Hearing, vision and brain health

Hearing and seeing well keep you in touch with other people and the world around you. Large studies show that people with hearing loss, or with vision loss that is not treated, are more likely to develop dementia.^1,2

The good news is that hearing and vision problems are common and often treatable. This page explains what the research shows, what it does not show yet, and simple steps you can take this year.

Why hearing and vision matter for the brain

Scientists are still working out why these senses are tied to dementia. A few ideas have support:^2,3

• The brain works harder. When sound or sight is blurry, the brain spends extra effort just making sense of it. That may leave less effort for thinking and remembering.
• Less social contact. People who struggle to hear often pull back from others and feel lonely.^2,3 Read more about how loneliness affects health.

Hearing loss also raises the risk of falls, depression and safety problems, such as missing a smoke alarm.³ So treating it helps in many ways, even apart from dementia.

What the 2024 Lancet Commission found

The Lancet Commission is a group of dementia experts from around the world. In 2024, it updated its list of risk factors that people and communities may be able to change. The list grew from 12 to 14 factors. Together, they are linked to nearly half of all dementia cases worldwide.¹

Two factors were new in 2024: high LDL ("bad") cholesterol, and untreated vision loss in later life.¹ The report estimated:¹

These are estimates for whole populations, not your own chance of getting dementia. They suggest that if hearing and vision loss were treated for everyone, some cases might be prevented or delayed.

The Commission called for hearing aids to be available to everyone with hearing loss, and for less exposure to harmful noise. It also called for vision screening and treatment to be open to everyone.¹ The CDC also lists hearing loss as an important risk factor and suggests working with a hearing care professional to prevent, treat or manage it.²

Hearing loss: how common is it?

Hearing loss is one of the most common health problems of later life. About 1 in 3 older adults has some hearing loss.³ Hearing loss that makes daily life hard affects about 22% of people aged 65 to 74, and about 55% of people 75 and older.⁴

It often comes on so slowly that people do not notice it. Common signs include:³

• Asking people to repeat themselves often
• Trouble following a talk when several people speak, or in a noisy place
• Feeling that others mumble
• Turning the TV up so loud that others complain
• Trouble hearing on the phone, or hearing higher-pitched voices, such as children's
• Ringing or buzzing in the ears (tinnitus)

Start with your regular doctor. You may be sent to an audiologist (a hearing specialist who tests and treats hearing loss) or an ENT doctor (a doctor for the ears, nose and throat).³

The ACHIEVE trial: does treating hearing loss protect the brain?

A review of many studies found that people who use hearing aids or cochlear implants had a lower long-term risk of memory and thinking decline.³ But studies like these cannot prove that hearing aids are the reason. People who get hearing aids may differ in other ways, such as income or health.

ACHIEVE was the first large randomized trial (a study where a coin-flip decides who gets the treatment) to test this. Results were published in The Lancet in 2023.⁵

Who was in it. The study included 977 adults aged 70 to 84 in four U.S. communities. All had hearing loss that was not being treated. None had serious memory or thinking problems at the start.⁶

What they did. About half got hearing care. They met with an audiologist four times, got hearing aids and other listening devices, and learned ways to hear better in hard places. The other half got health education on topics such as vaccines and healthy bones. Both groups had check-ins every six months.⁸

What it found. After 3 years:⁵

• For the whole group, hearing care did not slow the decline in thinking skills compared with health education.
• In 238 people drawn from a long-running heart health study, hearing care slowed the decline by 48%. These people were older and had more risk factors for memory loss.
• In 739 newer, healthier volunteers, there was no clear effect. Their thinking skills changed slowly, so a benefit was harder to see in 3 years.

Other results. People who got hearing care kept slightly larger and more varied social circles. Their loneliness also rose a little less than in the other group.⁶ The researchers said these changes were modest. They did not see a change in overall quality of life.⁹

What this means for you. Hearing care is low-risk and helps people hear and connect. For older adults with several risk factors, it may also help protect thinking skills. It is not a proven way to prevent dementia, and follow-up continues.^5,6 We rate the evidence for brain benefit as promising. Promising

Getting hearing aids: your options

The FDA created the OTC hearing aid category in October 2022.⁷ Whichever you choose, read the return policy before you buy. OTC aids are not for severe hearing loss. People who are profoundly deaf may be helped by a cochlear implant, a device placed by surgery that sends sound signals to the hearing nerve.³

What Medicare pays. As of October 2026, Original Medicare does not cover hearing aids or exams to fit them.¹¹ Part B does cover hearing tests that your doctor orders to check for a medical problem. You usually pay 20% after the deductible. You can also see an audiologist once a year without a doctor's order for hearing loss that came on slowly.¹¹ If you have a Medicare Advantage plan, ask whether it offers extra hearing benefits.

Help in Virginia. The Virginia Department for the Deaf and Hard of Hearing runs a Technology Assistance Program. It provides amplified phones, captioned phones, signalers and listening systems to Virginians with hearing loss who meet income rules. Virginia veterans with hearing loss qualify at no cost. Call 1-800-552-7917 or 804-662-9502.¹² Hearing aids themselves are not on its equipment list.

Vision loss and the brain

Untreated vision loss can make reading, driving, cooking and going out harder. It is linked to dementia risk in later life.¹ Common eye problems in older adults include cataracts, glaucoma, macular degeneration and diabetes-related eye damage.^13,16

Many vision problems can be found early with a dilated eye exam. The eye doctor uses drops to widen the pupils and look inside the eye. The National Eye Institute suggests this exam every 1 to 2 years for adults over 60. People with diabetes or high blood pressure often need it once a year.¹³

What Medicare pays. Original Medicare does not cover routine eye exams for glasses. Some Medicare Advantage plans add vision benefits.¹⁴ Medicare does cover some medical eye care, such as cataract surgery (see below).

Cataract surgery and dementia risk

A cataract is a cloudy area in the lens of the eye. It can make vision blurry, colors faded, and night driving hard. More than half of Americans aged 80 and older have a cataract or have had surgery for one.¹⁶

Surgery replaces the cloudy lens with a clear artificial lens. It is very safe, and about 9 in 10 people see better afterward.¹⁶ You do not always need surgery right away. Brighter lights, new glasses and anti-glare sunglasses can help at first. Surgery is usually a good choice when cataracts get in the way of daily life.¹⁶

The study. Researchers in Washington State followed 3,038 adults aged 65 and older who had cataracts or glaucoma. None had dementia at the start.¹⁰

• People who had cataract surgery were about 29% less likely to develop dementia over the years of the study.¹⁰
• Glaucoma surgery, which does not bring back lost vision, showed no such link. That supports the idea that seeing better is what matters.¹⁰

The limits. This was an observational study. It found a link but cannot prove that surgery prevents dementia. Most people in the study were white, and the records did not measure how bad each cataract was. The authors said more studies are needed.¹⁰ We rate this evidence as limited. Limited research

What Medicare pays. Medicare Part B may cover cataract surgery with a standard lens. After the deductible, you usually pay 20%. Part B also covers one pair of glasses with standard frames, or one set of contact lenses, after each covered surgery.¹⁵

If you care for someone with memory loss

Hearing and vision problems can make memory loss look worse than it is. A person who cannot hear the question may seem confused. A person who cannot see well may seem lost.

• Before a memory test, make sure the person wears their hearing aids and glasses. Tell the doctor about any hearing or vision problems. See memory and thinking tests.
• Ask about treatable causes. Hearing loss is on our list of conditions that can look like dementia.
• Check devices daily. Clean glasses, check hearing aid batteries, and keep spares in one place.
• Help them hear you. Face the person in a quiet, well-lit room. Speak clearly and a bit louder, but do not shout. Say it a new way rather than repeating the same words.³ See talking with someone who has dementia.
• Watch for brain-based vision problems. Some types of dementia affect how the brain handles what the eyes see, even when the eyes are healthy. See posterior cortical atrophy and Lewy body dementia.
• Lower fall risk. Good lighting and up-to-date glasses help. See preventing falls.

Steps you can take this year

1. Get your hearing checked. Ask your doctor, or see an audiologist. If you are 18 or older and think your loss is mild to moderate, OTC hearing aids are an option.⁷
2. Wear your hearing aids every day. They help most when you use them in real life, not in a drawer.
3. Protect your hearing. Turn down loud music and use earplugs around loud tools and engines.¹
4. Get a dilated eye exam every 1 to 2 years after age 60, or as often as your eye doctor advises.¹³
5. Keep glasses up to date and ask about cataracts if your vision is getting cloudy or glare bothers you.
6. Stay connected. Better hearing and sight make it easier to join friends, family and groups. See staying mentally and socially active.

Hearing and vision are only two pieces. Blood pressure, exercise, sleep and other habits matter too. See blood pressure and the brain, exercise for brain health, and our daily plan for keeping your brain healthy.

Hearing loss can also lead to loneliness and low mood. Read more in hearing loss, loneliness and the brain and depression in later life.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.