You Heard It Here — Helping Older Patients Hear Better Is Easy, Smart

You can change a life without breaking a sweat — read on to find out how

Smart Practice: If you find yourself shouting to a patient who is hard of hearing, suggest a hearing aid, and you might decrease that patient’s three-year risk of dementia by nearly 50%.

What’s the Claim?

We know you care about your patients, so every once in a while, we’ll share something that’s just good medicine.

Among patients with factors for dementia, a recent landmark randomized trial found that simply receiving audiological counseling and hearing aids reduced the risk of dementia by 48% over the next three years. The authors defined patients to be at increased risk of dementia if they were previously enrolled in the Atherosclerosis Risk in Communities study, a massive, longitudinal investigation of patients with risk factors for atherosclerosis (you know what those are).

Among patients with no risk factors for dementia (a minority of patients, as it turns out, in the age >70 population they screened), hearing aids did not reduce the risk of dementia.

How’s It Stack Up?

This is practice-changing for those in primary care and ENT surgery, but the key takeaway is so easy that orthopaedic surgeons ought to know about it, because almost all of us treat older people. You can have confidence in this study’s methods — it was about as bombproof as an RCT on this kind of topic can be — and a recent longitudinal study published in JAMA reinforces the main findings. In that study, investigators observed that among community-dwelling individuals over the age of 65, moderate to severe hearing loss was associated with a higher prevalence of dementia, and that use of a hearing aid was associated with a lower prevalence of dementia. The authors there point out that hearing loss is the single largest modifiable cause of dementia — it's responsible for 8% of dementia diagnoses.

What’s Our Take?

Everyone has (or has had) a family member with dementia. We all know how devastating this can be. Everyone also has had relatives who are hard of hearing, and they generally don’t like to be nagged about this. They’ve heard complaints from their families on this already (you can count on it), and perhaps also from their family doctors.

But they won’t expect to hear it from you. You’re a trusted source, you’d be stepping a bit out of your lane, and doing so conveys care. Your recommendation therefore is likely to make the difference. I’ve done this, and it works.

If you have to shout for your patient to hear you, offer to refer them to audiology. Your recommendation can make a world of difference.


Lin FR, Pike JR, Albert MS, et al. 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. Lancet. 2023;402:786-797.