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Dementia and hearing-aid use: a two-way street

Naylor, Graham; Dillard, Lauren; Orrell, Martin; Stephan, Blossom C M; Zobay, Oliver; Saunders, Gabrielle H

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Professor of Hearing Sciences

Lauren Dillard

Director - Institute of Mental Health

Blossom C M Stephan

Gabrielle H Saunders


Hearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths.

Health records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n = 72,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5–5 years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n = 272,748) modelled the likelihood of being a persistent hearing-aid user at 3 years 2 months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors.

The adjusted OR for incident dementia was 0.73 (95% CI 0.66–0.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43–0.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia).

Substantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status.


Naylor, G., Dillard, L., Orrell, M., Stephan, B. C. M., Zobay, O., & Saunders, G. H. (2022). Dementia and hearing-aid use: a two-way street. Age and Ageing, 51(12), Article afac266.

Journal Article Type Article
Acceptance Date Sep 14, 2022
Online Publication Date Dec 19, 2022
Publication Date 2022-12
Deposit Date Jan 4, 2023
Publicly Available Date Jan 5, 2023
Journal Age and Ageing
Print ISSN 0002-0729
Electronic ISSN 1468-2834
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 51
Issue 12
Article Number afac266
Keywords Geriatrics and Gerontology; Aging; General Medicine
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