Hearing loss can be a sudden or gradual change in how well you hear. People with hearing loss may notice difficulties with everyday conversations, especially in noise. Dementia is a general term for a group of symptoms that impact abilities to think, remember, and reason through activities of daily living. Understanding the symptoms of hearing loss and dementia, and the connection between them can be helpful in ensuring proper prevention, diagnosis, and treatment.
Early Signs of Hearing Loss
These are some common signs of hearing loss:
- Difficulty understanding speech in noisy environments (restaurants, malls, cars, etc…)
- Feeling like people “mumble”; speech is unclear
- Saying things like “I can hear, but I can’t understand!”
- Family and friends often need to repeat themselves for you
- Difficulty understanding someone if you aren’t looking at them
- Your family says your TV and/or radio is too loud
- Increased frustration during conversations
- Avoiding social situations because it is hard to hear
Early Signs of Dementia
These are some common signs of dementia (MIND Center, 2019):
- Forgetfulness (especially of recently learned information)
- Difficulty performing tasks that are familiar (e.g., preparing a meal, placing a phone call, playing a game)
- Problems with language (increased difficulty recalling words)
- Disorientation to time and place (e.g., getting lost in familiar areas)
- Poor or decreased judgment (e.g., inappropriate clothing choices, financial decisions)
- Problems with complex mental tasks
- Losing things and/or misplacing them into unusual places
- Changes in mood or behavior (e.g., rapid mood swings)
- Changes in personality (e.g., more confused, suspicious, fearful)
- Loss of initiative; becoming more passive
Are Dementia and Cognitive Decline the Same?
Cognitive decline is a general term that can be used to describe common effects of brain aging. Even healthy aging may include a slow decline in memory and thinking abilities. Dementia is a syndrome that can impact memory and thinking abilities, particularly activities of daily living or social functioning. It may affect judgment, problem solving, and even personality. There are many different types of dementia; Alzheimer’s disease is the most well-known and most common.
Of the early signs of dementia, some minor changes may be expected indications of slight cognitive decline. The following are typical changes in memory and thinking, and are likely normal (MIND Center, 2019):
- Occasionally forgetting and misplacing things, especially if you remember later
- Occasionally forgetting what you were planning to do or say
- Sometimes having trouble finding words
- Losing track of day of week or date but can think through to figure it out
- Occasional bad decision unless increasing frequency
- Occasional error paying bills, forgetting medications
- Misplacing keys or wallet, but finding them later
- Occasionally feeling sad or moody
- Tired with demands of work, family, life.
- Occasional irritability especially if long standing routine is disrupted
Is There a Link Between Hearing Loss and Dementia?
Untreated hearing loss increases the risk for dementia (Livingston et al., 2020). Adults with hearing loss have a faster rate of cognitive decline that adults with normal hearing (Lin et al., 2013). Hearing loss demands extra cognitive (thinking-related) resources, which limits the cognitive resources that are available for memory and thinking. There are also documented changes in the brain as a result of hearing loss (Lin et al., 2014); these changes are thought to impact cognition over time. Additionally, hearing loss can lead to a decrease in social engagement (Weinstein & Ventry, JSHR, 1982), which is a known risk factor of dementia. Although hearing loss does not cause dementia, it does place people at risk for developing dementia; a supportive reason that hearing loss should not be ignored.
Many communication difficulties related to hearing loss can cross-over with difficulties related to dementia. If adults are uncertain which dysfunction may be causing difficulties, it is recommended to seek evaluation from an audiologist (for hearing) and a physician. A primary care physician can help patients determine if a cognitive evaluation is necessary and refer to the correct specialist for testing.
Can Hearing Aids Reduce the Risk of Dementia?
Hearing aids are a type of amplification device used to manage hearing loss. Recent research indicates that for people at greater risk of developing dementia, using appropriately fitted hearing aids reduces the risk of cognitive decline as compared to people who are high risk and who did not use hearing aids in the same 3-year period (Lin et al., 2023). Continued research in this area is ongoing, but it is possible that treating hearing loss can have a positive impact on the risk for dementia and possibly on the rate of cognitive decline, particularly for at-risk populations.
Properly fit hearing aids are known to reduce listening effort, allowing for more cognitive resources to be available for other brain tasks. Hearing aids can also re-stimulate areas of the brain that have been neglected due to hearing loss. Lastly, hearing aids are known to improve social communication, which may prevent or delay dementia. If someone suspects they have hearing loss, it is recommended to have a hearing evaluation and discuss treatment options with an audiologist.
What Assistive Devices Would Be Helpful to Those with Dementia?
For patients diagnosed with dementia, hearing loss should be considered and treated. In early dementia, and with patients who have in-tact support systems, hearing aids may still be a good treatment option. For patients without the option of hearing aids, there are other assistive listening devices that could be helpful, such as remote microphones. See our pages on assistive listening devices and aural rehabilitation for more information.
Suspect Hearing Loss? Find an Audiologist.
If you are concerned about hearing loss, the next step is to schedule a hearing test with an audiologist. The audiologist will be able to determine presence, type, and severity of hearing loss. This information will allow them to provide advice regarding the next steps in treatment.
Lin FR, Yaffe K, Xia J, Xue QL, et al. (2013) Hearing loss and cognitive decline in older adults. JAMA Int Med 173:293–299.
Lin FR, Ferrucci L, An Y, Goh JO, et al. (2014) Association of hearing impairment with brain volume changes in older adults. Neuroimage 90:84–92.
Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., Couper, D., Deal, J. A., Goman, A. M., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Huang, A. R., Knopman, D., Mitchell, C. M., Mosley, T., Pankow, J. S., Reed, N. S., Sanchez, V., … ACHIEVE Collaborative Research Group (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. The Lancet 402(10404): 786–797. https://doi.org/10.1016/S0140-6736(23)01406-X
Livingston G, Huntley J, Sommerlad A, Ames D, et al. (2020) Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet 396:413–446.
MIND Center (2019)Navigating Alzheimer’s and Related Dementias: A Roadmap for Families. https://umc.edu/mindcenter/files/resourceguide_ms_2009.pdf (accessed June 13, 2022).
Weinstein BE, Ventry IM. (1982) Hearing impairment and social isolation in the elderly. J Speech Lang Hear Res 25(4):593–599.