October is National Audiology Awareness Month, and every year it comes with the same well-meaning reminder: get your hearing checked. It’s good advice. But at Gateway, we’d rather talk about why that advice matters more than most people realize — because the real story isn’t about hearing loss itself. It’s about what happens during the years people wait to address it.
The nine-year gap
Most people don’t treat hearing loss the moment they notice it. On average, people who eventually do seek treatment wait about nine years between first noticing a change and getting their first hearing aid, according to research published in Ear and Hearing. The National Institute on Deafness and Other Communication Disorders (NIDCD) puts the scale of the problem in perspective: roughly 28.8 million U.S. adults could benefit from hearing aids, yet fewer than one in five of them actually use one.
That gap isn’t really about awareness. Most people know their hearing has changed — they’re just waiting for it to feel urgent enough to act on. The research on what happens during that waiting period is what makes the case for acting sooner.
What the waiting period actually costs
Cognitive health. The most closely watched research on this comes from Dr. Frank Lin and colleagues at the Johns Hopkins Bloomberg School of Public Health and Cochlear Center for Hearing and Public Health. Longitudinal studies led by Lin’s team have found that even mild, untreated hearing loss is associated with meaningfully higher dementia risk, and that risk climbs with the severity of the loss. A 2023 study in JAMA, co-authored by Lin, found that older adults with more severe hearing loss were more likely to have dementia — but that likelihood was lower among people who used hearing aids. The 2017 Lancet Commission on Dementia Prevention went further, naming hearing loss the single largest potentially modifiable risk factor for dementia among the twelve it identified.
The encouraging half of this research is the ACHIEVE study, a large NIH-funded randomized trial Lin co-led. It found that hearing intervention — simply treating the hearing loss — measurably slowed the rate of cognitive decline over three years in older adults already at elevated risk. In other words, this isn’t a risk factor people are stuck with. It’s one of the few that responds directly to treatment.
Falls. Separate Johns Hopkins research led by Lin, using national health survey data, found that people with even mild hearing loss were about three times more likely to have a history of falling than people with normal hearing. One proposed explanation is cognitive load: when the brain has to work harder to process degraded sound, it has fewer resources left over for balance and spatial awareness — two things most people never think about until they’re compromised.
Everyday connection. Beyond the clinical research, the more immediate cost is relational. Untreated hearing loss is consistently linked to social withdrawal, strained communication with family, and disengagement at work — the everyday erosion that happens quietly, one skipped conversation at a time, long before anyone calls it a medical issue.
Why the wait happens anyway
None of this is about blame. Hearing loss is usually gradual, which makes it easy to adapt around rather than address — turning the TV up a little more each year, asking people to repeat themselves, sitting closer at meetings. By the time it’s disruptive enough to prompt an appointment, the adaptation has often been happening for years. That’s exactly why “get it checked” is easier said as advice than done as a habit — and why treating the wait as the real risk factor, not just the hearing loss itself, matters.
What this means at Gateway
Gateway’s audiology team sees this pattern regularly: people who come in describing a problem that’s been building for years, often prompted by a family member rather than their own sense of urgency. A hearing evaluation is a straightforward, non-invasive first step — it doesn’t commit anyone to a specific treatment, it simply gives a clear picture of where things stand, which is the piece most people are missing when they’re deciding whether to wait another year.
If you’ve been meaning to get your hearing checked, or you’ve noticed a family member turning the volume up a little more each year, National Audiology Awareness Month is as good a nudge as any to stop waiting on the wait.
Resources and further reading
- National Institute on Deafness and Other Communication Disorders (NIDCD), Quick Statistics About Hearing: nidcd.nih.gov
- Huang, A.R., Jiang, K., Lin, F.R., Deal, J.A., Reed, N.S. “Hearing Loss and Dementia Prevalence in Older Adults in the US.” JAMA, 2023.
- Johns Hopkins Bloomberg School of Public Health, ACHIEVE Study overview: publichealth.jhu.edu
- Johns Hopkins Medicine, “Hopkins researchers explore the link between hearing loss and dementia”
- Livingston, G. et al. “Dementia prevention, intervention, and care.” The Lancet Commission, 2017.
- American Academy of Audiology, National Audiology Awareness Month: audiology.org
- Hearing Loss Association of America, Hearing Loss by the Numbers: hearingloss.org
Note: This article is not a substitute for individualized medical advice. Anyone concerned about their hearing should speak with a licensed audiologist. Find on here: https://gatewaymaryland.org/services/audiology/
Learn More About Gateway Maryland
Gateway Maryland connects people to their worlds and aids individuals in their ability to understand and to be understood. Gateway Maryland has grown into an organization that serves more than 8,000 children and adults every year, helping them communicate more effectively. With programming both on our Baltimore campus and through community-based programming, we provide education, access, and medical support to anyone who needs it.
We envision a society where everyone can understand and be understood and where everyone is treated with integrity, compassion, and equity.
