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You’ve probably heard advice about exercising your mind to deal with age-related changes in memory and thinking. Along with staying socially active and making healthy lifestyle choices, these tips can reduce your risk for cognitive decline. 

But what about your hearing? While hearing loss has long been associated with cognitive decline, a recent report adds an important piece to the puzzle. 

In a review published in the journal, JAMA Neurology, researchers found that restoring hearing loss with hearing devices resulted in measurable cognitive benefits. The review looked at 19 studies with a total of 127,471 participants. Highlights included:  

  • The use of hearing aids was associated with a 19% reduced risk of long-term cognitive decline compared to uncorrected hearing loss.
  • Hearing aid or cochlear implant use was also linked to a 3% improvement in short-term cognitive test scores. 

Summit Health otologist-neurotologist Jed Kwartler, MD, says the findings make for compelling discussion among primary care providers, geriatric specialists, and their patients. “The absence of hearing can be so impactful,” he says. 

Hearing loss and cognitive decline 

Many factors may increase one’s risk for cognitive decline. Some can’t be changed, such as your age and family history. Other factors, which physicians call modifiable, can be changed. Researchers identify hearing loss as the top modifiable risk factor for dementia. 

Hearing aids can help modify possible links between hearing loss and dementia, such as:

  • Social isolation due to difficulty conversing with others 
  • Depression associated with hearing loss, which also increases cognitive decline risk 
  • Brain atrophy or weakening due to hearing loss 

Another possible link Dr. Kwartler mentions is “cognitive load theory,” or the brain having to work harder because of hearing loss. “If you can improve hearing, you can allocate brain resources to higher-level function,” he explains. 

Hearing aids and hearing loss services: what to know 

More than 37 million American adults say they have some trouble hearing. And more than 28 million could benefit from using hearing aids. However, only 16% of adults who could benefit from hearing aids have used them. 

Given this public health issue, efforts are underway to make hearing health care more accessible and affordable. In 2022, the Food and Drug Administration approved a rule allowing adults, aged 18 and older, to purchase hearing aids over the counter (OTC) without a prescription or medical exam. 

While Dr. Kwartler agrees that expanded access to hearing aids is a good thing, he says OTC hearing aids can have some limitations. 

  • OTC hearing aids are only for mild to moderate hearing loss. And it’s hard to know what degree of hearing loss you have without a professional diagnosis.

    Also, certain medical conditions can cause hearing loss, such as earwax buildup, infections, tumors, and other structural issues with the ear. Seeing an ear specialist is an opportunity to identify and treat these conditions if needed.
  • No customization. An audiologist can tailor hearing aids to your unique hearing needs, from programming to custom fitting. OTC hearing aids may involve more trial and error.
  • Less personalized service. OTC hearing aids can be convenient, but they don’t come with as much in-person care after you buy them. In addition to selection and fitting, an audiologist can help with the  ongoing maintenance and management of custom devices. 

“It’s like buying a car and not having a mechanic,” says Dr. Kwartler. “You’re losing out on a human touch to the hearing rehabilitation process.”  

What to do if you’re concerned about hearing loss 

Talk to your doctor if you’re experiencing any signs of hearing loss. You can also take this five-minute hearing test from the American Academy of Otolaryngology-Head and Neck Surgery. If the test results suggest further evaluation, Summit Health’s Audiology team can help connect you to the services you need.