead to denial and disengagement with hearing care. Instead, promoting the positive benefits of hearing aids, such as improved communication and a more active, socially engaged lifestyle, might be more effective.
Furthermore, any potential benefit of hearing aids in preventing dementia is likely small and not clinically significant at the individual level. While hearing interventions might prevent a substantial number of dementia cases at the population level, promoting dementia prevention as a primary benefit of hearing aids is inappropriate due to the lack of clear evidence and its limited relevance to individuals.
References
Dawes, P., & Munro, K. J. (2024). Hearing loss and dementia: Where to from here? Ear and Hearing, 45(3), 529–536. https://doi.org/10.1097/AUD.0000000000001494
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., … & Mukadam, N. (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
