ASSOCIATION BETWEEN HEARING LOSS AND COGNITIVE DECLINE: CLINICAL EVIDENCE AND PRACTICAL IMPLICATIONS

Abstract

Age-related hearing loss is one of the most prevalent chronic conditions and the leading modifiable risk factor for dementia. This narrative review, conducted in line with PRISMA 2020 guidelines, searched PubMed/MEDLINE, LILACS, and BVS from January 2017 to August 2025. Eligible designs included randomized controlled trials, longitudinal cohorts, systematic reviews, meta-analyses, and official reports, totaling 23 studies after screening and full-text review. Evidence indicates that hearing loss nearly doubles dementia risk (RR/HR 1.9–2.4) and accounts for a population-attributable fraction of 8.2% in midlife. Proposed mechanisms include increased cognitive load, sensory deprivation, and social isolation. The ACHIEVE trial showed a 48% reduction in cognitive decline among high-risk older adults receiving auditory rehabilitation, though significance was not reached in the overall sample. Hearing loss should therefore be recognized both as a sensory disorder and as a key intervention point for brain health promotion and dementia prevention. In Brazil, high prevalence and rapid aging underscore the need for public policies that expand screening and access to rehabilitation, positioning Otolaryngology as a central specialty in the agenda for healthy aging.