A study of more than 250 million health records suggests hearing aids could lower dementia risk in adults with epilepsy and hearing loss, highlighting a simple intervention that may help protect brain health.

Adults living with both epilepsy and hearing loss may be significantly less likely to develop dementia if they use hearing aids, according to research presented at the European Academy of Neurology (EAN) Congress 2026, offering fresh evidence that routine hearing checks could become an important part of epilepsy care.

Researchers from University Hospital Zurich and the University of Liverpool analysed electronic health records for well over 250 million patients in the global TriNetX network. They compared adults with hearing loss who used hearing aids with closely matched patients who did not. The analysis covered the general hearing-loss population and people with epilepsy, strokes, type 2 diabetes, chronic kidney disease, heart failure, migraines, and osteoarthritis.

The findings revealed a striking pattern. Hearing aid use showed no significant link with dementia risk in the wider hearing loss population or in people with strokes, diabetes, heart failure, and other chronic illnesses. However, among adults with both epilepsy and hearing loss, hearing aid users had a 23% lower risk of developing dementia over five years. The researchers also found an absolute risk reduction of 2.7 percentage points, meaning one case of dementia could potentially be prevented for every 37 people using hearing aids.

“What surprised us most was how specific the finding was to epilepsy. We expected to see a small benefit across several of the higher-risk groups we studied. Instead, we observed no significant association in most cases, while the association with epilepsy remained consistent across all of our analyses. That consistency provides us greater confidence that the result is a meaningful finding,” said lead author Dr Carolina Ferreira-Atuesta.

Scientists believe the explanation may lie in cognitive reserve—the brain's ability to keep working despite ageing or disease. People with epilepsy often have reduced cognitive reserve because repeated seizures can gradually damage brain networks. When hearing loss forces the brain to work harder to understand sounds, that extra mental effort may push an already vulnerable brain closer to dementia. A hearing aid restores clearer sound, reducing that daily strain.

“There are several biologically plausible reasons why we might see this effect in epilepsy. The condition is associated with accelerated cognitive decline; temporal lobe epilepsy affects areas of the brain involved in hearing, and some anti-seizure medications may worsen hearing,” Dr Ferreira-Atuesta explained.

The temporal lobe, the part of the brain that helps process sound, memory and language, is commonly affected in epilepsy. Some anti-seizure medicines may also contribute to hearing problems, creating a cycle that could further increase pressure on brain function.

The researchers stressed that the study was observational, meaning it found a strong association but cannot prove that hearing aids directly prevent dementia. Even so, the findings are supported by established evidence showing that untreated hearing loss is one of the largest modifiable risk factors for dementia worldwide, and hearing aids improve communication, reduce social isolation, and enhance quality of life.

“Hearing loss is one of the few dementia risk factors we can actually do something about,” said Dr Ferreira-Atuesta. “It’s easy to detect, and hearing aids are established, reversible, and low-risk. This is a real call for increased awareness and screening. We have a vulnerable population, a problem that’s straightforward to identify and a correction that’s simple to deliver.”

The researchers say future prospective clinical studies are needed to confirm whether hearing aids directly protect brain health. Meanwhile, they recommend that people living with epilepsy discuss regular hearing assessments with their healthcare team, as early treatment of hearing loss may offer benefits that extend well beyond better hearing.