Can Hearing Aids Have a Cognitive Benefit for Seniors?

Restoring hearing loss with hearing aids or cochlear implants was linked with less long-term cognitive decline and even some gain, according to a systematic review and meta-analysis.

Use of hearing aids by adults with hearing loss showed “a significant 19% relative reduction in risk of any cognitive decline” when compared with uncorrected hearing loss across long-term studies. These studies had follow-up periods ranging from two to 25 years.

Hearing aid or cochlear implant use was also associated with a 3% improvement in short-term cognitive scores, per Benjamin Kye Jyn Tan, MBBS, of the National University of Singapore, and colleagues, as reported in JAMA Neurology.

The researchers noted that “this benefit is evident for both normal baseline cognition and baseline mild cognitive impairment” after accounting for confounding factors including age, gender, education, socioeconomic status, and comorbidities.

Hearing loss has been identified as a top modifiable risk factor for dementia. The study authors emphasized that their findings support clinicians encouraging patients with hearing loss to adopt hearing restorative devices to reduce dementia risk.

An accompanying editorial by Justin S. Golub, MD, MS, of Columbia University supported including hearing evaluation “as part of a standard workup for patients experiencing cognitive decline.”

Proposed Mechanisms

The researchers discussed several theories explaining how hearing aids might provide cognitive benefits:

• The “sensory deficit hypothesis” suggests that lacking sensory input may cause structural brain changes, including atrophy. Hearing aids could provide stimulation that prevents cognitive deterioration.

• Hearing aid use may prevent social isolation, which commonly accompanies hearing loss and can contribute to cognitive impairment, though further research is needed.

However, the authors acknowledged an alternative hypothesis: hearing loss and cognitive decline might occur independently due to common age-related neurodegenerative processes.

Study Details

The analysis examined long-term associations in a pooled analysis of eight studies involving 126,903 participants, plus short-term outcomes from 11 studies with 568 participants. Most were prospective cohorts or observational designs; the two randomized clinical trials only had short-term data available.

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