Hearing loss might seem like an inconvenience. You turn the TV louder, or choose quieter restaurants, or ask people to repeat themselves.

But it’s actually not just an annoyance — hearing loss is also linked with some serious health problems.

“We used to feel that hearing loss was a loss of communication opportunity and that was about it, but what has become clearer in the last several years is that there are much deeper cognitive and physical health implications,” says Donald Schum, vice president of audiology at Oticon, a hearing aid manufacturer.

Paul Farrell, associate director of audiology for the American Speech-Language-Hearing Association, outlines the types of health problems we’re talking about:

1. Social isolation, loneliness and depression

“Most adults develop hearing loss gradually over many years,” Schum says. Over time, you might gravitate away from experiences you no longer enjoy, like restaurants and parties, and toward less-social activities that don’t put as much demand on your hearing.  

“As older adults get more and more isolated, that can lead to stress and depression,” Schum says. It’s a downward spiral.

Communication difficulties isolate people, and then people become more depressed and stressed. 

Communication difficulties isolate people, and then people become more depressed and stressed.

“Their physical health starts to deteriorate as a result of these factors, and as their physical health deteriorates they become more isolated because they can’t participate. These factors are building on each other,” he says.

“Our big concern in audiology is that we believe we can stop some of that [downward spiral] earlier on if people are willing to do something about their hearing loss,” Shrum says. “We want to get more people to recognize that linkage and act.”

2. Cognitive impairment and dementia

There are a few different hypotheses about the link between hearing loss and decreased brain function, Farrell says. One says neither causes the other, but that neurodegeneration as you age causes both. 

Another thinks the energy the brain uses as you struggle to hear might deplete the energy the brain needs in other areas, Farrell says.

And a third suggests that the social isolation that can stem from hearing loss can lead to decreased sensory input, which can then lead to dementia.

“One of the best stimulations for the cognitive system is to be around other people, having a good conversation,” Shrum says. “When you start to lose that because of isolation you’re at greater risk of cognitive decline.”

He points to a British study that found that untreated hearing loss tops the list of factors leading to dementia that are under your control.

“We are in no way saying that getting hearing aids prevents dementia or Alzheimer’s — we’re not anywhere near that — but we do recognize how important social interaction is in the later years, and it’s tricky to create those environments for yourself if you allow yourself to become more isolated because of hearing loss,” Schum says. 

3. Falls

Farrell says a study of 2,000 people found that those with a higher degree of hearing loss had a greater risk of falling. It’s not yet clear what the connection is between falling and hearing loss. 

Schum says, “It’s a little premature to suggest that hearing loss causes falls. There’s some speculation about the mechanisms behind that, but it’s early days.” 

4-5. Diabetes and heart disease

Diabetes might affect the blood flow to the cochlea and lead to hearing loss, Farrell says. And while it could be that diabetes is causing hearing loss, not the reverse, hearing loss could still be an important indicator.

That’s because 8.1 million people in the United States with diabetes are undiagnosed.

And hearing loss in the low frequencies could indicate heart disease, though the connection is still unclear. “We’re seeing more and more evidence and continuing to discover the links between these serious conditions and hearing loss,” Schum says. 

A wide-ranging concern

Hearing loss is a common problem as you age. According to the National Institute on Deafness and other Communication Disorders, disabling hearing loss affects about 2% of adults aged 45 to 54, 8.5% of adults aged 55 to 64 and nearly 25% of those aged 65 to 74.

Schum says there are two reactions that adults often have that interfere with treatment for hearing loss. One is denial: “They say, ‘It’s not my hearing, people mumble.’”

The other is normalization. “It’s more subtle, but equally dangerous,” Schum says. That’s the assumption that your hearing is going to deteriorate as you get older, so you just accept the effects. “They think, ‘None of my friends can hear well,’ or ‘You should see my spouse.’”

“It’s really important for any individual who has hearing loss to ensure they have a good conversation with their physician and audiologist,” Farrell says. “Be open and honest about all the health conditions you’re being faced with.”