Adults with both epilepsy and hearing loss who use hearing aids may have a significantly lower risk of developing dementia than those who do not wear the devices, according to research presented at an international neurology conference.
Researchers from University Hospital Zurich and the University of Liverpool found hearing aid use was associated with a 23% lower risk of dementia among people living with both conditions, highlighting a potential opportunity to reduce cognitive decline in a particularly vulnerable patient group.
They presented an abstract of their research at the 12th European Academy of Neurology (EAN) Congress 2026 on 27 June 2026.
The team analysed electronic health records from more than 250 million patients in the TriNetX global health research network. They compared adults with hearing loss who used hearing aids against closely matched adults who did not, examining the overall hearing-loss population as well as people with epilepsy, stroke, migraine, type 2 diabetes, chronic kidney disease, heart failure and osteoarthritis.
While no significant association between hearing aid use and dementia risk was identified in the overall hearing-loss population or the other chronic disease groups, the findings were markedly different for people with epilepsy.
Among adults with epilepsy and hearing loss, hearing aid use was linked to an absolute risk reduction of 2.7 percentage points over five years, equating to one fewer case of dementia for every 37 people using hearing aids.
Lead author Dr Carolina Ferreira-Atuesta said the researchers had expected to see modest benefits across several high-risk patient groups.
“What surprised us most was how specific the finding was to epilepsy,” she said.
“We expected to see a small benefit across several of the higher-risk groups we studied. Instead, most showed no significant association, while the association in epilepsy was observed consistently across all of our analyses.”
She said the consistency of the results increased confidence that the association was meaningful, although the observational study could not establish cause and effect.
The researchers believe the findings may relate to reduced cognitive reserve in people with epilepsy. Cognitive reserve refers to the brain’s ability to maintain function despite ageing or disease-related damage.
“Most people with hearing loss have enough cognitive reserve to absorb the extra effort caused by hearing impairment,” Dr Ferreira-Atuesta said.
“Epilepsy is different because cognitive reserve is often already reduced, meaning that removing one additional source of strain may have a greater impact.”
She said there were several biologically plausible explanations for the finding, including accelerated cognitive decline associated with epilepsy, the involvement of hearing-related brain regions in temporal lobe epilepsy, and the potential for some anti-seizure medications to worsen hearing.
The researchers said the study also had implications for clinical practice. Because people with epilepsy were already reviewed regularly by healthcare professionals, hearing assessments could be incorporated into routine care.
“Hearing loss is one of the few dementia risk factors we can actually do something about,” Dr Ferreira-Atuesta said.
“It’s easy to detect, and hearing aids are established, reversible and low-risk. This is a real call for increased awareness and screening.”
She added that regardless of any potential impact on dementia risk, treating hearing loss offers well-established benefits for communication, mood and social connectedness.
The researchers said prospective studies were now needed to determine whether hearing aid use could directly help protect long-term brain health in people with epilepsy and hearing loss.
