Photo credit: lil artsy
by Daniel Fink, MD, Chair, The Quiet Coalition
The February 2025 issue of Frontiers in Public Health has an article by Chinese researchers reporting a correlation between noise exposure, occupational hearing loss and cognitive impairment. The Frontiers family of publications is an open-access peer-reviewed group of journals, but it is not in the same league as journals such as The Lancet, The New England Journal of Medicine, or any of the JAMA Network journals. I have also learned to be careful about relying on information from articles written by researchers I haven’t heard of at institutions I also am not familiar with, which is the case here. Unfortunately, research from China is especially suspect. Finally, I don’t understand the statistical methods used in the article.
With those caveats, the article is interesting and perhaps even worrisome. The researchers correlated cumulative occupational noise exposure with noise-induced hearing loss (NIHL), and then measured cognitive abilities using the Mini-Mental State Exam and the Montreal Cognitive Assessment tool. The results showed that cumulative noise exposure was associated both with hearing loss and cognitive impairment. The researchers concluded that “job-related noise exposure is not only associated with NIHL, but also with early cognitive impairment in occupational groups. However, there is not enough evidence indicating that NIHL mediates the associations.” What is most concerning to me about the results is that the mean age of the subjects was only 34.3, with 62.3% of the subjects having a college degree or more education. These are individuals who should not be showing any signs of cognitive impairment!
I would take this as a preliminary report indicating the need for further research. It has been known for more than a decade that there is a strong correlation between hearing loss and dementia in older people, with greater hearing loss being associated with a greater risk of dementia. The Lancet has recognized hearing loss as one of the most important potentially modifiable factors causing dementia. Research is under way to determine if providing hearing aids to older people who need them will reduce or delay the onset of dementia. If hearing loss is shown to be associated with cognitive impairment in relatively young adults, maybe this will motivate individuals, public health authorities and regulators to do more to reduce noise exposure.
A quieter world would be a better and healthier world for all.
