A large U.S. study has found that among people living with dementia (PLWD) who report functional hearing loss, those who use hearing aids experience fewer and less severe neuropsychiatric symptoms (NPS) compared to those who do not.
The research, published online in The American Journal of Geriatric Psychiatry, analyzed data from more than 10,000 older adults in the National Alzheimer’s Coordinating Center’s Uniform Data Set (NACC-UDS). The team examined whether self-reported hearing loss and hearing aid use were associated with the number and severity of NPS—symptoms such as depression, agitation, apathy, and anxiety, which are common in dementia and linked to poorer outcomes, higher caregiver burden, and increased mortality.
Study Overview
The study included 10,054 participants, with an average age of 75.2 years. Nearly one in four (24%) reported functional hearing loss. Within this group, 54.8% said they used hearing aids.
Researchers adjusted for demographic and clinical factors and, in the subsample with hearing loss, applied a statistical technique called nearest neighbor matching to account for potential selection bias in hearing aid use.
While functional hearing loss itself was not associated with a higher number or greater severity of NPS, hearing aid use among those with hearing loss was linked to measurable differences. After matching and adjustment, hearing aid use was associated with an average of 0.71 fewer NPS and 1.79 lower NPS severity score compared to non-use.
Potential Non-Pharmacological Intervention
Lead author Ahjeetha Shankar, BS, and colleagues noted that these findings suggest hearing aid use may represent an underutilized, non-drug strategy to help manage behavioral and psychological symptoms in dementia.
“Hearing aid use among persons living with dementia and concurrent functional hearing loss may have a role in the management of NPS,” the authors wrote. “These findings highlight the importance of identifying and addressing hearing loss as part of comprehensive dementia care.”
Neuropsychiatric symptoms affect between 61% and 97% of people with dementia, depending on disease stage, and are a major contributor to caregiver stress and healthcare costs.
Non-drug interventions are increasingly being explored as safer alternatives to medications, which may carry risks in this population.
Next Steps for Research
The authors emphasized the need for further research to confirm causality and explore how hearing care can be integrated into dementia management plans. They noted that improving access to hearing aids could be particularly impactful, given the high prevalence of hearing loss in this group—affecting more than 90% of people with dementia.
“This study underscores the potential benefits of hearing care for individuals with dementia,” the researchers concluded. “Future studies should investigate the mechanisms linking hearing aid use and neuropsychiatric symptoms and evaluate the long-term outcomes of hearing intervention in this population.”
Reference:
Ahjeetha Shankar, Emmanuel E. Garcia Morales, Jeannie-Marie Leoutsakos, Valerie T. Cotter, Milap A. Nowrangi, Sevil Yasar, Constantine G. Lyketsos, Esther S. Oh, Carrie L. Nieman, Hearing Loss, Hearing Aid Use, and Neuropsychiatric Symptoms among Persons Living with Dementia: Findings from NACC, The American Journal of Geriatric Psychiatry, 2025, ISSN 1064-7481, https://doi.org/10.1016/j.jagp.2025.07.007.
