AGE-RELATED HEARING LOSS AS A RISK FACTOR FOR DEPRESSION AND DEMENTIA: MECHANISMS, SOCIAL CONSEQUENCES, AND HEARING REHABILITATION

Abstract

Age-related hearing loss (ARHL), or presbycusis, is one of the most common sensory disorders affecting older adults and may have consequences extending beyond impaired auditory perception. This narrative review aimed to examine the associations of ARHL with depression and cognitive decline, including dementia, with particular attention to underlying mechanisms, psychosocial consequences, and the potential role of hearing rehabilitation. Relevant literature was identified through searches of PubMed and Google Scholar, with priority given to systematic reviews, meta-analyses, longitudinal studies, and randomized controlled trials. Current evidence indicates that ARHL is associated with social withdrawal, loneliness, reduced independence, depressive symptoms, and cognitive decline. Proposed mechanisms linking ARHL with cognitive impairment include increased cognitive load during effortful listening, sensory deprivation and neuroplastic changes, and reduced social and cognitive stimulation. These processes may interact, creating a bidirectional cycle involving hearing impairment, social isolation, depression, and cognitive deterioration. Despite these consequences, ARHL remains frequently underdiagnosed and undertreated. Hearing rehabilitation can improve communication and social functioning, while evidence regarding prevention of depression and cognitive decline remains inconclusive. ARHL should therefore be regarded as a potentially modifiable component of healthy ageing. Early recognition and appropriate rehabilitation may reduce its psychosocial and functional consequences, while further research is required to determine whether hearing interventions can modify long-term depression and dementia risk. Methodology: This narrative literature review examines the relationship between age-related hearing loss (ARHL), depression, social isolation, cognitive decline, and dementia, as well as the potential role of hearing rehabilitation. Relevant publications were identified through searches of PubMed and Google Scholar. Peer-reviewed systematic reviews, meta-analyses, cohort studies, randomized controlled trials, and selected observational and qualitative studies were included, with preference given to recent evidence. World Health Organization publications were additionally used where appropriate. The literature was synthesized narratively, with particular attention to proposed mechanisms, psychosocial consequences, and the potential effects of hearing rehabilitation.