Background: One-third of persons age 60 y+ have hearing loss, and hearing loss is a leading preventable risk factor for dementia. We estimated the number of age-associated dementia cases attributable to hearing loss in 2022.
Methods: We used DeciBHAL, a validated microsimulation\of hearing loss that includes age- and sex-specific annual probabilities of incident hearing loss (0·1-10·4%) and dementia (0·3-7·1%). Utility decrements are incorporated yearly, based on hearing loss (-0·13 to -0·31) and dementia severity (-0·04 to -0·42), to calculate quality-adjusted life-years (QALYs). We estimated dementia incidence for persons with and without hearing loss by removing the estimated proportion attributable to hearing loss (adjusted incidence risk ratio, 2·0 [range: 1·5-2·5]). We projected two cohorts: the general US population and a hypothetical US population without hearing loss (counterfactual). We applied model-projected dementia incidence and utility among both cohorts to the 74,190,000 US adults >60 y and without dementia in 2022.
Results: Model-projected incident cases of dementia are 412,000/year (males) and 523,000/year (females). In the simulation without hearing loss, dementia cases/year fall to 339,000 for males and 455,000 for females projecting that 141,000 new dementia cases in 2022 would be attributable to hearing loss. In probabilistic sensitivity analysis, 95% of simulations projected the proportion of dementia cases attributable to hearing loss were 11·5-23·6% for males and 6·7-18·7% for females. Hearing loss and associated dementia reduced life-time QALYs by 1.38 for females and 1.69 for males.
Conclusion: Model-projected estimates support that hearing loss prevention could substantially reduce new dementia cases and should be a priority.
Keywords: decision modeling; dementia; hearing loss.
© The Author(s) 2026. Published by Oxford University Press on behalf of the Gerontological Society of America.