Exploring Age Differences in the Association between Hearing Aid Use and Dementia Diagnosis

Background

Hearing loss affects nearly two-thirds of adults in the United States over age 70. Older adults with limited socioeconomic resources often face barriers to accessing hearing care and cognitive screening services, potentially exacerbating disparities in dementia detection and treatment. Although hearing loss is linked to dementia risk, few studies have examined whether hearing aid use affects dementia diagnosis—especially whether this varies by age, despite both conditions becoming more common with age. This study aims to examine the association between hearing aid use and the probability of receiving a dementia diagnosis among older adults, and whether this association varies by age.

Methods

This study used a cross-sectional design with data from Round 13 (2023) of the National Health and Aging Trends Study (NHATS), including 5,624 Medicare beneficiaries aged 65 and older. Dementia diagnosis was defined using a NHATS binary variable based on self/proxy reports, screening test?, and cognitive test scores. Participants were coded as 1 = dementia and 0 = no dementia. Hearing aid use was measured by the item: “In the last month, have you used a hearing aid or other hearing device?” Responses were recoded into a binary variable (1 = used hearing aid; 0 = did not use hearing aid). Logistic regression was used to examine study aims. Covariates included gender, education, marital status, race/ethnicity, log-transformed income, and overall health status. Age was treated as a continuous variable.

Results

Logistic regression analysis showed that hearing aid use was not significantly associated with dementia diagnosis. However, a statistically significant interaction between hearing aid use and age was observed (OR = 0.88, p = .037). Further analysis shows that the likelihood of receiving a dementia diagnosis decreased with age among hearing aid users, while this trend was not observed among non-users. Additionally, several covariates were significantly associated with the likelihood of receiving a dementia diagnosis. Individuals with higher educational attainment (OR = 1.53, p < .001), those who were married or partnered (OR = 1.16, p = .050), those with greater income (OR = 1.12, p < .001), and those reporting better self-rated health (OR = 1.24, p < .001) had higher odds of receiving a dementia diagnosis.

Conclusions

Among hearing aid users, the likelihood of receiving a dementia diagnosis declined with increasing age, suggesting that hearing aid use may interact with age-related processes that shape how symptoms are expressed, recognized, or reported. This may be due to clearer communication, greater clinical engagement, or reduced stigma among older users.

Additionally, individuals with a partner, higher education, income, and better self-rated health were more likely to receive a dementia diagnosis. These findings likely reflect disparities in access to diagnostic services, where socioeconomically advantaged individuals may receive earlier or more frequent evaluations, while disadvantaged older adults may face underdiagnosis due to limited access, lower health literacy, or structural barriers to care.

Therefore, these results emphasize the importance of expanding access to hearing aids and ensuring equitable cognitive screening, particularly for older adults with fewer resources. Future studies should use longitudinal data.