There’s now even more of a reason to urge that senior member of your family who doesn’t like wearing hearing aids to keep them in.
Researchers from the School of Public Health at HKUMed, together with a multinational team, have found that the effective use of hearing aids is associated with a lower risk of probable dementia among older adults with hearing loss. The findings, published in the journal Cell Reports Medicine, underscore the importance of quality hearing rehabilitation for healthy ageing.
As the global population ages, the number of people living with dementia continues to grow. Dementia is projected to affect 150 million people worldwide by 2050, placing a significant burden on healthcare systems and societies. Hearing loss, a common condition affecting approximately 30% of people over 65 and up to 90% of those aged 85 and older, has emerged as one of the most important potentially modifiable risk factors for dementia.
According to the 2024 Lancet Commission on dementia, hearing loss accounts for approximately 7% of dementia cases, making it a leading modifiable risk factor among 14 identified modifiable risk factors including less education, high LDL cholesterol and social isolation.
“While hearing aids are widely regarded as the standard first-line treatment for adult hearing loss, their role in preventing cognitive decline has remained uncertain,” said Professor Shanquan Chen, Assistant Professor in the School of Public Health, HKUMed, and joint corresponding author of the study.
The study, jointly led by Professor Chen, and Professor Lei Xu of Shandong Provincial ENT Hospital, Shandong University, analysed data from 61,089 hearing-impaired adults aged 55 and older across 33 countries, including China, Korea, Europe, the UK, the US, Ireland and Mexico. Over an average follow-up period of 6.5 years, 8,911 participants developed probable dementia.
The study found that hearing aid users had a 9% lower risk of probable dementia compared to hearing-impaired non-users. Importantly, the benefit appeared to depend on the effectiveness of the devices. Participants who reported good hearing improvement with hearing aids had a 14% lower risk of probable dementia, whereas those who reported poor hearing improvement showed no significant reduction in risk.
The association appeared stronger in middle-income countries, where hearing aid adoption was substantially lower. Only 2.6% of hearing-impaired participants in these countries reported using a hearing aid, compared with 20% in high-income countries. Together, these findings suggest that improving both access to hearing aids and the quality of hearing rehabilitation should be key public health priorities.
The study also found that the association between hearing-aid use and lower dementia risk was more pronounced among women, unmarried individuals and those with lower educational attainment. This points to the possibility that hearing rehabilitation may be particularly important for socially vulnerable groups, who may face a higher risk of isolation or have less access to health resources.
Building on these findings, the researchers have called for future research using objective hearing assessments, real-world device-use data, and more representative samples from low-resource settings. They also recommend that hearing care should be better integrated into dementia prevention, primary care, and healthy-ageing strategies.
The researchers emphasised that the study was observational and cannot prove that hearing aids directly prevent dementia. Nevertheless, the results provide large-scale, multi-country evidence that effective hearing rehabilitation may be linked to better cognitive ageing outcomes.
Professor Chen noted, “Hearing loss is increasingly recognised as one of the most important risk factors for dementia that can potentially be addressed. Our study suggests that the benefit is not simply about wearing a device, but whether the device meaningfully improves hearing in daily life.”
“These findings have important implications for healthy ageing policies,” Professor Chen added. “In high-income settings, the priority may be on fitting improvement, follow-up care and the long-term effectiveness of hearing aids. In middle-income settings, however, expanding affordable access to hearing care remains a major challenge.”
