Audiometric Hearing Loss and the Risk of Developing Dementia Over Eight Years in Older Black and White Adults: Findings from the Atherosclerosis Risk in Communities Neurocognitive Study - Scorecard - MDSpire
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Audiometric Hearing Loss and the Risk of Developing Dementia Over Eight Years in Older Black and White Adults: Findings from the Atherosclerosis Risk in Communities Neurocognitive Study

  • By

  • Jennifer A. Deal

  • John J. Shin

  • Kening Jiang

  • A. Richey Sharrett

  • Josef Coresh

  • Rebecca F. Gottesman

  • David S. Knopman

  • Thomas Mosley

  • Keenan A. Walker

  • Frank R. Lin

  • Nicholas S. Reed

  • April 9, 2026

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Clinical Scorecard: Audiometric Hearing Loss and the Risk of Developing Dementia Over Eight Years in Older Black and White Adults: Findings from the Atherosclerosis Risk in Communities Neurocognitive Study

At a Glance

CategoryDetail
ConditionAudiometric hearing loss and its association with dementia and mortality
Key MechanismsHearing loss as a risk factor for dementia potentially through cognitive decline; racial disparities may reflect social and structural factors rather than biological differences
Target PopulationOlder adults aged 68–89 years, including Black and White racial groups
Care SettingCommunity-based epidemiologic and clinical research settings with audiometric and cognitive assessments

Key Highlights

  • Moderate-to-severe hearing loss is associated with increased risk of dementia similarly in Black and White older adults.
  • Moderate-to-severe hearing loss is linked to a 2.3-fold increase in mortality among Black participants only.
  • Racial disparities in hearing healthcare access and treatment may impact health equity and dementia outcomes.

Guideline-Based Recommendations

Diagnosis

  • Use audiometric pure-tone threshold testing (0.5–4 kHz) to categorize hearing loss severity.
  • Adjudicate dementia diagnosis using neurocognitive tests, proxy reports, and hospital/death records.

Management

  • Include hearing loss treatment (hearing aids and aural rehabilitation) as a potential intervention to delay cognitive decline.
  • Address racial disparities in hearing healthcare access to improve outcomes.

Monitoring & Follow-up

  • Conduct longitudinal follow-up for cognitive function and mortality in patients with hearing loss.
  • Monitor hearing loss progression and its impact on dementia risk across racial groups.

Risks

  • Recognize increased mortality risk associated with moderate-to-severe hearing loss in Black older adults.
  • Consider social determinants and structural racism as factors influencing hearing healthcare disparities.

Patient & Prescribing Data

Older adults aged 68–89 years, including 22% self-identified Black participants

Hearing interventions may delay cognitive decline by nearly 50%, with benefits observed across racial groups though representation in trials is limited.

Clinical Best Practices

  • Incorporate routine audiometric screening in older adults to identify hearing loss early.
  • Promote equitable access to hearing healthcare services for minoritized populations.
  • Use multidisciplinary approaches combining audiology and cognitive assessments for comprehensive care.
  • Educate patients and caregivers about the link between hearing loss and dementia risk.
  • Support research inclusive of diverse racial groups to inform policy and clinical guidelines.

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