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Is Age-Related Hearing Loss a Modifiable Risk Factor for Cognitive Decline? Mechanisms, Evidence, and Future

Giovanni Motta1, Giuseppe Tortoriello1, Domenico Testa2

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Audiology Research
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PubMed
Summary

Age-related hearing loss (ARHL) is linked to faster cognitive decline and dementia risk. Early hearing rehabilitation may help slow this decline, offering a modifiable factor for brain health.

Keywords:
age-related hearing loss (ARHL)cochlear implants (CIs)cognitive declinecortical plasticitydementia riskhearing aids (HAs)hearing rehabilitationlistening effortmodifiable risk factorsneurocognitive agingsensory deprivationsocial isolation

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Area of Science:

  • Neuroscience
  • Gerontology
  • Audiology

Background:

  • Age-related hearing loss (ARHL) is a prevalent sensory impairment in older adults.
  • ARHL is increasingly recognized as a modifiable risk factor for cognitive decline and dementia.
  • Auditory dysfunction may negatively impact cognitive trajectories via interconnected pathways.

Purpose of the Study:

  • To review mechanisms linking ARHL and cognitive decline.
  • To evaluate the effectiveness of hearing rehabilitation interventions.
  • To identify future research priorities in dementia prevention.

Main Methods:

  • Narrative synthesis of epidemiological, neurobiological, and interventional studies.
  • Emphasis on longitudinal cohort, neuroimaging, and clinical trials of hearing aids (HAs) and cochlear implants (CIs).

Main Results:

  • ARHL is consistently associated with accelerated cognitive decline and increased dementia risk.
  • Mechanisms include cortical reorganization, increased listening effort, shared pathology, and social isolation.
  • Neuroimaging reveals structural/functional brain changes; HAs/CIs show potential cognitive benefits, but more data is needed.

Conclusions:

  • ARHL is a significant, modifiable contributor to cognitive decline.
  • Further research should clarify causal links and optimize early hearing rehabilitation.
  • Optimizing hearing rehabilitation is crucial for dementia prevention strategies.