In 2024 the British Society of Audiology (BSA), in collaboration with the British Academy of Audiology (BAA) and the British Society of Hearing Aid Audiologists (BSHAA), published a joint position statement on adult-onset hearing loss and dementia.
Much of the research literature in this area has focused on population-level risk. Our position statement instead addressed individual risk within a clinical context, with the aim of supporting hearing professionals in communicating evidence accurately and responsibly.
The guidance was developed to:
- Promote continuous professional development and ensure knowledge remains current.
- Support clinical and commercial practice grounded in evidence-based, critical thinking.
- Provide a framework that helps justify clinical decisions and actions while supporting autonomous professional practice.
The central message remains clear: hearing interventions have well-established benefits for hearing, communication, social participation, and quality of life. By helping people remain cognitively and socially engaged, these interventions can support active, independent, and healthy ageing.
However, the guidance also emphasises that there is currently no conclusive evidence that hearing loss causes dementia, nor that hearing interventions reduce the risk of developing dementia. For this reason, the association between hearing loss and dementia should not be used to justify the promotion or sale of hearing aids.
“International publications reach similar conclusions: there is no conclusive evidence that hearing loss causes dementia or that hearing aids reduce the risk.”
Since publication, the joint BSA/BAA/BSHAA statement has been widely disseminated and referenced internationally, including in a journal letter intended to raise awareness among the global hearing-care community. Its prominence in internet search results suggests that the guidance is reaching a broad professional audience.
Importantly, the position statement is consistent with current guidance from the World Health Organization (WHO), recent umbrella reviews of the evidence, and the conclusions of major systematic reviews examining hearing aids and cognitive outcomes. While epidemiological studies demonstrate a statistical association between hearing loss and dementia, correlation should not be interpreted as causation. Shared underlying factors may contribute to both dementia and multisensory loss, including hearing loss.
A recent article in The Hearing Review, a monthly resource for the hearing industry, outlined 10 recommendations for hearing professionals, encouraging the development of position statements and practice guidance addressing hearing and cognition. Although that article did not cite the BSA/BAA/BSHAA statement directly, it reached similar conclusions, provided similar guidance and used similar wording (see Table 1). We welcome the growing international consensus on a complex topic with ongoing uncertainties.
Table 1: Recommendations from BSA et al (2024) [2] and Sanchez et al (2026) [6]. Some statements have been paraphrased for brevity. (HL = hearing loss; HA = hearing aid).
Why clear communication matters
Despite publication of the joint position statement, misunderstanding and misreporting of the relationship between hearing loss and dementia continue. The evidence base has not changed substantially since 2024, and subsequent publications have largely reinforced the same core messages.
Clear, balanced communication can help individuals develop realistic expectations and make informed decisions about hearing care. We therefore encourage hearing professionals to familiarise themselves with the guidance and incorporate it into their clinical practice. Doing so helps ensure that services, procedures, and clinical decisions remain evidence-based, professionally accountable, and ethically sound.
Professional and ethical considerations
We remain concerned that some publications continue to present the hearing loss–dementia association as if it were evidence of a causal relationship. In some cases, clinicians are encouraged to highlight a possible dementia risk to patients in order to increase hearing-aid uptake.
Both UK and international guidance are clear that the association between hearing loss and dementia should never be used as a means of persuading someone to acquire hearing aids. Presenting dementia as a consequence of untreated hearing loss has the potential to create fear, anxiety, and significant emotional distress, and raises important issues of professional ethics.
Hearing professionals should therefore take care to communicate within the limits of the current evidence and within their professional scope of practice. Misleading or overstated claims may place clinicians at professional risk if they fail to follow established national guidance.
Ultimately, our shared goal is to maintain high-quality, evidence-based patient care while ensuring that hearing professionals practise within recognised professional and ethical boundaries.
References
Munro KJ, Dawes P, BSA, BAA and BSHAA. Explaining the link between adult-onset hearing loss and dementia to individuals with hearing loss. Int J Audiol 2025;64(8):861–862.
The link between adult-onset hearing loss and dementia: a guide for hearing professionals. Joint position statement of the BSA, BAA and BSHAA, 2024.
Chowdhary N, Barbui C, Anstey KJ, et al. Reducing the risk of cognitive decline and dementia: WHO recommendations. Front Neurol 2022;12:765584.
Tang D, Tran Y, Bennett RJ. The benefits of hearing aids for adults: a systematic umbrella review. Ear Hear 2025;46(3):563–570.
Dawes P, Munro KJ. Hearing loss and dementia: Where to from here? Ear Hear 2024;45(3):529–536.
Sanchez V, Hickson L, Rich S, et al. Addressing cognition and hearing: 10 recommendations for hearing professionals. The Hearing Review 2026.
Declaration of competing interests:
KJM is Director of the NIHR Research for Patient Benefit Programme. RW is employed by Diatec Diagnostics UK as Clinical Manager, including the development of courses and training relating to equipment supplied by Diatec.
This version adopts a collective BSA voice (“our position statement”, “we encourage”, “we remain concerned”) and removes wording that implied the article was written by an external publication about BSA.
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