May 2026 Update: Understanding the Connection Between Hearing Health and Overall Wellness

Holistic hearing healthcare

In this issue

• Hearing loss and overall health: Bridging the perception gap 

• The gut-ear axis: First evidence and implications for daily practice 

• Evidence-based perspective on hearing loss and cognitive health 

• Tapping into the double potential of hearing interventions 

  
  

Hearing loss and overall health: Bridging the perception gap

Understanding how people perceive the broader impacts of their hearing loss is essential for effective counseling and holistic patient care. Data from the EuroTrak’s Germany 2025 survey¹ reveal a noteworthy consumer insight: 

43% of people with self-reported hearing loss do not believe there is a correlation between their hearing loss and other health issues¹, despite established scientific evidence linking untreated hearing loss with an increased risk of falls², social isolation³, and cognitive decline⁴. This gap between clinical data and patient perception underscores a persistent need for targeted patient education. 

The findings highlight an opportunity to strengthen patient understanding of the broader impact of untreated hearing loss on health by 

• Proactively educating patients about the benefit of hearing care on cognitive, emotional, and physical health in routine consultations. 

• Personalizing messages using relatable examples to show how addressing and treating hearing loss can impact overall health and wellbeing. 

• Leveraging collaborative care pathways to reinforce the importance of hearing care on overall health and wellbeing. 

By aligning communication with clinical evidence, professionals can support patients not only in seeking hearing care earlier, but also potentially support them in achieving better overall outcomes.⁵ 

References

1 EuroTrak Germany 2025, retrieved from https://www.ehima.com/wp-content/uploads/2025/04/EuroTrak_GERMANY_2025.pdf

2 Jiam, N.T.-L., Li, C., & Agrawal, Y. (2016). Hearing loss and falls: A systematic review and meta-analysis. The Laryngoscope, 126(11), 2587–2596. https://doi.org/10.1002/lary.25927

3 Shukla, A., Harper, M., Pedersen, E., Goman, A., Suen, J. J., Price, C., … Reed, N. S. (2020). Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology–Head and Neck Surgery, 162(5), 622–633. https://doi.org/10.1177/0194599820910377

4 Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., Samus, Q., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet (London, England), 404(10452), 572–628. https://doi.org/10.1016/S0140-6736(24)01296-0

5 Stropahl, M., Scherpiet, S., & Launer, S. (2024). Viewpoint on the benefit of hearing care on cognitive health. American Journal of Audiology, 33(2), 606-610. https://doi.org/10.1044/2024_AJA-23-00176

The gut-ear axis: First evidence and implications for daily practice

First evidence suggests that gut health may play a role in hearing function, including conditions such as tinnitus and sensorineural hearing loss.^1,2,3,4 Although most evidence today comes from animal models and direct cause-and-effect relationships are still under investigation, these findings indicate alignment with clinical observations connecting overall health and hearing outcomes. 

Experimental research in mice models show that chronic gut inflammation can lead to widespread inflammation in the body which may also negatively affect the inner ear.¹ Disruption of the gut microbiota has been associated with increased inflammation and oxidative stress in the cochlea, which may impair hearing sensitivity. Conversely, improving gut microbiota balance appears to have protective effects on auditory function, suggesting that systemic inflammatory processes may mediate communication between the gut and the ear.¹ 

Clinical conditions such as inflammatory bowel disease and celiac disease provide additional real-world examples of this connection.² Patients with these disorders show higher rates of auditory and neurological symptoms, including sensorineural hearing loss, likely related to immune activation and increased intestinal permeability.^1,2 

New data also suggests a link between gut microbiota and tinnitus. A recent large-scale study indicates that certain types of gut bacteria were linked to a higher or lower chance of having tinnitus. The results suggest that this link is not just a coincidence but that changes in gut bacteria may actually play a role in tinnitus risk. Gut health could affect brain connectivity or neural pathways, which in turn may mediate tinnitus symptoms. This supports the idea of a gut–brain-ear-connection, where gut microbiota may affect the brain and neuroinflammation which may influence tinnitus.⁴  

While translational research needs to mature, incorporating gut–ear axis concepts into daily practice as part of a holistic, systems-based, and multidisciplinary approach to hearing health may have an effect on tinnitus prevention and treatment.⁴ 

 References

1 Pisani, A., Petito, V., Paciello, F., Emoli, V., Masi, L., Hizam, V. M., Puca, P., Montuoro, R., Chierico, F. D., Putignani, L., Grassi, C., Galli, J., Taglialatela, M., Caristo, M. E., Ianiro, G., Lopetuso, L. R., Cammarota, G., Gasbarrini, A., Fetoni, A. R., & Scaldaferri, F. (2025). Intestinal inflammation and microbiota modulation impact cochlear function: emerging insights in gut-ear axis. Cell communication and signaling : CCS, 23(1), 357. https://doi.org/10.1186/s12964-025-02338-1 

2 Kociszewska, D., & Vlajkovic, S. M. (2022). The Association of Inflammatory Gut Diseases with Neuroinflammatory and Auditory Disorders. Frontiers in bioscience (Elite edition), 14(2), 8. https://doi.org/10.31083/j.fbe1402008  

3 Yin, Q., Shi, G., & Zhu, L. (2023). Association between gut microbiota and sensorineural hearing loss: a Mendelian randomization study. Frontiers in microbiology, 14, 1230125. https://doi.org/10.3389/fmicb.2023.1230125 4 Fang, C., Lin, L., Chen, W., Xu, Q., Tong, Z., Sun, S., Chen, Y. C., Liang, M., & Cai, Y. (2025). The hidden gut-brain connection in tinnitus: Insight from a cross-sectional and genetic causal mediation study in over 900,000 individuals. NeuroImage, 322, 121565. https://doi.org/10.1016/j.neuroimage.2025.121565  

Evidence-based perspective on hearing loss and cognitive health

The impact of untreated hearing loss on different aspects of life including overall health is often underestimated. Given the high global prevalence of hearing loss – affecting around 1,5 billion people worldwide¹ - and the growing body of research examining the relationship with cognitive health, this aspect has become a key focus in contemporary hearing care.² 

More and more studies exploring both the role of untreated hearing loss in cognitive decline and the impact of hearing intervention on cognitive health have been conducted at a population or group level.^{3,4,5,6,7,8,9} While these findings provide important insights, including the importance of early intervention, they make it difficult to predict the individual risk or the potential benefits of intervention for a given patient.² 

Two recent studies focused on the short-term effect of hearing aid use on cognitive performance. ^10,11 Schafer and colleagues demonstrated significant improvements in cognitive performance, self-assessed hearing difficulties, and noise acceptance after two and four months of hearing aid use. Participants with lower fluid cognition at baseline showed greater improvements in working memory. In addition, average test performance was associated with both hearing thresholds and daily hearing aid usage time.¹⁰ 

Toptas et al. examined the influence of unilateral and bilateral hearing aid fittings on cognition and verbal fluency in patients with presbycusis found measurable cognitive improvements, regardless of the fitting type.¹¹ 

Even though the effects of hearing care on reducing dementia risks are still unclear, the findings of the two mentioned studies highlight the value of hearing intervention on the brain and reinforce that the benefits of hearing solutions extend beyond improved hearing alone. 

References

1 World Health Organization. World report on hearing. World Health Organization, 2021. 

2 Stropahl, M., Scherpiet, S., & Launer, S. (2024). Viewpoint on the benefit of hearing care on cognitive health. American Journal of Audiology, 33(2), 606-610. https://doi.org/10.1044/2024_AJA-23-00176 

3 Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., ... & Coresh, J. (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. The Lancet, 402(10404), 786-797. https://doi.org/10.1016/S0140-6736(23)01406-X 

4 Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., Samus, Q., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet (London, England), 404(10452), 572–628. https://doi.org/10.1016/S0140-6736(24)01296-0 

5 Loughrey, D. G., Kelly, M. E., Kelley, G. A., Brennan, S., & Lawlor, B. A. (2018). Association of Age-Related Hearing Loss With Cognitive Function, Cognitive Impairment, and Dementia: A Systematic Review and Meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 144(2), 115–126. https://doi.org/10.1001/jamaoto.2017.2513 

6 Lin, F. R., Yaffe, K., Xia, J., Xue, Q. L., Harris, T. B., Purchase-Helzner, E., ... Health ABC Study Group (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine, 173(4), 293–299. https://doi.org/10.1001/jamainternmed.2013.1868 

7 Taljaard, D. S., Olaithe, M., Brennan-Jones, C. G., Eikelboom, R. H., & Bucks, R. S. (2016). The relationship 

between hearing impairment and cognitive function: a meta-analysis in adults. Clinical Otolaryngology, 41(6), 718–729. https://doi.org/10.1111/coa.12607 

8 Croll, P. H., Vinke, E. J., Armstrong, N. M., Licher, S., Vernooij, M. W., Baatenburg de Jong, ... Ikram, M. A. (2021). Hearing loss and cognitive decline in the general population: a prospective cohort study. Journal of Neurology, 268(3), 860–871. https://doi.org/10.1007/s00415-020-10208-8 

9 Sarant, J. Z., Busby, P. A., Schembri, A. J., Fowler, C., & Harris, D. C. (2024). ENHANCE: a comparative prospective longitudinal study of cognitive outcomes after 3 years of hearing aid use in older adults. Frontiers in Aging Neuroscience, 15, 1302185. https://doi.org/10.3389/fnagi.2023.1302185 

10 Schafer, E. C., Miller, S., Lam, B. P. W., Lee, D., Lohrey, M., Eason, A., Nedrud, C., Cairo, K., Olvera, G., Klarmann, R., Brooks, B., Cumiskey, B., Kruse, C., Johnson, D., Laroi, A., & Musselman, M. (2025). Impact of Short-Term Hearing Aid Use on Cognitive Performance, Noise Acceptance, and Self-Perceived Benefit. American Journal of Audiology, 34(3), 707–721. https://doi.org/10.1044/2025_AJA-25-00039 

11 Toptas, G., Doluoglu, S., Arslan, E., Er, S., Soylemez, D., & Dagli, M. (2025). Impact of hearing aid use on cognitive skills and verbal fluency in patients with presbycusis. Irish Journal of Medical Science (1971-), 194(5), 1805-1809. https://doi.org/10.1007/s11845-025-04036-w 

Tapping into the double potential of hearing interventions

A recent analysis of 33,741 individuals of waves 1–9 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) by the University of Geneva focused on profiles of social isolation and loneliness (e.g., non-isolated but lonely) and if those profiles explain the association between hearing impairment and cognition over time across domains.¹ The profiles identified were 

• Isolated and lonely 

• Connected but lonely 

• Isolated but not lonely. 

They found that higher levels and worsening self-reported hearing impairment were associated with lower cognitive performance. Additionally, profiles that where not isolated but felt lonely were linked to accelerated episodic memory decline compared to the non-isolated and not lonely profiles.¹  

These findings support that untreated hearing loss may lead to social isolation and/or loneliness which can have further impact on cognitive health.² Hearing intervention is an effective treatment to improve audibility and communication which can help to maintain social connectedness.^3,4  

This aligns with a recent systematic review and meta-analysis investigating the impact of hearing aids and cochlear implants on social outcomes.⁵ 65 studies were included in the systematic review as well as 35 articles in the meta-analysis including overall over 8,000 participants. Their findings show that, compared to before using hearing solutions or non-users, hearing rehabilitation with cochlear implants or hearing devices is associated with improved social quality of life and decreased perception of social handicap.  

Auditory rehabilitation can have benefits that go beyond audibility which will help people with hearing impairment to stay socially connected and have a better quality of life.  

References

1 Lampraki, C., Zuber, S., Turoman, N., Joly-Burra, E., Mack, M., Laera, G., ... & Ihle, A. (2025). Profiles of social isolation and loneliness as moderators of the longitudinal association between uncorrected hearing impairment and cognitive aging. Communications psychology, 3(1), 101.https://doi.org/10.1038/s44271-025-00277-8 

2 Shukla, A., Harper, M., Pedersen, E., Goman, A., Suen, J. J., Price, C., … Reed, N. S. (2020). Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology–Head and Neck Surgery, 162(5), 622–633. https://doi.org/10.1177/0194599820910377https://doi.org/10.1177/0194599820910377 

3 Ferguson, M. A., Kitterick, P. T., Chong, L. Y., Edmondson‐Jones, M., Barker, F., & Hoare, D. J. (2017). Hearing aids for mild to moderate hearing loss in adults. Cochrane Database of Systematic Reviews, (9).  https://doi.org/10.1002/14651858.CD012023.pub2 

4 Reed, N. S., Chen, J., Huang, A. R., Pike, J. R., Arnold, M., Burgard, 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. doi:10.1001/jamainternmed.2025.1140 

5 Hori, K., Shah, R., Paladugu, A., Gallagher, T. J., Jang, S. S., Weinfurter, E. V., ... & Choi, J. S. (2025). Social Outcomes Among Adults With Hearing Aids and Cochlear Implants: A Systematic Review and Meta-Analysis. JAMA Otolaryngology–Head & Neck Surgery, 151;(8):806-816. doi:10.1001/jamaoto.2025.1777