Let's talk


Hearing health

With growing evidence around the connection between hearing loss and cognition, what will this mean for patient conversations?

As a hearing care professional, you’ll know how crucial it is to have clear and carefully planned discussions with your patients. Because for many, talking about their hearing needs or concerns can be a sensitive topic. 

And now, with new research further supporting the link between hearing loss and dementia, cognition is fast becoming the hot topic in audiology. But does this mean everyone should be talking about it with patients? 

If you’ve asked yourself this question let’s talk… 

Do I really need to be thinking about dementia? 

Jumping headfirst into a dialogue about dementia and any potential risk factors would be an alarming prospect for any patient. That’s why it’s always best to start and focus the discussion firmly around hearing care and its holistic benefits, including:

  • How we hear and understand with our brain – as well as our ears 
  • How cognition is a key part of processing speech and interpreting sounds
  • How helping your hearing can help to maintain good cognitive function 
  • How good hearing health can positively impact your overall quality of life 

In this way, any conversation around hearing intervention can be framed as a positive and natural part of supporting good hearing health, good cognitive health, and overall wellbeing. 

What if a patient brings up the cognition topic?    

If you’re talking with patients about any noticeable hearing difficulties, conversation strains, or tiredness after socialising, then cognition is in many ways already part of that discussion.    

But with new research and ongoing studies, we know more about the relationship between hearing and cognitive health than ever before:

  • Hearing loss is the single largest potentially modifiable risk factor for dementia1
  • Hearing aid users are at a significantly lower risk of developing all-cause dementia2
  • Hearing aids have been shown to slow the rate of cognitive decline by 48%3

However, for patients, what’s perhaps more important is that any facts like these become a catalyst to help them feel informed and empowered to take a proactive role around their hearing health.  

How exactly can hearing loss affect the brain? 

A common patient question might be how does hearing loss impact the brain? Or rather, how can helping your hearing, help your brain? According to Johns Hopkins professor Dr Frank R. Lin, there are three main pathways from hearing loss to cognitive impairment:

  • The first is related to cognitive load, meaning that poor hearing can overwork the brain at the expense of thinking and memory
  • The second is down to brain structure and function – that if the brain isn't getting enough auditory input, parts of it may shrink
  • Thirdly, that hearing loss can cause someone to become socially isolated, another possible contributor to brain atrophy

The theory, of course, is that good hearing can target all these pathways: reducing load on the brain, providing more stimulation, and helping you be more engaged in life.

Should I be looking out for signs of decline? 

It’s well documented that dementia is an under-diagnosed disease due in large part to hesitancy and stigma4. And that there are a range of common early signs of cognitive decline5 which can be detected. 

But as a hearing care professional, it’s important to keep in mind that talking about cognitive health with a patient doesn’t constitute a thorough evaluation or diagnosis. 

However, if you’re spending time with a patient over several visits, this could be a good opportunity for staying alert to hearing and cognitive issues that may require a screening, referral, or further consultation. 

Want to know more?

Look out for future LET’S TALK stories where we’ll be diving deeper into some practical tools and knowhow to help you integrate cognition into your clinical conversations.


  1.  Livingston, G. et al. (2020) Dementia prevention, intervention, and care: 2020 report of the Lancet Commission, The Lancet, vol. 396, issue: 10248, https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext 
  2.  Bucholc M, McClean PL, et al. Association of the use of hearing aids with the conversion from mild cognitive impairment to dementia and progression of dementia: A longitudinal retrospective study. Alzheimer’s & Dementia (TRCI). Feb 2021, vol.7(1):e12122. https://doi.org/10.1002/trc2.12122
  3.  Lin FR, Pike JR, Albert MS, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet 2023; published online July 18. https://doi.org/10.1016/S0140-6736(23)01406-X
  4.  WHO (2017). Global action plan on the public health response to dementia 2017–2025. World Health Organization. https://apps.who.int/iris/handle/10665/259615 
  5.  “Symptoms of Dementia,” Alzheimer's Disease International, accessed Nov. 2023, https://www.alzint.org/about/symptoms-of-dementia/ 
Email icon