What is the relationship between Hearing Loss and Dementia?
Dr. Ho Eu Chin and April Chong engaging in a deep dive discussion on the critical link between hearing loss and cognitive decline.

Hearing Loss & Cognitive Decline: The Dementia Connection

Our Local South East Asia Clinical Excellence team held a webinar, which explains the connection between hearing loss and cognitive decline, and the importance of early intervention and aural rehabilitation. The summary highlights the crucial role that timely and comprehensive treatment plays in improving the lives of individuals with hearing loss and their families. Joining us is Dr. Ho Eu Chin, a renowned Ear, Nose, Throat (ENT) physician, from Gleneagles Hospital Singapore. He is accompanied by Senior Principal Audiologist, April Chong.


Hearing loss is a prevalent condition that affects millions of people worldwide. About 48 million adults report some degree of hearing loss. By the age of 65, 1 in 3 people suffer from hearing loss. In fact, hearing loss is the 3rd most common medical condition, after arthritis and heart disease. Hearing loss at any age, young or old, should be treated early, and not be ignored.

This condition is frustrating to those who have it, as well as to their loved ones. However, delays in hearing treatment and management is still prevalent in today's society. In fact, the average person waits approximately ten years after being diagnosed to receive treatment! Studies have highlighted that late intervention in hearing loss can potentially contribute to cognitive decline, or dementia, and its severity through several mechanisms.

The Proven Link Between Hearing Loss and Dementia

In a research conducted at Johns Hopkins University in 2014, scientists monitored brain alterations in a group of 126 individuals over a span of ten years. All participants underwent a hearing examination, revealing 75 individuals with normal auditory abilities and 51 individuals with diminished hearing capabilities, marked by at least a 25-decibel deficit.

The key findings of the study were:

  • Participants who were hearing-impaired at the start of the study had accelerated rates of brain tissue loss.
  • If you think of the brain like a sponge, the people with hearing loss were like a sponge that was slowly getting smaller. They had lost over an additional cubic centimetre of brain tissue annually than those with normal hearing.
  • Notably, areas of the brain responsible for sound and speech processing exhibited greater shrinkage in the group with hearing deficiencies.

Hearing Loss is the Leading Modifiable Risk Factor for Dementia

Auditory deprivation occurs when the brain is deprived of sound for an extended period, leading to a loss of the ability to process sounds. Prolonged deprivation can result in brain atrophy, increasing the risk of developing dementia. 

Late intervention in hearing loss can potentially contribute to dementia and its severity through several mechanisms:

  • Cognitive Load
    Untreated hearing loss forces the brain to work harder to process sound signals. This increased cognitive load can interfere with other cognitive functions, including memory and thinking, which may speed up cognitive decline and contribute to the development of dementia.
  • Social Isolation
    People with untreated hearing loss often find social situations challenging and may start to withdraw from social activities. This can lead to social isolation, a well-established risk factor for cognitive decline and dementia.
  • Brain Structure Changes
    As the study above has shown, untreated hearing loss may result in changes to brain structures over time. The areas of the brain responsible for processing sound may start to shrink due to lack of stimulation, and this atrophy could spread to other areas of the brain, leading to cognitive decline and dementia.

Managing and Treating Hearing Loss

Early treatment of hearing loss is crucial as it not only affects the individual but the whole family, due to increasing communication challenges. Seeking treatment earlier leads to better outcomes, as it improves mental health and overall wellness. Once auditory deprivation sets in, managing the situation becomes a lot more challenging. It's highly recommended to consult a hearing care professional who can perform a thorough hearing evaluation, and advise you on the most appropriate treatment option based on your individual needs and lifestyle.

  • Hearing Aids
    These are small devices that sit either behind or in your ear, amplifying sound so that it's easier for you to hear. They're commonly used to treat most types of hearing loss. It's important to get a proper hearing test and fitting from a professional to ensure the device is right for your specific type and degree of hearing loss. Hearing aids can greatly improve communication and quality of life, but they also require regular maintenance and care.

    If you opt for this treatment, you'll need to be patient and give yourself time to adjust to the new sounds and listening situations. Check out our other article on the cost of hearing aids in Asia, which also discusses available financing options.
  • Cochlear Implants
    These are used primarily for severe to profound hearing loss in both adults and children. The device has two parts: an external processor that sits behind the ear and an electrode that is surgically inserted into the cochlea. Unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear to provide sound signals to the brain.
  • Aural Rehabilitation
    This therapy aims to optimize hearing and communication skills. It might include speech reading, auditory training, and strategies to manage conversations. It's often used alongside other treatments like hearing aids or cochlear implants.

The Bright Side

Treating hearing loss not only improves communication but also has many additional benefits. The brain is flexible and can be re-trained to understand sounds, making it easier to stay engaged in daily activities. Hearing aids can significantly reduce the hidden costs associated with untreated hearing loss. Keeping the brain active and stimulated through improved hearing also helps reduce the risk of developing dementia, loneliness, and depression. Seeking treatment for hearing loss can lead to an improved overall well-being and quality of life.


The conversation between Dr. Ho and April emphasized the need for a holistic and comprehensive approach to addressing hearing loss. Early intervention, proper diagnosis, and appropriate treatment are essential to mitigating the potential consequences of untreated hearing loss, including cognitive decline and dementia. 

Moreover, involving the right hearing care professionals, using good quality hearing aids, and employing aural rehabilitation can significantly improve the quality of life for individuals with hearing loss and their families. This discussion underlines the importance of raising awareness about the link between hearing loss and cognitive decline, and the need to adopt a paradigm shift in the treatment and management of hearing loss to ensure optimal outcomes for patients and their loved ones.

Watch the webinar series on our official YouTube channel.


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