Hearing Loss and Brain Health: Why It Pays to Act Early

Why it matters

The Lancet Commission on dementia named hearing loss among the largest modifiable risk factors. A major trial in older adults at risk found that hearing support slowed cognitive decline in the highest-risk group.

Signs

Common signs are asking people to repeat themselves, trouble following conversation in noise, turning the television up and avoiding social events.

What to do

See an audiologist for a hearing test. If recommended, try hearing aids and give yourself a few weeks to adjust. Over-the-counter options exist in some countries for mild loss.

Protect what you have

Limit loud noise and use ear protection.

Tinnitus, dizziness and ear health

Tinnitus, ringing or buzzing in the ears, is common in older adults and often accompanies hearing loss. Sound therapy, hearing aids, relaxation and cognitive behavioural therapy can ease distress. Sudden hearing loss, new tinnitus in one ear, ear discharge or dizziness with hearing loss needs prompt medical assessment. Earwax can reduce hearing and is easily removed by a professional; avoid cotton buds and ear candles. Some medicines, such as certain antibiotics and diuretics, can affect hearing.

Check with your doctor about anything sudden.

Hearing in groups and public places

Restaurants, temples, weddings and meetings can be difficult. Choose seats with your back to a wall, near the speaker and away from noise. Ask people to speak one at a time. Use hearing loops and captions where available. Tell hosts about your needs. Remote microphones that clip on to a speaker's clothing can transform group conversations. Do not withdraw; with the right tools, social life can continue.

Advocating for yourself helps others, too.

Costs and support

Hearing aids range widely in price. Government schemes, charitable programmes and employer or insurance benefits may help; ask your audiologist. Free hearing camps run in many areas. Look for a reputable provider who offers a trial period, follow-up and repairs. Do not buy from unsolicited door-to-door sellers. Remember that the cost of untreated hearing loss, in isolation and health, may be higher than the cost of aids.

Seek help early, and do not delay.

Hearing health across the family

Hearing loss affects families as well as individuals. Partners may feel frustrated, grandchildren may avoid speaking and the person may withdraw. Open conversations, shared appointments and patience help. Encourage family members to have their own hearing checked, and to protect their ears from noise. Make family gatherings accessible with good lighting and quiet corners.

Seek support groups for people with hearing loss and families.

Hearing well is a gift to everyone around you.

How common hearing loss is and why we ignore it

Around one in three adults over 65 has disabling hearing loss, yet many wait years before seeking help. Loss usually begins with high-pitched sounds, so speech becomes less clear, especially in noise. People often blame others for mumbling, avoid social situations or withdraw. Because the change is gradual, the brain adapts, and the loss may go unnoticed by the person but not by family.

The link with dementia and what trials show

The 2024 Lancet Commission lists untreated hearing loss as among the largest modifiable risk factors for dementia, with an estimated contribution of around 7 per cent of cases. The ACHIEVE trial, a randomised study in older adults, found that hearing aids and counselling slowed cognitive decline over three years by about 48 per cent in the subgroup at higher risk, though not in the whole group. This suggests that correcting hearing may help protect the brain, especially for those at risk. More research is under way.

Getting tested and choosing help

Start with a hearing test by an audiologist. Hearing aids are available in many styles, from behind-the-ear to nearly invisible; modern models filter noise and connect to phones. Expect an adjustment period of a few weeks and follow-up visits for fine-tuning. Cochlear implants may suit severe loss. Use captions, quiet rooms and face-to-face conversation to help. Protect remaining hearing by avoiding loud noise and checking medicines that can affect hearing.

Living well with hearing aids

Wear them every day, from morning until bedtime. Clean them daily, change batteries or charge regularly and keep spares. Start in quiet places, then try conversations and restaurants. Ask your audiologist to adjust settings. Practise listening with audio books or the news. Over time, your brain relearns to interpret sound. If a hearing aid is uncomfortable or ineffective, return for adjustments; do not give up.

Communicating with someone who has hearing loss

Get their attention before speaking. Face them in good light so they can see your lips. Speak clearly at a normal pace, not louder. Rephrase rather than repeat. Reduce background noise by switching off the television. Write down key information. Include them in group conversations and avoid talking about them as if they were not there. Patience and kindness keep relationships strong.