Summary: Can a simple ear surgery protect your memory? A major new study suggests the answer is yes.
By analyzing data from over 363,000 participants in the NIH’s All of Us Research Program, researchers discovered that two treatable middle ear conditions, eardrum perforations and cholesteatoma (abnormal skin growth), are linked to nearly double the odds of developing dementia. Crucially, the study found that when these conditions were treated with surgery or hearing aids, the elevated dementia risk significantly decreased or disappeared entirely.
Key Findings
- The Risk Factor: Participants with a perforated eardrum had twice the odds of dementia, while those with cholesteatoma had nearly double the risk compared to those with healthy hearing.
- The “Cure” for Cognitive Risk: For those with cholesteatoma, surgical treatment made the association with dementia nonsignificant, effectively “resetting” the risk profile to that of a healthy individual.
- Hearing Aids as a Shield: Using hearing aids also reduced the dementia link for both conditions, reinforcing the theory that keeping the brain “plugged in” to sound is vital for cognitive health.
- A Targeted Exception: Otosclerosis (a bone-related middle ear condition) was not significantly linked to dementia in this specific study, suggesting that certain types of hearing loss may impact the brain differently.
Source: AAO
A new study published in Otolaryngology–Head and Neck Surgery, the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF), finds that two common and treatable causes of conductive hearing loss—eardrum perforations and cholesteatoma, a type of abnormal skin growth in the middle ear—are associated with higher odds of dementia.
Notably, the study also found that treatment, whether through surgery or hearing aids, was associated with a reduction in that elevated risk.
The findings, first presented at the AAO-HNSF 2025 Annual Meeting & OTO EXPO in Indianapolis, Indiana, add to a growing body of evidence linking hearing loss to cognitive decline and raise an important question: if the underlying cause of hearing loss is treatable, could treating it help protect the brain?
“We have known for some time that untreated hearing loss is related to worse cognition in adults. This study shows that specific forms of surgically addressable hearing loss are also adversely related to cognition.
“But what is most exciting is that treatment with routine surgery may improve both the hearing and possibly reduce the risk of dementia,” said Justin S. Golub, MD, MS, corresponding author on the paper from the Department of Otolaryngology–Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center.
Researchers at Columbia University and the University of Utah analyzed data from more than 363,000 participants in the All of Us Research Program, a large and diverse national health dataset sponsored by the National Institutes of Health.
They found that participants with eardrum perforations had more than twice the odds of dementia compared to those without, and those with cholesteatoma had nearly twice the odds. Otosclerosis, a condition affecting the bones of the middle ear, was not significantly associated with dementia in this study.
Importantly, when surgical treatment was accounted for in the analysis, the association between cholesteatoma and dementia became nonsignificant. Treatment with hearing aids also reduced the association for both conditions, suggesting that restoring hearing, whether through surgery or devices, may play a meaningful role in lowering dementia risk.
Key Questions Answered:
A: It’s all about “cognitive load.” When you have conductive hearing loss, your brain has to work much harder to decode sound. This extra effort “steals” resources from other functions like memory. Additionally, social isolation caused by poor hearing can lead to brain atrophy.
A: The study found that for cholesteatoma, surgery made the dementia risk “nonsignificant.” While it’s not a 100% guarantee, restoring the physical pathway for sound appears to be one of the most effective ways to lower the biological risk associated with hearing loss.
A: Good news: the study found that hearing aids were also associated with a reduction in dementia risk. The key is simply restoring the flow of auditory information to the brain, whether through a device or a surgical fix.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this dementia and auditory neuroscience research news
Author: Tina Maggio
Source: AAO
Contact: Tina Maggio – AAO
Image: The image is credited to Neuroscience News
Original Research: Closed access.
“Conductive Hearing Loss Pathologies are Associated With Dementia in the All of Us Research Program” by Powell, S.D., Weinstein, H.N.W., Tucker, L.H., Denham, M.W., Gurgel, R.K. and Golub, J.S. Otolaryngology – Head and Neck Surgery
DOI:10.1002/ohn.70152
Abstract
Conductive Hearing Loss Pathologies are Associated With Dementia in the All of Us Research Program
Objective
Recently, conductive hearing loss (CHL) has been associated with dementia in two large independent cohorts. However, the disease-specific association with dementia is unknown. We investigate the association of specific CHL pathologies and dementia in a large national cohort.
Study Design
Cross-sectional epidemiologic study.
Setting
NIH All of Us Research Program.
Methods
Participants were ≥18 years old (n = 396,194). The exposures were CHL pathologies defined by ICD-10 code: cholesteatoma (H71.X), tympanic membrane (TM) perforation (H72.X), and otosclerosis (H80.X). The outcome was all-cause dementia defined by ICD-10 codes (F01, F03, G30-32). The odds of dementia in subjects with and without a CHL pathology were assessed with multivariable regression including age, sex, education, race, and ethnicity. Additional analyses included treatments.
Results
The mean (SD) age was 55 years (±17). After controlling for covariates, the odds of dementia were 1.77 times (1.08-2.73; P = .015) higher for cholesteatoma compared to those without, 2.09 times (1.68-2.59; P < .001) higher for TM perforation, and were nonsignificant for otosclerosis. After adding surgical treatment, odds of dementia dropped to 1.40 (0.82-2.27; P = .198) for cholesteatoma and 2.01 (1.60-2.50; P < .001) for TM perforation.
Conclusions
Cholesteatoma and TM perforation were associated with dementia in the All of Us Research Program. Treatment attenuates these relationships. Given the general implausibility for dementia to cause these CHL pathologies, reverse causation—that dementia causes hearing loss—is an unlikely explanation for the association. This study adds to the evidence that cognition is impacted by sensory deprivation but extends to correctable conductive causes.
