Understanding the Risks of Untreated Hearing Loss
- Koorosh Nejad
- Sep 14
- 4 min read
Updated: 3 days ago
Hearing loss is one of the most common yet under‑treated health conditions worldwide. The World Health Organisation (WHO) estimates that over 430 million people live with disabling hearing loss, but less than 20% of those who could benefit from hearing aids actually use them. As an audiologist, I often see the consequences of untreated hearing loss firsthand, both in the clinic and in the lives of my patients. Choosing not to manage hearing loss with hearing aids can lead to a cascade of physical, cognitive, emotional, and social risks that extend well beyond “just not hearing well.”
Please note that this is not a sales pitch.
In this article, I’ll review the main risks associated with untreated hearing loss, supported by evidence from audiology and neuroscience research.
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Here are 8 risk factors of not attending to your hearing loss:
1. Cognitive Decline and Dementia Risk
One of the most widely researched consequences of untreated hearing loss is its association with cognitive decline. Multiple large‑scale longitudinal studies, including those led by Dr. Frank Lin at Johns Hopkins University, have found that hearing loss is independently associated with accelerated cognitive decline and a higher risk of dementia. For example, Lin et al. (2011, Archives of Neurology) showed that older adults with hearing loss had a significantly higher risk of developing dementia compared to peers with normal hearing. The risk increased with the severity of hearing loss.
Why does this happen? Several mechanisms are proposed:
Cognitive load: The brain works harder to decode degraded auditory input, leaving fewer resources for memory and thinking.
Social isolation: Reduced communication can lead to withdrawal, which itself is a risk factor for cognitive decline.
Neuroplasticity changes: Auditory deprivation can lead to reorganisation of brain networks, altering how sound, memory, and language are processed.
Encouragingly, more recent studies (Deal et al., 2023, Lancet) suggest that the use of hearing aids may reduce or even slow this risk.
2. Social Isolation and Loneliness
Hearing loss makes conversations more challenging, particularly in noisy environments. Over time, many individuals withdraw from social activities because of embarrassment, fatigue, or frustration. Research published in The Journals of Gerontology (Mick et al., 2014) highlights a strong link between hearing loss, reduced social engagement, and increased loneliness and depression. Social isolation is not a trivial issue—it is associated with higher risks of depression, cognitive decline, and even cardiovascular problems.
3. Increased Risk of Depression and Anxiety
Untreated hearing loss is strongly associated with poorer mental health outcomes. The National Council on Ageing has reported that older adults with untreated hearing loss are more likely to experience depression, anxiety, and paranoia. A 2014 systematic review in JAMA Otolaryngology–Head & Neck Surgery found that treating hearing loss with hearing aids improved quality of life and reduced depressive symptoms in many individuals.
4. Safety Concerns and Reduced Awareness
Hearing plays a crucial role in environmental awareness. Individuals with untreated hearing loss may miss alarms, doorbells, sirens, approaching vehicles, or even someone calling for help. This increases the risk of accidents, falls, and injuries. In fact, research from Johns Hopkins University (2012) showed that even mild hearing loss was associated with a threefold increased risk of falls. Hearing aids help restore environmental awareness and improve personal safety.
5. Communication Breakdown in Relationships
Communication is the foundation of relationships. When hearing loss goes untreated, misunderstandings, frustration, and withdrawal can affect partnerships, family dynamics, and friendships. Studies have shown that spouses and family members of those with untreated hearing loss also experience reduced quality of life, highlighting that the condition affects more than just the individual.
6. Employment and Financial Impact
Hearing loss, if unmanaged, can also impact professional life. A report from the Better Hearing Institute (2011) found that untreated hearing loss was linked to lower income and higher unemployment rates, while hearing aid use mitigated these effects. Effective communication is critical in nearly every workplace, and untreated hearing loss can limit career advancement and productivity.
7. Accelerated Brain Atrophy
Neuroimaging studies provide further evidence of the risks. Peelle et al. (2011, Journal of Neuroscience) found that older adults with hearing loss experienced faster rates of brain tissue loss compared to those with normal hearing. This suggests that auditory deprivation doesn’t just affect hearing—it impacts overall brain health.
8. Quality of Life Reduction
Ultimately, untreated hearing loss diminishes quality of life. Activities that once brought joy—family dinners, concerts, social gatherings—become sources of stress or frustration. Many patients describe feeling “cut off” from the world. Hearing aids, by restoring communication and participation, directly improve well‑being and life satisfaction.
Conclusion: Why Treating Hearing Loss Matters
I often mention this to my patients, that "my main concern is not your hearing, it is your brain health". As audiologists, our role is to help patients understand these risks, offer evidence-based solutions, and guide them toward improved hearing and a better quality of life.
The risks of leaving hearing loss unaddressed extend far beyond mere inconvenience. From cognitive decline and depression to safety risks and strained relationships, Untreated hearing loss can profoundly affect health and quality of life.
If you think your hearing is going down or you miss the conversation, please do yourself a favour and do a free online hearing test to start with. If the result shows any hearing loss, then book a hearing test and consultation with a local audiologist to investigate this further.
References
Lin FR, et al. (2011). Hearing loss and incident dementia. Archives of Neurology.
Deal JA, et al. (2023). Hearing intervention and cognitive decline in older adults. The Lancet.
Mick P, et al. (2014). The association between hearing loss and social isolation. The Journals of Gerontology.
National Council on Ageing (2000). Untreated hearing loss and quality of life.
Choi JS, Betz J, Li L, et al. (2014). Association of hearing loss with depression. JAMA Otolaryngology–Head & Neck Surgery.
Lin FR, et al. (2012). Hearing loss and falls among older adults. JAMA Internal Medicine.
Peelle JE, et al. (2011). Hearing loss in older adults affects neural systems. Journal of Neuroscience.
Better Hearing Institute (2011). The impact of untreated hearing loss on income.
Questions
Please get in touch if you have any questions about your hearing loss..
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