Schwerhörigkeit und Demenz: Risikofaktor, Frühzeichen oder beides?

<h4>Purpose</h4>Hearing loss (HL) has been increasingly recognized as a potential risk factor for cognitive decline and dementia. However, findings from existing meta-analyses remain heterogeneous. This umbrella review aimed to comprehensively synthesize current meta-analytic evidence on the association between adult hearing loss and cognitive outcomes.<h4>Methods</h4>PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception to 9 January 2026. Systematic reviews with meta-analyses examining the relationship between hearing loss and cognitive outcomes in adults were included. Methodological quality was assessed using AMSTAR-2. Evidence credibility was evaluated using the Ioannidis classification framework, and certainty of evidence was assessed using the GRADE approach. Overlap among primary studies across meta-analyses was quantified using the corrected covered area (CCA).<h4>Results</h4>Nine meta-analyses were included. Hearing loss was significantly associated with increased risk of cognitive impairment (OR = 1.34, 95% CI: 1.17-1.53) and dementia (OR = 1.43, 95% CI: 1.21-1.68). In older adults, the associations were slightly stronger. Hearing loss was also associated with higher risk of Alzheimer's disease (OR = 1.66, 95% CI: 1.33-2.07). Evidence credibility was classified as highly suggestive for cognitive impairment and dementia.<h4>Conclusion</h4>Adult hearing loss is significantly associated with increased risks of cognitive im

<h4>Objective</h4>We investigated potential racial disparities in the effects of audiometric hearing loss and its treatment on dementia and mortality among 3,602 older adults aged 68-89 years, 22% of whom were self-identified Black race.<h4>Methods</h4>Adjudicated all-cause dementia was determined using neurocognitive test data, proxy reports, and surveillance of hospital records and death certificates. Audiometric hearing loss, defined as the better-ear averaged pure-tone threshold (0.5-4 kHz), was categorized using clinical cutpoints. Multivariable-adjusted Cox proportional hazards models included hearing loss-race interaction terms.<h4>Results</h4>Dementia risk associated with moderate-to-severe hearing loss did not differ by race [Black participants: hazard ratio (HR): 1.66; 95% confidence interval (CI): 1.05, 2.61; White participants: HR: 1.71; 95% CI: 1.16, 2.51; <i>P</i>-interaction = 0.92]. However, moderate-to-severe hearing loss was associated with a 2.3-fold increase in mortality among Black participants only (95% CI: 1.17, 4.60).<h4>Conclusions</h4>Our findings emphasize the importance of including minoritized populations in hearing treatment research to build an evidence base for policy development and clinical decision-making. Hearing loss affects the health of both Black and White Americans. Racial disparities in hearing healthcare should be addressed to advance health equity for all older adults.

<b>Background/Objectives:</b> Hearing loss and dementia are highly prevalent conditions in older adults and represent a growing public health challenge. Over the past decade, a substantial body of epidemiological evidence has demonstrated a consistent association between age-related hearing loss and cognitive dysfunction, including incident dementia. However, the nature of this relationship remains incompletely understood. <b>Methods:</b> This narrative review provides a structured overview of current evidence, focusing on epidemiological findings, mechanistic pathways, and clinical implications. Hearing loss has been associated with both accelerated cognitive decline and increased dementia risk, with a clear severity-impact relationship. <b>Results:</b> Several interacting mechanisms have been proposed, including increased cognitive load, structural and functional brain changes, social isolation, and shared vascular and metabolic risk factors. Emerging concepts such as the "auditory brain" and central auditory dysfunction further suggest that hearing impairment may also represent an early manifestation of neurodegenerative processes. Intervention studies have yielded mixed results. While hearing rehabilitation improves communication and quality of life, randomized evidence has not consistently demonstrated a reduction in cognitive decline in the general population, but potential benefits may exist in higher-risk subgroups. Increasing attention has been directed toward the ro

Hearing loss in midlife is an important and potentially modifiable risk factor for the development of dementia. Research examining the association between dementia and hearing loss has expanded rapidly; however, evidence for the mechanisms linking the two conditions is inconclusive, limiting the development of targeted interventions. This review provides a critical overview of current evidence on dementia risk in relation to hearing loss, proposed mechanisms underpinning this association, and emerging evidence on the effectiveness of hearing interventions in modifying trajectories of cognitive decline, dementia risk, and disease progression. Alongside its role as a risk factor, hearing loss commonly co-occurs with dementia, highlighting the need for integrated approaches to care that address the considerable impact of these co-morbid conditions on individuals and communities. Finally, we emphasise the importance of including diverse populations in future research to improve generalisability of findings and help advance equity in dementia prevention and care.