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Linking sensory loss to cognitive decline

Originally published: Jul 9, 2025
Last modified: Jul 10, 2025
Article from McMaster Optimal Aging
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The Bottom Line

  • Researchers have found links between sensory loss (e.g., hearing and/or vision) and declines in cognitive performance.  

  • Older adults who have sensory impairments are more likely to experience future cognitive declines (e.g., in memory). But we still do not know the reasons for sensory-cognitive connections.  

  • Utilize early sensory screening and protection for eyes and ears. 

Sensory loss has been linked to cognitive decline. A large body of evidence suggests that individuals with hearing and/or vision loss have an increased risk of developing cognitive impairments, including dementia (although not everyone with a sensory loss develops dementia) (1-3). We do not yet know how exactly sensory losses and cognition are linked but several possible explanations are discussed. Taking preventative measures to protect your sensory health and addressing sensory challenges when they arise are key to preserving your cognitive function and reducing risk for dementia.

 

What the research tells us

A landmark study from the USA in 2013 reported that older adults with hearing loss had a 24% increased risk of cognitive decline compared to those with normal hearing (1). Since then, many other studies have reported similar findings of links between hearing loss and cognitive decline (2). Vision loss also increases the risk for cognitive decline (3). Untreated vision loss has been added to the list of potentially modifiable risk factors for dementia (4). Research in Canada found that hearing and vision loss together (i.e., dual-sensory loss) are linked to declining cognitive performance in older adults (5).

 

New research evidence from a 2024 review predicts that 9% of dementia cases could be reduced if hearing loss (7%) and vision loss (2%) were eliminated (4).

Researchers have proposed three possible explanations for the links between sensory and cognitive functions:

  • The same health issues (e.g., poor heart health or diabetes) can cause both sensory impairments and poorer brain health (7).
  • Staying active is good for brain health, but sensory impairments can make it more difficult for people to stay active. People with sensory impairments often have lower physical activity levels (8;9) and less social interactions (10). In turn, reduced physical and social isolation have been shown to increase the risk of cognitive decline and dementia (11;12). 
  • Poor hearing and vision make it harder for the brain to understand and/or remember information. Over time, the structure of the brain and how the brain uses information may change permanently (7). The brain may have to work harder and it may become more difficult to do two things at the same time (e.g., listening to the radio while driving a car or talking to a friend while crossing the road) (13). 

 

Recommendations 

  • Protect your senses: Use protection to avoid damage to the eyes and ears.
  • Check your senses: Using free online tests to check hearing and vision can help people to recognize if they have sensory problems, starting at age 50.  
  • Seek help if you have sensory problems: People should seek help and information about how to live with sensory impairments as soon as they notice sensory problems.  
  • Use your senses to stay active: Hearing and seeing better may make it easier and more enjoyable to participate in regular physical and social activities (e.g., engaging in meaningful conversations or doing sports with friends). In turn, these activities are good for brain health (14-16). 

References

  1. Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Medi. 2013; 173(4): 293-299. doi: 10.1001/jamainternmed.2013.1868.
  2. Loughrey DG, Kelly ME, Kelley GA, et al. Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: A systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018; 144(2):115-126. doi: 10.1001/jamaoto.2017.2513.
  3. Ehrlich, JR, Goldstein J, Swenor B, et al. Addition of vision impairment to a life-course model of potentially modifiable dementia risk factors in the US. JAMA Neurol. 2022; 79(6):623-626. doi: 10.1001/jamaneurol.2022.0723.
  4. Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024; 404(10452):572-628. doi: 10.1016/S0140-6736(24)01296-0.
  5. Phillips N, Isler L, Kabir R, et al. Hearing and visual acuity predict cognitive function in adults aged 45-85 years: Findings from the baseline wave of the Canadian Longitudinal Study on Aging (CLSA). Psychol Aging. 2022; 37(8):891-912. doi: 10.1037/pag0000716.
  6. The Lancet. Risk factors for dementia. [Internet] 2024. [cited January 2025]. Available from: https://www.thelancet.com/infographics-do/dementia-risk
  7. Uchida Y,  Sugiura S. Nishita Y, et al. Age-related hearing loss and cognitive decline—The potential mechanisms linking the two. Auris Nasus Larynx. 2019; 46(1):1-9. doi: 10.1016/j.anl.2018.08.010.
  8. Assi S, Twardzik E, Deal JA, et al. Hearing loss and physical activity among older adults in the United States. J Gerontol A Biol Sci Med Sci. 2024; 79(1):glad186. doi: 10.1093/gerona/glad186.
  9. Ong SR, Crowston JG, Loprinzi PD, et al. Physical activity, visual impairment, and eye disease. Eye. 2018; 32(8): 1296-1303. doi: 10.1038/s41433-018-0081-8.
  10. Mick P, Parfyonov M, Wittich W, et al. Associations between sensory loss and social networks, participation, support, and loneliness: Analysis of the Canadian Longitudinal Study on Aging. Can Fam Physician. 2018; 64(1):e33-41.
  11. Evans IE, Martyr A, Collins R, et al. Social isolation and cognitive function in later life: A systematic review and meta-analysis. J Alzheimers Dis. 2019 70(s1):S119-44. doi: 10.3233/JAD-180501.
  12. Blondell SJ, Hammersley-Mather R, Veerman JL. Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies. BMC Public Health. 2014; 14:1-2. doi: 10.1186/1471-2458-14-510.
  13. Fortunato S, Forli F, Guglielmi V, et al. A review of new insights on the association between hearing loss and cognitive decline in ageing. Acta Otorhinolaryngologica Ital. 2016; 36(3):155. doi: 10.14639/0392-100X-993.
  14. Kelly ME, Duff H, Kelly S, et al. The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review. Syst Rev. 2017; 6:1-8. doi: 10.1186/s13643-017-0632-2.
  15. Domingos C, Pêgo JM, Santos NC. Effects of physical activity on brain function and structure in older adults: A systematic review. Behav Brain Res. 2021; 402:113061. doi: 10.1016/j.bbr.2020.113061.
  16. Liu-Ambrose T, Barha CK, Best JR. Physical activity for brain health in older adults. Appl Physiol Nutr Metab. 2018; 43(11):1105-12. doi: 10.1139/apnm-2018-0260.

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