Updated guidance on risk reduction of cognitive decline and dementia from the World Health Organisation: implications for hearing professionals
Recent World Health Organization (WHO) guidance on reducing the risk of cognitive decline and dementia includes hearing loss among a number of potentially modifiable risk factors. The WHO recommendation states:
“To reduce the risk of cognitive decline and/or dementia, hearing aids may be offered to adults with hearing loss.”
What is the evidence?
The WHO has rated the certainty of the evidence as low, meaning confidence in the estimated effect is limited and the true effect may be substantially different from current estimates. This reflects the fact that most available evidence comes from observational studies rather than high-quality randomised controlled trials (RCTs).
The low certainty of the evidence means WHO cannot be confident that hearing aids reduce cognitive decline and/or dementia, and it is not possible for WHO to make a “strong” recommendation of hearing aids use on this basis. The strength of the recommendation is regarded as “conditional” (weak), indicating that hearing aids are unlikely to cause harm but may reduce cognitive decline. This represents a change from the 2019 WHO guidance, where evidence was considered “insufficient” to support a recommendation. A Cochrane review on hearing aids for mild to moderate hearing loss did not provide evidence from RCTs that hearing aids were effective at improving working memory (prioritised important outcome, very low certainty), and the other eight subdomains of cognition were rated as either low or very low certainty of evidence.
What does this mean for hearing professionals?
The WHO guidance should not be interpreted as evidence that hearing aids prevent dementia. Rather, it recognises that hearing loss is associated with dementia and it is possible that hearing aid use may (or may not) have a role in reducing dementia risk, while acknowledging that the supporting evidence remains limited.
Hearing well helps us to grow, live and age well, but we do not know if hearing loss causes dementia or if hearing aids reduce the risk. Hearing interventions facilitate an active, independent, engaged and healthy life. Hearing professionals should continue to recommend hearing aids primarily for their established benefits, including:
- Improved listening ability
- Improved communication
- Greater participation in everyday activities
- Reduced listening effort
- Enhanced quality of life
Notably, these established benefits may support brain health in a broader sense through a socially connected and engaged life. This does not mean that hearing aids will prevent dementia. Dementia risk is influenced by a range of factors, with hearing loss one piece of a larger picture (and not the leading personal risk).
The association between hearing loss and dementia should not be used to coax patients into acquiring hearing aids or promoting hearing aids to prevent dementia.
Existing Professional Guidance Remains Unchanged
The WHO recommendations do not replace condition-specific professional guidance from organisations such as the joint guidance from British Society of Audiology (BSA), the British Academy of Audiology (BAA), and the British Society of Hearing Aid Audiologists (BSHAA) that was issued in 2024. Current UK guidance on the link between adult-onset hearing loss and dementia remains unchanged. This message was repeated in a recent article by Windle et al (2026) on behalf of the three organisations.
References
British Society of Audiology, British Academy of Audiology, the British Society of Hearing Aid Audiologists 2024. The link between adult-onset hearing loss and dementia. [Online]. Accessed July 22, 2026. Available from https://baaudiology.org/professional-information/hearing-loss-and-dementia/ [Link last accessed July 2026].
Ferguson MA, Sarant JZ, Bennett RJ, McIlhiney P, Badcock N, Bothe E (provisionally accepted). Hearing aids for mild to moderate hearing loss in adults. Cochrane Database of Systematic Reviews.
Windle R, Munro KJ, Dawes P. 2026. Getting the message right on hearing loss and dementia: Are we reaching a consensus on how hearing professionals should talk about hearing loss and dementia? ENT & Audiology News ENT & Audiology News, July/August 2026 35(3). https://www.entandaudiologynews.com/features/audiology-features/post/getting-the-message-right-on-hearing-loss-and-dementia
World Health Organisation 2026. Risk reduction of cognitive decline and dementia: WHO guidelines, second edition. Geneva: World Health Organization; 2026. https://www.who.int/publications/i/item/9789240123557