Hearing Aids and Cochlear Implants in the Prevention of Cognitive Decline and Dementia—Breaking Through the Silence

Dementia is extremely common and presents a sizable economic cost to societies. Given that its prevalence and resulting financial burden on health care systems are expected to balloon in the context of an aging population and a lack of a cure, public policy strategies aimed at reducing the prevalence of this disease often focus on addressing its modifiable risk factors. Hearing loss has recently been recognized as one of the greatest of these modifiable risk factors. Hearing interventions, including both hearing aids and cochlear implants, have previously been investigated as possible means of lowering the incidence of dementia. These research efforts have mostly consisted of observational studies due to the high costs of providing hearing aids or cochlear implants to large groups in randomized clinical trials (RCTs) and the need for lengthy follow-up. In the case of cochlear implants, recruitment challenges arise for trials that would randomize individuals to an elective surgery involving device implantation. Because of these impediments to running RCTs, there is a critical need in the literature for robust meta-analyses to justify further inquiry.