How do I talk with my patients about cognition and hearing?

Question

Answer

As the prevalence of dementia increases with age, affecting nearly 30% of adults over 85, the link between hearing and cognition has become a daily topic in clinical practice. Patients and families are increasingly curious. To talk effectively to your patients about cognition, you must balance evidence-based recommendations with a focus on holistic wellness.

1. Define the Relationship Accurately
The first step is clarifying terminology. While we cannot yet say untreated hearing loss causes dementia, there is a strong statistical association between the two. Explain to patients that hearing loss is a modifiable risk factor, much like sun exposure is a risk for skin cancer, and that intervention may help decrease that risk.

2. Differentiate Normal Aging from Warning Signs
Patients often fear that any memory lapse indicates dementia. Use the conversation to distinguish between normal healthy aging and pathological changes. You can introduce these topics naturally by asking a simple screening question: "During the last 12 months, have you experienced confusion or memory loss that is happening more often or getting worse?". This opens the door for patients to voice concerns without the pressure of a formal cognitive test. Clinicians are in a unique position to observe and recognize cognitive changes over time, making appropriate referrals, as necessary.

3. Focus on proven benefits
Avoid scare tactics or unsubstantiated claims that hearing aids will “prevent” dementia. Instead, frame hearing intervention as a proactive health decision. You may like to use the "toolbox" analogy: just as eating well and exercising support the body, treating hearing loss is a tool to keep the brain stimulated and active.
Highlight the proven benefits of intervention, such as:
•    Reducing cognitive load: Technology like Spheric Speech Clarity can reduce listening effort (Vaisberg et al., 2025).
•    Social Connectivity: Recent analysis from the ACHIEVE study shows users of hearing technology often maintain larger social networks and feel less lonely (Reed et al., 2025).

4. Use Evidence-Based Language
When patients ask, "Will this help my memory?" respond with a balanced view. You can indicate that while conclusive evidence for every individual isn't available, providing a clearer signal to the brain allows it to function more efficiently and taking action to hear better supports healthy aging and overall well-being.

5. Involve the Family
Effective communication is a family affair. Including family members or close friends is essential for success, as perceived social support is a significant predictor of hearing aid satisfaction (Singh et al., 2015). They can help reinforce instructions, provide history, and support the patient’s journey.
By moving beyond pure-tone audiometry and embracing a holistic, person-centered approach, you can provide the clarity and quality care patients need to navigate their cognitive and hearing health.

For more information, check out the Phonak course, Clarity you hear, Connection you Feel, on AudiologyOnline.

References

Reed, N. S., Chen, J., Huang, A. R., Pike, J. R., Arnold, M., Burgard, S., Chen, Z., Chisolm, T., Couper, D., Cudjoe, T. K. M., Deal, J. A., Goman, A. M., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Mitchell, C. M., Mosley, T., Oh, E. S., . . . ACHIEVE Collaborative Research Group. (2025). Hearing intervention, social isolation, and loneliness: A secondary analysis of the ACHIEVE randomized clinical trial. JAMA Internal Medicine, 185(7), 797–806. https://doi.org/10.1001/jamainternmed.2025.1140

Singh, G., Lau, S. T., & Pichora-Fuller, M. K. (2015). Social support predicts hearing aid satisfaction. Ear and Hearing, 36(6), 664–676. https://doi.org/10.1097/AUD.0000000000000182

Vaisberg, J. M., Dang, C., Jiang, Y., Qian, J., & Russo, F. A. (2025). Brain benefits of deep learning-based noise management in experienced hearing aid users using functional near infrared spectroscopy. Scientific Reports, 15, Article 41815. https://doi.org/10.1038/s41598-025-25801-y