Would you rather lose your sight or your hearing?
It's an agonizing question to consider. Most folks might instinctively want to protect their vision at all costs. After all, we humans are visual creatures. And we naturally fear the dark. Losing our sight feels like losing total independence.
But Helen Keller lived without both – and her answer might surprise you.
After becoming blind and deaf due to illness at just 19 months old, Keller famously defied the odds to become a world-renowned author, disability-rights advocate, and the first blind-and-deaf person to earn a college degree.
And it was in a 1910 letter to a doctor where she admitted this:
The problems of deafness are deeper and more complex, if not more important, than those of blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus – the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man.
Longtime readers know that among the many hats I've worn, one of them is ophthalmology. As an eye doctor, I spent my career helping folks protect their vision. I know firsthand how much we all dread losing our sight.
But Keller understood a painful truth about what happens after losing one's hearing... She recognized how it cuts you off from the people around you. And more than a century later, the science shows that this isolation does far more than just ruin your social life...
Letting your hearing fade threatens your brain, independence, and overall longevity. And it's becoming a big problem for many folks...
According to the Hearing Loss Association of America, more than 50 million Americans – about 1 in 7 people nationwide – have some kind of hearing loss. It's the No. 3 most common chronic physical condition in the U.S. – twice as common as diabetes or cancer.
And a staggering 65.3% of Americans aged 71 and older grapple with hearing loss.
Many folks treat hearing loss as a minor annoyance...
Of the nearly 29 million U.S. adults who could actively benefit from wearing hearing aids, fewer than 1 in 5 use them. And most delay treatment for years – often close to a decade – after first noticing symptoms.
But don't settle for turning up the TV volume. Addressing hearing loss early on is about preserving the quality of your life... including your mental health.
Your ears matter far more than you might realize. So let's take a close look at the connection between your hearing and your overall health…
The Hearing-Brain Axis
Hearing isn't just one of your five senses – it's a foundation for thinking, remembering, and interacting with the world around you. And if you neglect it, you may start paying the price in your brain – long before you notice it.
To understand the connection, we need to first understand a little about how we actually hear...
Hearing involves the ear and brain – the former for sound detection and the latter for sound interpretation.
In your inner ear lies a tiny, snail-shell-shaped, three-chambered, fluid-filled organ called the cochlea. It's lined with thousands of microscopic sensory hair cells that convert sound-wave vibrations in the fluid into an electrical signal that your brain can understand.
But aging, loud noises, and poor diet can take a toll on your hair cells. The ensuing damage can make them malfunction or, worse, die off.
And once a hair cell in your inner ear dies, it never grows back.
With fewer of these functioning hair cells, your brain stops getting crisp, clear signals. Instead, it gets a muffled, distorted mess. Your brain has to work harder to make sense of it.
Scientists believe that the degraded sound makes your brain allocate more resources to understanding speech... leaving less capacity for memory and higher-level thinking. Studies have shown that as hearing difficulty increases, performance on memory tasks declines. This is called the cognitive load hypothesis.
Mental fatigue aside, when the brain's auditory pathways lose stimulation from clear sound, the brain physically changes, losing volume.
A 2014 study of 126 older adults over a roughly six-year period found that those with hearing loss experienced faster rates of brain atrophy – especially in the temporal-lobe regions responsible for processing sound and language.
Also, a November JAMA Network Open study looked at hearing tests, cognitive assessments, MRI brain scans, and dementia risk using data from more than 2,000 participants in the Framingham Heart Study (a multigenerational project that has tracked health outcomes since 1948).
Researchers found that at the least, mild hearing loss was linked to having smaller brain volume and a faster decline in executive function (i.e., the mental skills that help you plan, focus, and multitask).
The team also noted even slight hearing loss was associated with greater abnormalities in white matter (the "wiring" parts of the brain that connect different brain regions for processing information quickly).
And among participants aged 60 and older, those with at least slight hearing loss had a roughly 70% higher risk of developing dementia over 15 years versus those with normal hearing.
So hearing loss can be an early marker of brain vulnerability. And negative effects in the brain can begin even in the early stages of hearing loss, which folks often chalk up to "just getting old."
How Hearing Loss Harms Your Heart
Beyond the brain, untreated hearing loss poses a danger to your heart, physical safety, and happiness...
With all of those tiny hair cells, the inner ear needs a lot of energy to function. That calls for a rich, constant supply of blood and oxygen, all delivered by a structure in the cochlea called the stria vascularis.
Think of this structure as your inner-ear battery... It powers the hair cells so they can do their job.
The stria vascularis is chock-full of tiny blood vessels that deliver oxygen and nutrients needed by the cochlea. And research increasingly links conditions that damage blood vessels to significantly higher rates of hearing loss...
For instance, a 2018 study in JAMA Otolaryngology–Head & Neck Surgery looked at hearing loss in 433 Americans aged 80 and older.
Researchers linked hypertension, Type 2 diabetes, a history of stroke, and coronary artery disease to a faster decline in hearing ability... And coronary artery disease had the strongest association.
The team concluded that treating cardiovascular disease "may prevent or slow the progression of hearing loss" and that hearing loss "may suggest underlying cardiovascular disease."
More recently, a 2024 issue of the same journal published a meta-analysis of 10 studies with more than 1.6 million participants. It found that individuals with hearing loss face a roughly 26% to 38% higher risk of experiencing a stroke, coronary artery disease, or other cardiovascular events.
A drop in your hearing ability isn't exactly a crystal ball pointing to a heart attack... But like a canary in a coal mine, it's an early warning. It shows your circulatory system may be under strain – especially at the level of your body's smallest and most vulnerable blood vessels.
Heart health aside, older adults face two other big health problems that relate to hearing loss. I covered them – and shared my four practical tips for healthy hearing – in my April Retirement Millionaire issue. If you're not already a subscriber, click here to learn how to get started.
What We're Reading...
- Something different: This is the world's loudest person.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
June 25, 2026