This episode features an interview with Dr. Jennifer Deal regarding the complex link between hearing loss and cognitive decline in older adults. Dr. Deal explains several hypotheses for how hearing impairment may cause cognitive decline, including increased cognitive load, structural brain changes, and social isolation. She highlights findings from the ACHIEVE trial, which suggest that while hearing interventions might not help everyone, they appear to slow cognitive decline in high-risk populations. Furthermore, the episode addresses the methodological challenges of testing patients with sensory deficits and advocates for universal accommodations in clinical settings. Ultimately, the episode underscores the importance of treating hearing loss to improve quality of life and potentially preserve long-term brain health.
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Guest disclosures: Dr. Deal receives grants from the National Institute on Aging, and serves as an unpaid member of the Advisory Board for Sonova/Phonak.
About Jennifer
Jennifer A. Deal is an Associate Professor of Epidemiology and Otolaryngology-Head & Neck Surgery at the Johns Hopkins University, and the Interim Director of the Johns Hopkins Cochlear Center for Hearing and Public Health, a first-in-kind research center dedicated to training a generation of clinicians and researchers to understand and address the impact of hearing loss on older adults and public health. She leads research dedicated to improving the health and well-being of older adults, with a focus on brain aging, sensory health, and disability across the life-course. She also co-leads the SENSE Network, an international network of researchers building the infrastructure to support research on sensory and cognitive health in older adults.
References
- Brewster, K. K., Deal, J. A., Lin, F. R., & Rutherford, B. R. (2022). Considering hearing loss as a modifiable risk factor for dementia. Expert Review of Neurotherapeutics, 22(9), 805–813. https://doi.org/10.1080/14737175.2022.2128769
- Deal, J. A., Betz, J., Yaffe, K., Harris, T., Purchase-Helzner, E., Satterfield, S., Pratt, S., Govil, N., Simonsick, E. M., & Lin, F. R. (2016). Hearing impairment and incident dementia and cognitive decline in older adults: The Health ABC Study. The Journals of Gerontology: Series A, 72(5), 703–709. https://doi.org/10.1093/gerona/glw069
- Deal, J. A., Gross, A. L., Sharrett, A. R., Abraham, A. G., Coresh, J., Carlson, M., Griswold, M., Mosley, T., Power, M. C., Ramulu, P., Reed, N. S., Lin, F. R., & Swenor, B. K. (2021a). Hearing impairment and missing cognitive test scores in a population-based study of older adults: The Atherosclerosis Risk in Communities neurocognitive study. Alzheimer’s & Dementia, 17(10), 1725–1734. https://doi.org/10.1002/alz.12339
- Deal, J. A., Smith, J. R., & Jiang, K. (2025). Hearing loss, vascular function, and brain health in older adults. In Age-related hearing loss, brain health, and dementia (pp. 53–78). Elsevier. https://doi.org/10.1016/B978-0-443-29198-2.00002-3
- Grenier, B., Berr, C., Goldberg, M., Jouven, X., Zins, M., Empana, J.-P., & Lisan, Q. (2024). Hearing loss, hearing aids, and cognition. JAMA Network Open, 7(10), Article e2436723. https://doi.org/10.1001/jamanetworkopen.2024.36723
- Kolo, F. B., Lu, S., Beiser, A. S., Francis, L., Melo van Lent, D., Gireud-Goss, M., Himali, J. J., Ghosh, S., Ting, S. J., Banerjee, A., Kowalczyk, T. L., Zucker, J. M., Heard-Costa, N., Wood, C. G., Maillard, P., Fletcher, E. M., DeCarli, C. S., Welling, D. B., Kujawa, S. G., . . . Seshadri, S. (2025). Hearing loss, brain structure, cognition, and dementia risk in the Framingham Heart Study. JAMA Network Open, 8(11), Article e2539209. https://doi.org/10.1001/jamanetworkopen.2025.39209
- Lau, K., Dimitriadis, P. A., Mitchell, C., Martyn-St-James, M., Hind, D., & Ray, J. (2022). Age-related hearing loss and mild cognitive impairment: A meta-analysis and systematic review of population-based studies. The Journal of Laryngology & Otology, 136(2), 103–118. https://doi.org/10.1017/S0022215121004114
- Liang, Z., Li, A., Xu, Y., Qian, X., & Gao, X. (2021). Hearing loss and dementia: A meta-analysis of prospective cohort studies. Frontiers in Aging Neuroscience, 13, Article 695117. https://doi.org/10.3389/fnagi.2021.695117
- 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., Gravens-Mueller, L., Hayden, K. M., Huang, A. R., Knopman, D., Mitchell, C. M., Mosley, T., Pankow, J. S., Reed, N. S., . . . 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
- 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
