AGE-RELATED HEARING LOSS AS A RISK FACTOR FOR DEPRESSION AND DEMENTIA: MECHANISMS, SOCIAL CONSEQUENCES, AND HEARING REHABILITATION

Kamila Zmysłowska; Kornelia Tyczka; Anna Szatkowska; Malwina Kwaśniewska; Adam Hajdaniak; Jan Mateusz Kiersztyn; Aleksandra Grabowska; Natalia Seńcio; Klaudia Stadnik

doi:10.31435/ijitss.3(51).2026.6529

Authors

Kamila Zmysłowska Nicolaus Copernicus Voivodeship Hospital in Koszalin, Tytusa Chałubińskiego 7, 75-581 Koszalin, Poland https://orcid.org/0009-0002-2413-0806
Kornelia Tyczka Independent Public Regional Hospital in Szczecin, 4 Arkońska Street, 71-455 Szczecin, Poland https://orcid.org/0000-0001-8700-2372
Anna Szatkowska Jan Mikulicz-Radecki University Hospital in Wrocław, Borowska 213, 50-556 Wrocław, Poland https://orcid.org/0009-0003-9970-3354
Malwina Kwaśniewska Nicolaus Copernicus Voivodeship Hospital in Koszalin, Tytusa Chałubińskiego 7, 75-581 Koszalin, Poland https://orcid.org/0009-0006-0775-8174
Adam Hajdaniak Jan Mikulicz-Radecki University Hospital in Wrocław, Borowska 213, 50-556 Wrocław, Poland https://orcid.org/0009-0005-1401-3122
Jan Mateusz Kiersztyn Dr Jurasz University Hospital No.1 in Bydgoszcz, Marii Skłodowskiej Curie 9, 85-094, Bydgoszcz, Poland https://orcid.org/0009-0004-4714-0868
Aleksandra Grabowska Regional Hospital in Kołobrzeg, Edmunda Łopuskiego 31-33, 78-100 Kołobrzeg, Poland https://orcid.org/0009-0003-6112-1260
Natalia Seńcio Poznan University of Medical Sciences, Collegium Maius, Fredry 10, 61-701 Poznań, Poland https://orcid.org/0009-0009-4358-7511
Klaudia Stadnik Regional Hospital in Szczecinek, Tadeusza Kościuszki 38, 78-400 Szczecinek, Poland https://orcid.org/0009-0006-2601-3813

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6529

Keywords:

Age-Related Hearing Loss; Presbycusis; Depression; Dementia; Cognitive Decline; Social Isolation; Hearing Aids; Hearing Rehabilitation

Abstract

Age-related hearing loss (ARHL), or presbycusis, is one of the most common sensory disorders affecting older adults and may have consequences extending beyond impaired auditory perception. This narrative review aimed to examine the associations of ARHL with depression and cognitive decline, including dementia, with particular attention to underlying mechanisms, psychosocial consequences, and the potential role of hearing rehabilitation. Relevant literature was identified through searches of PubMed and Google Scholar, with priority given to systematic reviews, meta-analyses, longitudinal studies, and randomized controlled trials. Current evidence indicates that ARHL is associated with social withdrawal, loneliness, reduced independence, depressive symptoms, and cognitive decline. Proposed mechanisms linking ARHL with cognitive impairment include increased cognitive load during effortful listening, sensory deprivation and neuroplastic changes, and reduced social and cognitive stimulation. These processes may interact, creating a bidirectional cycle involving hearing impairment, social isolation, depression, and cognitive deterioration. Despite these consequences, ARHL remains frequently underdiagnosed and undertreated. Hearing rehabilitation can improve communication and social functioning, while evidence regarding prevention of depression and cognitive decline remains inconclusive. ARHL should therefore be regarded as a potentially modifiable component of healthy ageing. Early recognition and appropriate rehabilitation may reduce its psychosocial and functional consequences, while further research is required to determine whether hearing interventions can modify long-term depression and dementia risk.

Methodology: This narrative literature review examines the relationship between age-related hearing loss (ARHL), depression, social isolation, cognitive decline, and dementia, as well as the potential role of hearing rehabilitation. Relevant publications were identified through searches of PubMed and Google Scholar. Peer-reviewed systematic reviews, meta-analyses, cohort studies, randomized controlled trials, and selected observational and qualitative studies were included, with preference given to recent evidence. World Health Organization publications were additionally used where appropriate. The literature was synthesized narratively, with particular attention to proposed mechanisms, psychosocial consequences, and the potential effects of hearing rehabilitation.

References

Spanke, A. M. (2025). Age-related hearing loss: Causes, treatment, and care. Nursing, 55(12), 26–34. https://doi.org/10.1097/NSG.0000000000000291

Yang, W., Zhao, X., Chai, R., & Fan, J. (2023). Progress on mechanisms of age-related hearing loss. Frontiers in Neuroscience, 17, 1253574. https://doi.org/10.3389/fnins.2023.1253574

Kim, H. J., Jeong, S., Roh, K. J., Oh, Y. H., & Suh, M. J. (2023). Association between hearing impairment and incident depression: A nationwide follow-up study. The Laryngoscope, 133(11), 3144–3151. https://doi.org/10.1002/lary.30654

Readman, M. R., Littlejohn, J., Dodd, I., Rhodes, S., Wareing, L., Polden, M., Plack, C. J., & Giebel, C. (2025). Hearing loss as a risk factor for dementia: A systematic review and meta-analysis from a global perspective. Aging & Mental Health, 29(10), 1831–1844. https://doi.org/10.1080/13607863.2025.2515180

Shukla, A., Harper, M., Pedersen, E., Goman, A., Suen, J. J., Price, C., Applebaum, J., Hoyer, M., Lin, F. R., & Reed, N. S. (2020). Hearing loss, loneliness, and social isolation: A systematic review. Otolaryngology–Head and Neck Surgery, 162(5), 622–633. https://doi.org/10.1177/0194599820910377

Li, J., Sun, L., Zhao, Y. Y., Wang, H. T., & Liu, J. E. (2026). What role does social activity play in the relationship between hearing loss and cognitive decline or mental health in older adults: A systematic review and meta-analysis. Journal of Psychosomatic Research, 200, 112449. https://doi.org/10.1016/j.jpsychores.2025.112449

Dhanda, N., Hall, A., & Martin, J. (2024). Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies. Frontiers in Public Health, 12, 1347794. https://doi.org/10.3389/fpubh.2024.1347794

Mahmoudi, E., Zazove, P., Pleasant, T., Meeks, L., & McKee, M. M. (2021). Hearing loss and healthcare access among adults. Seminars in Hearing, 42(1), 47–58. https://doi.org/10.1055/s-0041-1726000

Lu, L. L. M., Henn, P., O’Tuathaigh, C., & Smith, S. (2024). Patient-healthcare provider communication and age-related hearing loss: A qualitative study of patients’ perspectives. Irish Journal of Medical Science, 193(1), 277–284. https://doi.org/10.1007/s11845-023-03432-4

Genther, D. J., Betz, J., Pratt, S., Martin, K. R., Harris, T. B., Satterfield, S., Bauer, D. C., Newman, A. B., Simonsick, E. M., Lin, F. R., & Health, Aging and Body Composition Study. (2015). Association between hearing impairment and risk of hospitalization in older adults. Journal of the American Geriatrics Society, 63(6), 1146–1152. https://doi.org/10.1111/jgs.13456

Chern, A., & Golub, J. S. (2019). Age-related hearing loss and dementia. Alzheimer Disease & Associated Disorders, 33(3), 285–290. https://doi.org/10.1097/WAD.0000000000000325

Sharma, R. K., Chern, A., & Golub, J. S. (2021). Age-related hearing loss and the development of cognitive impairment and late-life depression: A scoping overview. Seminars in Hearing, 42(1), 10–25. https://doi.org/10.1055/s-0041-1725997

Wu, F., & Zhou, C. (2024). Hearing impairment and cognitive function: Mediating role of social isolation and depression. American Journal of Alzheimer’s Disease & Other Dementias, 39, 15333175241227318. https://doi.org/10.1177/15333175241227318

Tarawneh, H. Y., Jayakody, D. M. P., Sohrabi, H. R., Martins, R. N., & Mulders, W. H. A. M. (2022). Understanding the relationship between age-related hearing loss and Alzheimer’s disease: A narrative review. Journal of Alzheimer’s Disease Reports, 6(1), 539–556. https://doi.org/10.3233/ADR-220035

Lawrence, B. J., Jayakody, D. M. P., Bennett, R. J., Eikelboom, R. H., Gasson, N., & Friedland, P. L. (2020). Hearing loss and depression in older adults: A systematic review and meta-analysis. The Gerontologist, 60(3), e137–e154. https://doi.org/10.1093/geront/gnz009

Wei, J., Li, Y., & Gui, X. (2024). Association of hearing loss and risk of depression: A systematic review and meta-analysis. Frontiers in Neurology, 15, 1446262. https://doi.org/10.3389/fneur.2024.1446262

Rutherford, B. R., Brewster, K., Golub, J. S., Kim, A. H., & Roose, S. P. (2018). Sensation and psychiatry: Linking age-related hearing loss to late-life depression and cognitive decline. American Journal of Psychiatry, 175(3), 215–224. https://doi.org/10.1176/appi.ajp.2017.17040423

Zhang, Z.-Q., Li, J.-Y., Ge, S.-T., Ma, T.-Y., Li, F.-Y., Lu, J.-L., Si, S.-R., Cui, Z.-Z., Jin, Y.-L., & Jin, X.-H. (2024). Bidirectional associations between sensorineural hearing loss and depression and anxiety: A meta-analysis. Frontiers in Public Health, 11, 1281689. https://doi.org/10.3389/fpubh.2023.1281689

Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, 404(10452), 572–628. https://doi.org/10.1016/S0140-6736(24)01296-0

Cao, X., Liu, Q., Liu, J., Yang, B., & Zhou, J. (2023). The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships. Frontiers in Public Health, 11, 1149769. https://doi.org/10.3389/fpubh.2023.1149769

World Health Organization. (2026). Deafness and hearing loss. World Health Organization.

World Health Organization. (2026). Deafness and hearing loss: Age-related hearing loss (presbycusis). World Health Organization.

World Health Organization. (2024). Hearing aid service delivery approaches for low- and middle-income settings. World Health Organization.

Jenstad, L., & Moon, J. (2011). Systematic review of barriers and facilitators to hearing aid uptake in older adults. Audiology Research, 1(1), e25. https://doi.org/10.4081/audiores.2011.e25

Hori, K., Shah, R., Paladugu, A., Gallagher, T. J., Jang, S. S., Weinfurter, E. V., Wee, C. P., & Choi, J. S. (2025). Social outcomes among adults with hearing aids and cochlear implants: A systematic review and meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 151(8), 806–816. https://doi.org/10.1001/jamaoto.2025.1777

Nieman, C. L., Marrone, N., Szanton, S. L., Thorpe, R. J., Jr., & Lin, F. R. (2017). The Baltimore HEARS pilot study: An affordable, accessible, community-delivered hearing care intervention. The Gerontologist, 57(6), 1173–1186. https://doi.org/10.1093/geront/gnw153

Yeo, B. S. Y., Song, H. J. J. M. D., Toh, E. M. S., Ng, L. S., Ho, C. S. H., Ho, R. C. M., & Sia, C. H. (2023). Association of hearing aids and cochlear implants with cognitive decline and dementia: A systematic review and meta-analysis. JAMA Neurology, 80(2), 134–141. https://doi.org/10.1001/jamaneurol.2022.4427

Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., Couper, D., Deal, J. A., Goman, A. M., Glynn, N. W., Gmelin, T., Hayden, K. M., Huang, A. R., Knopman, D., Mitchell, C. M., Mosley, T., Pankow, J. S., Reed, N. S., Sanchez, V., … Coresh, J. (2023). 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. The Lancet, 402(10404), 786–797. https://doi.org/10.1016/S0140-6736(23)01406-X

Beadle, J., Yuwono, E., Levasseur, M., & Wister, A. (2026). Effectiveness of interventions for social isolation, loneliness, and social participation in older adults with hearing loss: Results from a systematic review. Systematic Reviews, 15(1), 155. https://doi.org/10.1186/s13643-026-03107-y