Why Untreated Hearing Loss Matters

Hearing loss rarely announces itself. The TV creeps up a notch each year, the jokes at the bowls club land a beat late, and phone calls quietly become something to avoid. Because it happens so gradually, most people get remarkably good at working around it. Research suggests the average person waits about nine years between the point hearing aids would first help and the day they actually get them.

Nine years is a long time to work that hard at every conversation. And in the last few years, researchers have built a much clearer picture of what untreated hearing loss can quietly cost, not just in missed words, but in social life, mood and possibly long-term brain health. None of it is a reason to panic. All of it is a reason to get a free hearing check sooner rather than later.

The quiet cost of “I’m managing fine”

Hearing loss is very common at this stage of life. Australian studies find measurable hearing loss in around half of people over 70, and some estimates put it closer to three in four. So if this is you or your parent, you’re in plentiful company.

The trouble is what “managing” actually looks like day to day. Following a conversation with damaged hearing takes real mental effort. Your brain fills the gaps, guesses from context, reads lips a little. It works, mostly. It’s also exhausting. Many people describe coming home from a family gathering more tired than they can explain.

So people start skipping the noisy restaurant. Then the church morning tea. Then the phone calls, because voices without faces are the hardest of all. Nobody decides to withdraw. It happens one avoided situation at a time.

The research backs up what families notice. Large reviews of the evidence consistently find that older adults with hearing loss report more loneliness and social isolation than those who hear well, and studies also link hearing loss with higher rates of depressive symptoms. These are associations rather than proof of cause, but they point the same direction: struggling to hear makes it harder to stay connected, and staying connected is one of the things that keeps us well.

What the research says about hearing and the brain

This is the part that makes headlines, so it’s worth getting right. Two pieces of research matter most, and both are more encouraging than the scary versions you may have seen.

The Lancet Commission: hearing tops the list

Every few years, an international group of dementia researchers publishes a major report in The Lancet, one of the world’s leading medical journals, on what’s known about preventing dementia. The 2024 report identified 14 factors across a lifetime that, taken together, are linked to around 45 percent of dementia cases worldwide. Hearing loss sits at the top of that list, tied with high cholesterol, linked to about 7 percent of cases.

“Linked to” is doing careful work in that sentence. Nobody has proven that hearing loss causes dementia, and having hearing loss certainly doesn’t mean you’ll develop it. What the Commission concluded is that hearing is one of the largest factors we can actually change, and that the evidence that treating hearing loss may reduce risk had grown stronger since their previous report. That’s the useful takeaway. Of everything on that list, a hearing check is one of the easiest boxes to tick.

The ACHIEVE trial: an honest result

The other study you may have heard about is the ACHIEVE trial, published in The Lancet in 2023. It’s the first big randomised trial of its kind: 977 American adults aged 70 to 84 with untreated hearing loss, half given hearing aids and audiologist support, half given a health education programme instead, then followed for three years.

The headline result was mixed, and it’s better to know that than to be sold a miracle. Across all participants, thinking and memory scores changed about the same in both groups. But there’s a wrinkle. Most participants were healthy community volunteers whose thinking barely declined in three years, so there was little for hearing aids to slow. Among the group who started with more risk factors for cognitive decline, the hearing aid group’s decline was about 48 percent slower. That’s a striking difference, and researchers are following everyone for longer to see whether it holds up.

The fair summary: hearing aids aren’t proven to prevent dementia, and anyone who tells you otherwise is overreaching. But for people at higher risk, there’s a real signal that treating hearing loss may help protect thinking. And unlike most things on the dementia risk list, this one pays you back immediately, in conversations you stop missing.

What this means, and what it doesn’t

If you take one thing from the science, make it this: hearing care is health care. We don’t wait a decade to get glasses when print goes blurry, and hearing deserves the same footing. The case for a hearing check doesn’t rest on dementia risk anyway. Less strain, more energy, staying in the conversation, those benefits are certain, and they start the week your hearing is sorted.

Why people wait, and why earlier is easier

If people wait nine years on average, there are reasons. Hearing fades so slowly that there’s never an obvious moment to act. Old ideas about hearing aids linger, big beige things that whistle, even though modern aids are small, discreet and clever. And cost worries stop plenty of people before they start, which is a shame, because government help exists, and Pensioner Concession Card and DVA card holders can get hearing aids at no cost. The basic hearing check itself is often free too.

Here’s the part fewer people know. Acting earlier isn’t just about avoiding harm. It’s genuinely easier. Hearing happens in the brain as much as the ears, and when hearing fades for years, the brain slowly gets out of practice at processing certain sounds. Start wearing hearing aids while the loss is mild and the adjustment tends to be quicker and more comfortable. Wait a decade and the brain has more relearning to do, which is one reason some late starters give up on aids that would have delighted them five years sooner.

Signs worth acting on

You don’t need to be sure. That’s what the test is for. But these are the everyday flags that a check is due:

• The TV volume creeps up, or others say it’s too loud
• You hear people talking but can’t always make out the words
• Group conversations and cafes have become hard work
• You find yourself avoiding phone calls
• Family mention it. They usually notice a year or two before you do

If you’re reading this about a parent rather than yourself, we’ve written a companion guide on the signs a parent needs a hearing check, and how to raise it kindly.

Gentle next steps

None of this needs to happen this week, and none of it commits you to hearing aids. A hearing check is just information. Plenty of people walk out with a clean result and peace of mind.