Age-Related Hearing Loss and Correlation with Cognitive Decline: a Narrative Review

Age-related hearing loss (ARHL), also known as presbycusis, is one of the most prevalent long-term sensory difficulties in older people. It affects more than two-thirds of people over 70. In addition to communication challenges, ARHL has recently been revealed as a possible modifiable risk factor for cognitive decline and dementia. Comprehending this link is crucial for creating preventative interventions and maintaining healthy cognitive aging. This narrative review intended to analyze the evidence comprehensively relating age-related hearing loss (ARHL) with cognitive decline, define the possible pathophysiological mechanisms that may explain this association and assess the plausibility of hearing rehabilitation as a preventative therapy. A full literature search was done in PubMed, MEDLINE, Google Scholar and Frontiers databases employing the phrases "hearing loss" AND ("cognitive decline" OR "aging"). We only looked at articles that were published in English between 2014 and 2024 and were either systematic reviews, meta-analyses, or original research. We did not include any papers that were not peer-reviewed, not about people or not written in English. A total of 37 publications satisfied the inclusion criteria and underwent extensive review. There is strong evidence that ARHL is associated with rapid cognitive decline and an increased risk of dementia. Epidemiological studies suggest that hearing loss contributes to roughly 8-9% of worldwide dementia cases, which represents one of the primary modifiable risk factors. Some of the suggested ways that ARHL and cognitive decline are connected include through increased cognitive load, neuroplastic rearrangement, vascular dysfunction, oxidative stress and social isolation. Neuroimaging studies have revealed a reduction in gray matter and cortical atrophy in the auditory and associative areas of the brain in individuals with hearing loss. Hearing rehabilitation with hearing aids and cochlear implants has been connected to increased communication, higher social engagement and decreased cognitive decline; nevertheless, findings are rather inconsistent due to methodological errors and limited follow-up periods. Age-related hearing loss is a moderately widespread risk factor for cognitive decline and dementia that can be reduced. Early examination and effective auditory therapy can slow down cognitive decline and make life better for older people. Future longitudinal, multicenter and interventional studies are important to explain causal pathways, enhance intervention timing and assess cost-effective public health techniques for sustaining cognitive health in aging populations.