Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts

Fan Jiang; Qiuyue Dong; Dona M.P. Jayakody; Xi Chen; Christoph Mueller; Bei Wu; Benjamin R. Underwood; Lijing L. Yan; Xinyu Li; Chiara Bruck; Gordon G. Liu; Wai-Kit Ming; Sha Feng; Chenkai Wu; Lianping Yang; Alimu Dayimu; Haibo Wang; Shanquan Chen; Lei Xu

doi:10.1016/j.xcrm.2026.102802

Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts

Fan Jiang (Co-first Author)
, Qiuyue Dong (Co-first Author)
, Dona M.P. Jayakody
, Xi Chen
, Christoph Mueller
, Bei Wu
, Benjamin R. Underwood
, Lijing L. Yan
, Xinyu Li
, Chiara Bruck
, Gordon G. Liu
, Wai-Kit Ming
, Sha Feng
, Chenkai Wu
, Lianping Yang
, Alimu Dayimu
, Haibo Wang
, Shanquan Chen^* (Co-last Author)
, Lei Xu^* (Co-last Author)

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

2 Citations (Scopus)

1 Downloads (CityUHK Scholars)

Abstract

Given the inconsistent evidence regarding hearing aid use and reduced dementia risk, this study evaluates whether hearing aid use, particularly effective use, is associated with lower probable dementia risk among hearing-impaired older adults. Using harmonized longitudinal data from 61,089 hearing-impaired participants (aged 55+ years) from seven cohorts (CHARLS, KLOSA, SHARE, ELSA, TILDA, HRS, and MHAS), we employ IPTW-corrected Cox models stratified by country income. Over a 6.5-year average follow-up (8,911 events), hearing aid use is associated with reduced dementia risk (hazard ratio [HR] = 0.91, 95% confidence interval [CI] 0.88–0.94). This association is confined to participants reporting effective hearing improvement (HR = 0.86, 95% CI 0.80–0.93), whereas those reporting poor hearing improvement show no reduced risk (HR = 0.98, 95% CI 0.90–1.07). The association is stronger in middle-income countries (HR = 0.76) and among subgroup populations, including those aged <70 years, women, those who are unmarried, and those with lower education. Quality hearing rehabilitation is a potential public health priority for addressing the dementia burden. © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

Original language	English
Article number	102802
Journal	Cell Reports Medicine
Volume	7
Issue number	5
Online published	12 May 2026
DOIs	https://doi.org/10.1016/j.xcrm.2026.102802
Publication status	Published - 19 May 2026

Funding

We acknowledge funding by grant of National Natural Science Foundation of China (NNSFC) (82471176 and 82071053) to L.X., NNSFC (72204143) to F.J.; and Natural Science Foundation of Shandong Province of China (ZR2022QG081) to F.J.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 4 Quality Education

Research Keywords

cognitive decline
global health
hearing aid effectiveness
hearing aids
hearing loss
longitudinal cohort study
modifiable risk factors
older adults
pooled analysis
probable dementia

Publisher's Copyright Statement

This full text is made available under CC-BY-NC 4.0. https://creativecommons.org/licenses/by-nc/4.0/

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10.1016/j.xcrm.2026.102802

491124849.pdfFinal Published version, 3.39 MBLicence: CC BY-NC

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Jiang, F., Dong, Q., Jayakody, D. M. P., Chen, X., Mueller, C., Wu, B., Underwood, B. R., Yan, L. L., Li, X., Bruck, C., Liu, G. G., Ming, W.-K., Feng, S., Wu, C., Yang, L., Dayimu, A., Wang, H., Chen, S., & Xu, L. (2026). Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts. Cell Reports Medicine, 7(5), Article 102802. https://doi.org/10.1016/j.xcrm.2026.102802

@article{9eba11c4f1494c259c4f2ede80f9f37b,

title = "Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts",

abstract = "Given the inconsistent evidence regarding hearing aid use and reduced dementia risk, this study evaluates whether hearing aid use, particularly effective use, is associated with lower probable dementia risk among hearing-impaired older adults. Using harmonized longitudinal data from 61,089 hearing-impaired participants (aged 55+ years) from seven cohorts (CHARLS, KLOSA, SHARE, ELSA, TILDA, HRS, and MHAS), we employ IPTW-corrected Cox models stratified by country income. Over a 6.5-year average follow-up (8,911 events), hearing aid use is associated with reduced dementia risk (hazard ratio [HR] = 0.91, 95\% confidence interval [CI] 0.88–0.94). This association is confined to participants reporting effective hearing improvement (HR = 0.86, 95\% CI 0.80–0.93), whereas those reporting poor hearing improvement show no reduced risk (HR = 0.98, 95\% CI 0.90–1.07). The association is stronger in middle-income countries (HR = 0.76) and among subgroup populations, including those aged <70 years, women, those who are unmarried, and those with lower education. Quality hearing rehabilitation is a potential public health priority for addressing the dementia burden. {\textcopyright} 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/",

keywords = "cognitive decline, global health, hearing aid effectiveness, hearing aids, hearing loss, longitudinal cohort study, modifiable risk factors, older adults, pooled analysis, probable dementia",

author = "Fan Jiang and Qiuyue Dong and Jayakody, \{Dona M.P.\} and Xi Chen and Christoph Mueller and Bei Wu and Underwood, \{Benjamin R.\} and Yan, \{Lijing L.\} and Xinyu Li and Chiara Bruck and Liu, \{Gordon G.\} and Wai-Kit Ming and Sha Feng and Chenkai Wu and Lianping Yang and Alimu Dayimu and Haibo Wang and Shanquan Chen and Lei Xu",

year = "2026",

month = may,

day = "19",

doi = "10.1016/j.xcrm.2026.102802",

language = "English",

volume = "7",

journal = "Cell Reports Medicine",

issn = "2666-3791",

publisher = "Cell Press",

number = "5",

}

Jiang, F, Dong, Q, Jayakody, DMP, Chen, X, Mueller, C, Wu, B, Underwood, BR, Yan, LL, Li, X, Bruck, C, Liu, GG, Ming, W-K, Feng, S, Wu, C, Yang, L, Dayimu, A, Wang, H, Chen, S & Xu, L 2026, 'Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts', Cell Reports Medicine, vol. 7, no. 5, 102802. https://doi.org/10.1016/j.xcrm.2026.102802

Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts. / Jiang, Fan (Co-first Author); Dong, Qiuyue (Co-first Author); Jayakody, Dona M.P. et al.
In: Cell Reports Medicine, Vol. 7, No. 5, 102802, 19.05.2026.

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

TY - JOUR

T1 - Hearing aid effectiveness and probable dementia risk across 33 countries

T2 - A pooled analysis of seven cohorts

AU - Jiang, Fan

AU - Dong, Qiuyue

AU - Jayakody, Dona M.P.

AU - Chen, Xi

AU - Mueller, Christoph

AU - Wu, Bei

AU - Underwood, Benjamin R.

AU - Yan, Lijing L.

AU - Li, Xinyu

AU - Bruck, Chiara

AU - Liu, Gordon G.

AU - Ming, Wai-Kit

AU - Feng, Sha

AU - Wu, Chenkai

AU - Yang, Lianping

AU - Dayimu, Alimu

AU - Wang, Haibo

AU - Chen, Shanquan

AU - Xu, Lei

PY - 2026/5/19

Y1 - 2026/5/19

N2 - Given the inconsistent evidence regarding hearing aid use and reduced dementia risk, this study evaluates whether hearing aid use, particularly effective use, is associated with lower probable dementia risk among hearing-impaired older adults. Using harmonized longitudinal data from 61,089 hearing-impaired participants (aged 55+ years) from seven cohorts (CHARLS, KLOSA, SHARE, ELSA, TILDA, HRS, and MHAS), we employ IPTW-corrected Cox models stratified by country income. Over a 6.5-year average follow-up (8,911 events), hearing aid use is associated with reduced dementia risk (hazard ratio [HR] = 0.91, 95% confidence interval [CI] 0.88–0.94). This association is confined to participants reporting effective hearing improvement (HR = 0.86, 95% CI 0.80–0.93), whereas those reporting poor hearing improvement show no reduced risk (HR = 0.98, 95% CI 0.90–1.07). The association is stronger in middle-income countries (HR = 0.76) and among subgroup populations, including those aged <70 years, women, those who are unmarried, and those with lower education. Quality hearing rehabilitation is a potential public health priority for addressing the dementia burden. © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

AB - Given the inconsistent evidence regarding hearing aid use and reduced dementia risk, this study evaluates whether hearing aid use, particularly effective use, is associated with lower probable dementia risk among hearing-impaired older adults. Using harmonized longitudinal data from 61,089 hearing-impaired participants (aged 55+ years) from seven cohorts (CHARLS, KLOSA, SHARE, ELSA, TILDA, HRS, and MHAS), we employ IPTW-corrected Cox models stratified by country income. Over a 6.5-year average follow-up (8,911 events), hearing aid use is associated with reduced dementia risk (hazard ratio [HR] = 0.91, 95% confidence interval [CI] 0.88–0.94). This association is confined to participants reporting effective hearing improvement (HR = 0.86, 95% CI 0.80–0.93), whereas those reporting poor hearing improvement show no reduced risk (HR = 0.98, 95% CI 0.90–1.07). The association is stronger in middle-income countries (HR = 0.76) and among subgroup populations, including those aged <70 years, women, those who are unmarried, and those with lower education. Quality hearing rehabilitation is a potential public health priority for addressing the dementia burden. © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

KW - cognitive decline

KW - global health

KW - hearing aid effectiveness

KW - hearing aids

KW - hearing loss

KW - longitudinal cohort study

KW - modifiable risk factors

KW - older adults

KW - pooled analysis

KW - probable dementia

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U2 - 10.1016/j.xcrm.2026.102802

DO - 10.1016/j.xcrm.2026.102802

M3 - RGC 21 - Publication in refereed journal

C2 - 42127901

SN - 2666-3791

VL - 7

JO - Cell Reports Medicine

JF - Cell Reports Medicine

IS - 5

M1 - 102802

ER -

Hearing aid effectiveness and probable dementia risk across 33 countries: A pooled analysis of seven cohorts

Abstract

Funding

UN SDGs

Research Keywords

Publisher's Copyright Statement

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