Navigating Neuropsychology

196 | Hearing Loss and Cognitive Decline – A Conversation With Dr. Jennifer Deal

Aug 1, 2026
Dr. Jennifer Deal, a Johns Hopkins epidemiologist and hearing-health researcher, explores the intricate relationship between hearing loss, cognitive decline, and dementia risk. They discuss how hearing is measured, possible brain and social pathways, and the challenges sensory loss creates for cognitive testing. The ACHIEVE trial takes center stage, alongside hearing treatments, clinical accommodations, and quality-of-life benefits.
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INSIGHT

Hearing Loss Raises Dementia Risk But Causality Remains Open

  • Hearing loss is consistently associated with roughly 50% higher dementia risk, but causality remains unproven.
  • Evidence remains limited by few objective longitudinal studies, predominantly involving white participants in high-income countries.
INSIGHT

Missing Cognitive Tests Can Hide Hearing Effects

  • Hearing-impaired participants were more likely to leave cognitive tests incomplete, including visual Trails and Boston Naming tasks.
  • Excluding those participants weakened observed associations; multiple imputation produced stronger hearing-cognition relationships.
INSIGHT

The Hearing Dementia Link May Run Both Ways

  • Hearing loss may contribute to decline through cognitive load, brain changes, or social withdrawal, while reverse causation and shared causes remain plausible.
  • Jennifer Deal suspects a causal relationship but emphasizes that evidence has not yet established it.
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