Ear Health | brain health

Your ears are one of the biggest unlocks for long-term brain performance

Noise exposure doesn’t just affect hearing - it influences sleep, concentration, mood and, over many years, cognitive health. A growing body of research highlights this connection, and one of the clearest summaries comes from the 2020 Lancet Commission on dementia prevention, which identified hearing loss as the largest potentially modifiable risk factor for dementia (Livingston et al., 2020).

This doesn’t mean hearing loss directly causes dementia, or that everyone with changes in hearing will develop cognitive problems. It simply shows that supporting your hearing is an important, overlooked way to support brain health throughout life.

How hearing and cognition are connected

The Lancet Commission estimates that untreated hearing loss may contribute to just under 10% of dementia cases worldwide (Livingston et al., 2020). Several research-backed pathways explain this link:

Cognitive load

When hearing becomes more effortful, the brain must work harder to decode sound. Research shows this increased listening effort can reduce the resources available for memory and attention (Pichora-Fuller et al., 2016; Peelle et al., 2011).

Social engagement

Hearing difficulties can make conversations more tiring, especially in noisy settings. This can lead some people to reduce social activity. Social isolation is an established risk factor for cognitive decline (Shankar et al., 2013).

Changes in auditory brain regions

MRI studies have shown that untreated hearing loss is associated with reduced volume or activity in brain regions responsible for processing sound and speech (Lin et al., 2014; Peelle & Wingfield, 2016). These changes appear to reflect the brain adapting to reduced auditory input - they are not universal, but they help explain long-term cognitive effects.

Tinnitus, mood and sleep

Tinnitus - the ringing or buzzing that some people notice after loud sound exposure - varies widely in severity. While many people adapt well, research shows it can be associated with sleep disturbance, increased stress and changes in mood.

Studies suggest that:

• around 20% of people with chronic tinnitus experience depressive symptoms (Zöger et al., 2006)

• up to 40–50% report some degree of anxiety (Bhatt et al., 2017)

• sleep disturbance is common, and poor sleep often worsens tinnitus perception (Crönlein et al., 2016)

This doesn’t happen to everyone, but it explains why early awareness and ear protection can make a meaningful difference.

Supporting your ears to support your brain

The encouraging part of this story is that noise-related changes are largely preventable, and small habits can have a long-term impact.

Reduce unnecessary exposure

Limiting time in very loud environments and using protection when appropriate help preserve the delicate hair cells responsible for hearing clarity.

Know your noise dose

Understanding your personal exposure gives you a clearer sense of when your ears need a break - and when they don’t.

Act early if something feels different

If you notice persistent ringing or difficulty following conversations, early assessment can help maintain hearing clarity and reduce long-term listening effort.

Healthy listening habits

Keeping personal audio at comfortable levels and taking breaks during long listening sessions are simple steps that support hearing and cognitive health.

Final thoughts

Hearing and brain health are deeply connected. Looking after your ears isn’t about restriction - it’s about protecting the experiences, relationships and memories that rely on clear hearing and clear thinking. Small steps now can make a significant difference later on.

References

Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2017). Prevalence, severity, exposure and treatment patterns of tinnitus in the United States. JAMA Otolaryngology–Head & Neck Surgery, 142(10), 959–965.

Crönlein, T., Langguth, B., Pregler, M., Kreuzer, P., Wetter, T. C., & Schecklmann, M. (2016). Insomnia in patients with chronic tinnitus: cognitive and emotional distress as moderator variables. Behavioural Sleep Medicine, 14(5), 528–539.

Lin, F. R., Yaffe, K., Xia, J., et al. (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine, 173(4), 293–299.

Lin, F. R., Ferrucci, L., Metter, E. J., et al. (2014). Hearing loss and accelerated brain volume decline. NeuroImage, 90, 84–92.

Livingston, G., et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446.

Peelle, J. E., Gross, J., & Davis, M. H. (2011). Phase-locked responses to speech in human auditory cortex are enhanced during effortful listening. Cerebral Cortex, 21(6), 1377–1387.

Peelle, J. E., & Wingfield, A. (2016). The neural consequences of age-related hearing loss. Trends in Neurosciences, 39(7), 486–497.

Pichora-Fuller, M. K., Kramer, S. E., et al. (2016). Hearing impairment and cognitive energy: The framework for understanding effortful listening (FUEL). Ear and Hearing, 37, 5S–27S.

Shankar, A., Hamer, M., McMunn, A., & Steptoe, A. (2013). Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English longitudinal study of ageing. Psychosomatic Medicine, 75(2), 161–170.

Zöger, S., Svedlund, J., & Holgers, K. M. (2006). Relationship between tinnitus severity and psychiatric disorders. Psychosomatics, 47(4), 282–288.