The findings support late-life associations among hearing difficulty, loneliness, and cognitive performance but provide limited evidence that loneliness is a primary causal pathway linking hearing loss to cognitive aging; results were more consistent with shared liability, including overlap with neuroticism.
Key Findings
Results
At Wave 7 of SHARE, poorer hearing, greater loneliness, and poorer word-recall performance were associated, with a significant indirect association through loneliness.
Data came from the Survey of Health, Ageing and Retirement in Europe (SHARE), N = 10,375, with up to 18 years of follow-up.
Parallel-process latent growth curve models were used to examine level and change associations.
The level-based (Wave 7) association was cross-sectional in nature, so it describes late-life association rather than causation.
Results
Evidence for coordinated longitudinal mediation through loneliness was limited, and the primary change-to-change indirect effect was not significant.
Change in hearing did not significantly predict change in word recall through change in loneliness in the primary growth-curve model.
This contrasts with the significant indirect association seen at Wave 7 for levels.
Results
Current, but not cumulative, hearing-aid use was associated with a weaker concurrent hearing-loneliness association.
Hearing-aid moderation was evaluated as an additional analysis within the SHARE data.
Cumulative hearing-aid use did not show the same moderating pattern.
The moderation concerned the concurrent association between hearing and loneliness.
Results
Genetic analyses provided little evidence for direct or loneliness-mediated causal effects of hearing phenotypes on Alzheimer's disease or all-cause dementia.
Methods included Mendelian randomization, multivariable Mendelian randomization, and colocalization.
Summary statistics came from eight primary genome-wide association study sources.
Neither direct effects of hearing phenotypes nor effects mediated via loneliness were well supported.
Results
The genetic results were more consistent with shared liability among hearing, loneliness, and cognitive outcomes, including overlap with neuroticism.
An independent neuroticism dataset was used in sensitivity analyses.
Shared genetic liability, rather than a causal chain through loneliness, better fit the pattern of results.
Conclusions
The authors conclude that loneliness is not clearly a primary causal pathway from hearing loss to cognitive aging, and that etiology is more complex, supporting direct evaluation of hearing care and social connection in intervention studies.
Integrating longitudinal and genetic evidence pointed to shared liability.
The results support late-life associations among hearing difficulty, loneliness, and cognitive performance.
What This Means
This study asked whether hearing loss might harm thinking and memory in older adults partly by making people lonelier. The researchers combined up to 18 years of survey data from more than 10,000 older Europeans with large genetic datasets, and used several statistical approaches to test whether loneliness sits on a causal path between hearing problems and cognitive decline.
At a single late point in time, people with poorer hearing tended to be lonelier and to do worse on a word-recall memory test, and loneliness statistically accounted for part of the link. However, when the researchers looked at how hearing, loneliness, and memory changed together over time, they found limited evidence that loneliness explained the link. Using a hearing aid at the time of the survey was linked to a weaker connection between hearing difficulty and loneliness, but total years of hearing-aid use were not. The genetic analyses found little evidence that hearing problems cause Alzheimer's disease or dementia, either directly or through loneliness.
This research suggests that hearing difficulty, loneliness, and cognitive performance are related in later life, but that the relationship may reflect shared underlying vulnerabilities, such as personality traits like neuroticism, rather than a simple chain in which hearing loss leads to loneliness and then to cognitive decline. The authors call for intervention studies that directly test hearing care and social connection to learn whether they help protect cognition.
Yang S, Grilli M, Wootton R, van de Weijer M, Treur J, Klimentidis Y, et al.. (2026). Loneliness as a pathway linking hearing decline to cognitive aging: Longitudinal and genetic evidence.. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.71950