Key takeaways (for Australia)
Untreated hearing loss remains a modifiable risk factor for dementia. The 2024 Lancet Standing Commission reconfirmed hearing loss in its 14 modifiable risk factors list. Read the 2024 update. Health and Ageing Department The first large RCT, ACHIEVE (Lancet, 2023), found a best-practice hearing-care program (hearing aids + rehab) slowed cognitive decline by ~48% over 3 years in older adults at higher risk of decline. Overview. Health and Ageing Department In Australia, the Department of Health & Aged Care reports ~3.6 million Australians—about 1 in 6—live with some level of hearing loss, underlining the scale of early detection and treatment. Fact sheet PDF. Health and Ageing Department NeuRA and its CEO Professor Matthew Kiernan AM are leading national work on dementia prevention and risk reduction. Kiernan has publicly emphasized that dementia risk can be reduced via lifestyle and modifiable factors (which include hearing loss). ABC explainer with Kiernan. ABC
Why hearing loss matters for brain health
Large cohort studies link hearing impairment with higher dementia risk. The Lancet 2024 update synthesises this evidence and again lists hearing loss among modifiable risks across the life course—meaning earlier identification and management are sensible components of dementia-risk reduction. Lancet 2024. Health and Ageing Department
NeuRA’s Australian leadership. Neuroscience Research Australia (NeuRA) leads research on dementia prevention in our context (e.g., cognitive ageing and dementia epidemiology). NeuRA’s dementia & healthy ageing program. NeuRA NeuRA also co-led a regional roadmap highlighting prevention (including hearing loss) as part of an urgent public-health response. NeuRA–Lancet Regional Health WPR series. NeuRA
What the gold-standard trial (ACHIEVE) showed
Population: 977 adults, 70–84 years, mild–moderate hearing loss. Intervention: best-practice hearing care (fitting, verification, counselling/rehab) vs active health-education control. Result: In the higher-risk subgroup, hearing intervention slowed global cognitive decline by ~48% over 3 years; no difference was seen in a healthier, lower-risk subgroup over the same timeframe. ACHIEVE key findings. Health and Ageing Department
Implication for practice: The benefit is greatest when there is untreated hearing loss and meaningful baseline dementia risk—so timely intervention matters.
Where NeuRA and Prof. Matthew Kiernan AM fit in
Prof. Matthew Kiernan AM (NeuRA CEO & Institute Director) has been a national voice for earlier action on dementia risk reduction, consistently highlighting the role of modifiable risks. In ABC’s coverage of prevention strategies, he underscores that lifestyle changes can reduce risk—aligning with the Lancet’s modifiable factors, which include hearing loss. ABC explainer. ABC NeuRA’s own communications emphasise prevention and risk-reduction pathways for Australians and support the National Dementia Action Plan. NeuRA dementia page • NeuRA magazine (Prof. Kiernan’s comment). NeuRA+1 NeuRA’s analysis has also highlighted that hearing loss is now recognised among modifiable risks for dementia—reinforcing a prevention lens where hearing care belongs. NeuRA opinion note. NeuRA
Do hearing aids actually change dementia risk?
Randomised evidence: ACHIEVE shows clinically meaningful slowing of cognitive decline—with a full, best-practice hearing-care pathway—in higher-risk older adults. The Lancet RCT overview. Health and Ageing Department Meta-analyses and reviews continue to report associations between hearing-device use and lower risk of cognitive decline/dementia versus leaving hearing loss untreated. (Association ≠ causation, but the direction aligns with RCT findings.) JAMA Neurology 2023. Dementia Australia
Transparency note: A 2023 UK Biobank analysis about hearing aids and dementia risk was retracted in 2024; conclusions here don’t rely on it. Retraction notice. Health and Ageing Department
Australia’s numbers: why early intervention can’t wait
Scale: ~3.6 million Australians (≈1 in 6) live with some level of hearing loss. Dept. of Health & Aged Care fact sheet (PDF). Health and Ageing Department Trajectory: Government-backed reports anticipate substantial growth in prevalence by 2060, sharpening the case for prevention and early care. Roadmap for Hearing Health (PDF). Health and Ageing Department Service lens: Hearing Services Program statistics track device fittings and access; expanding timely uptake is a policy priority. HSP statistics collection. Health and Ageing Department
When should you act? (Age-based guidance grounded in the research)
Short answer for Australians:
Midlife (40s–50s): Don’t “wait until it’s bad.” Midlife is repeatedly flagged as a critical window to modify dementia risk factors, including hearing loss. If you notice difficulty in noise, TV creep, or fatigue from listening—get a hearing test and treat confirmed loss. Lancet 2024. Health and Ageing Department 50+: At minimum, baseline test once (earlier/more often with noise exposure, diabetes, smoking, cardiovascular risks, family history). Contemporary clinical guidance focuses screening and management here. Context overview. The Australian 70–84 with untreated loss + added risk (e.g., hypertension, diabetes, isolation): ACHIEVE shows a meaningful slowing of cognitive decline with a full hearing-care program. Don’t delay. ACHIEVE. Health and Ageing Department
What we do in-clinic (mapped to the evidence Australia cares about)
Assessment (esp. ≥50 or earlier with risk/symptoms): full audiometry + needs assessment. Evidence-based fitting & rehab (real-ear verification, communication coaching, family involvement)—the same pillars used in ACHIEVE. ACHIEVE protocol summary. Health and Ageing Department Follow-up & support: fine-tuning, listening-strategy training, periodic reviews; integrate with broader brain-health advice consistent with NeuRA and Dementia Australia messaging on risk reduction. NeuRA dementia hub • Dementia Australia on modifiable risks. NeuRA+1
References & further reading (Australia-first where possible)
Department of Health & Aged Care (Australia): Supporting patients with hearing loss (states ~3.6M Australians; early intervention). PDF. Health and Ageing Department Hearing Services Program statistics (ongoing). Collection. Health and Ageing Department Roadmap for Hearing Health. PDF. Health and Ageing Department NeuRA (Neuroscience Research Australia) & Prof. Matthew Kiernan AM: Dementia & Healthy Ageing research focus (prevention lens). NeuRA. NeuRA Regional roadmap on dementia prevention (WPR). Media release. NeuRA Kiernan on risk reduction and prevention (ABC). Article. ABC NeuRA magazine (Kiernan comment supporting National Dementia Action Plan). PDF. NeuRA NeuRA note: depression and hearing loss added to modifiable risk list in regional work. Opinion. NeuRA Global evidence (for context): Lancet Standing Commission 2024 update. Full text. Health and Ageing Department ACHIEVE RCT (hearing-care vs health education). Key findings. Health and Ageing Department JAMA Neurology 2023 meta-analysis on devices & cognition/dementia risk. Open. Dementia Australia
A clear, age-based message for Australians (clinic-ready)
40s–50s: If you’re noticing any hearing difficulties, test and treat—don’t wait. Midlife is where prevention pays off. Health and Ageing Department 50+: Get a baseline hearing check; treat confirmed loss and review regularly (especially with cardiovascular/metabolic risks). The Australian 70–84 with risk factors: A comprehensive hearing-care program can slow cognitive decline. Act now. Health and Ageing Department