Does Tinnitus Cause Dementia?

Tinnitus does not directly cause dementia, although many research studies show a correlation between the two. With the growing awareness of both tinnitus and dementia, it’s understandable that people are concerned. But it's important to fact check claims made in popular journals because simply having tinnitus will not cause dementia.

However, severe tinnitus is often linked to factors that may elevate dementia risk, including sleep disorders, chronic stress, anxiety, and brain inflammation. Addressing these issues is crucial—not just for tinnitus relief, but for protecting overall brain health and thus reducing your risk of dementia.

In this article, I will guide you through the evidence systematically—first by discussing cognitive impairment and dementia, then exploring the strong link between hearing loss and dementia, and finally addressing the key question: Does tinnitus cause dementia?

• Does Tinnitus Increase The Risk Of Dementia?
• How Is Hearing Loss Linked To Dementia?
• How Does Tinnitus Cause Dementia?
• Can Treating Tinnitus Help Prevent Dementia?
• Is Cognitive Impairment from Tinnitus Reversible?

Mild Cognitive Impairment vs. Dementia

It’s essential to understand the differences between mild cognitive impairment and dementia.

• Mild Cognitive Impairment (MCI): MCI represents a stage between normal cognitive aging and more severe conditions like dementia. People with MCI experience noticeable memory or thinking problems but can still function in everyday life.

Importantly, not all individuals with MCI progress to dementia—in fact, many remain stable, and over 30% actually revert to normal cognition with time [1].

• Dementia: Dementia is a clinical diagnosis based on the presence of symptoms like memory loss, difficulty with language, impaired reasoning, and trouble with daily tasks. Dementia is progressive, meaning that it worsens over time, often leading to total dependence on caregivers.

The key differences between MCI and early dementia lie in the severity of mental decline and its impact on daily life. While MCI involves noticeable mental challenges, early dementia leads to more significant impairment, especially in everyday functioning. Here's a breakdown:

MCI (Mild Cognitive Impairment):

• Noticeable memory or thinking problems but minimal impact on daily life.
• Represents a transitional phase between normal aging and dementia.
• Can remain stable or improve, with over 30% of individuals reverting to normal cognition.
• Not necessarily progressive; some individuals do not develop dementia.

Early Dementia:

• Significant cognitive decline that interferes with daily task performance.
• Affects memory, language, reasoning, and other cognitive abilities.
• Progressive in nature, typically worsening over time and leading to increased dependence on others for care.

As you can see, a significant part of the difference between the two has to do with daily functioning. Your mind may feel out of it, but if you are still able to function in daily life, it is most consistent with MCI, not dementia.

Is Ear Ringing a Sign of Dementia?

Tinnitus, or ear ringing, is not a sign of dementia. However, tinnitus often coexists with hearing loss, which itself is linked to cognitive decline. Differentiating between the two factors can sometimes be difficult, but the simple presence of tinnitus does not indicate dementia is present.

Does Tinnitus Increase The Risk Of Dementia?

Tinnitus has been linked to an increased risk of dementia in some studies, but the relationship appears to be correlational, not causal. People with tinnitus often also have hearing loss or age-related brain changes, which are stronger predictors of cognitive decline. Current research does not show that tinnitus causes dementia—only that the two conditions frequently occur together due to shared risk factors.

There are many studies with eye-catching headlines about tinnitus and dementia. For instance: “Tinnitus is strongly associated with an increased risk of cognitive disabilities… [and] has the potential to increase the risk of cognitive impairments” [2].

This sounds scary and awful! However, we need to approach these studies with caution.

The problem with these studies is the classic confusion between correlation and causation. In clinical studies, two things may correlate (e.g., tinnitus and cognitive decline) without one necessarily causing the other. As one author puts it:

• “Actual evidence does not allow us with certainty to establish if tinnitus matters as an independent risk factor for cognitive impairment or evolution to dementia”. [3]

In short, research does not show that tinnitus causes dementia, only that they show up together frequently.

What could explain this? Well, we know that tinnitus often coexists with age-related hearing loss. Both aging and hearing loss can increase cognitive load, straining the brain’s capacity to perform other tasks. In these cases, it would be the aging and hearing loss, not the tinnitus, that is the cause. In fact, some research shows improved cognitive performance in specific populations with tinnitus [4].

Furthermore, we know that tinnitus by itself does not cause neurodegeneration, the hallmark of dementia. In conditions like Alzheimer’s disease (AD), neurodegenerative changes primarily affect the central auditory system, not peripheral hearing. This indicates that cognitive decline is more related to central processing disorders rather than tinnitus or hearing loss alone  [5].

The bottom line is that thus far, while we do see multiple studies supporting a correlation between tinnitus and dementia, there is no evidence that tinnitus causes dementia.

How Is Hearing Loss Linked To Dementia?

Hearing loss, particularly age-related hearing loss, has been linked to dementia, with some studies suggesting that addressing hearing loss could prevent or delay up to 40% of dementia cases [6]. The difference here (vs. tinnitus) is that there are actual mechanisms that can explain how hearing loss can be a contributing cause of dementia.

The main theories explaining this connection include:

Theory	Hearing Loss and Dementia Connection
Cognitive Load Hypothesis	Hearing loss forces the brain to use extra resources for auditory processing, which detracts from other cognitive tasks such as memory and decision-making, accelerating cognitive decline.
Social Isolation	Difficulty hearing can lead to social withdrawal, as individuals struggle to engage in conversations. Social isolation is a known risk factor for cognitive decline and dementia.
Brain Atrophy	Untreated hearing loss has been associated with accelerated brain atrophy, particularly in regions involved in memory and auditory processing, which contributes to cognitive impairment.
Common Cause Hypothesis	Aging-related factors like inflammation, vascular issues, or general neurodegeneration may affect both hearing and cognition simultaneously, leading to both conditions occurring together but without one directly causing the other.
Cognitive Reserve Hypothesis	Individuals with better hearing maintain social engagement and cognitive activity, which builds cognitive reserve. Hearing loss reduces auditory input and social interactions, thus lowering cognitive resilience over time.
Sensory Deprivation Hypothesis	Reduced auditory input due to hearing loss may cause reorganization of neural networks, including those involved in higher cognitive functions, leading to cognitive decline over time.

However, as noted above, it is unclear if peripheral hearing loss is the link to dementia, or if dementia is itself causing a central auditory processing disorder. In short, we need more research to get to the bottom of this issue.

Do Hearing Aids Help Tinnitus And Dementia?

For individuals with both tinnitus and hearing loss, we nearly always recommend hearing aids as part of the treatment plan. Hearing aids provide two key benefits:

• Masking the Tinnitus: By amplifying external sounds, hearing aids can help mask the internal ringing of tinnitus, reducing the brain’s cognitive effort to manage it.

• Preserving Cognitive Function: Studies have shown that using hearing aids can help slow the progression of cognitive decline, as they reduce the cognitive load required to process sound and help maintain social engagement.

How Does Tinnitus Cause Dementia?

It is important to understand that current research cannot show that tinnitus causes dementia. All we have now is a strong statistical correlation between the two. However, we do know that tinnitus causes mild cognitive impairment. Please recall that mild cognitive impairment (MCI) and dementia are not the same thing and that MCI is often stable and is reversible 30% of the time.

Tinnitus affects our cognitive abilities in several indirect ways:

• Attention Center: Tinnitus affects the attention center of the brain. When tinnitus is loud, it can take up attentional resources, often leading to a form of “tinnitus brain fog”. This cognitive effect in tinnitus patients is actually measurable, but the deficits are different from those seen with early dementia.
• Inattentive Type ADHD: Emerging evidence suggests that the cognitive symptoms that come with tinnitus may actually represent inattentive type ADHD. This can lead to misdiagnosis, especially in older adults with similar cognitive issues.

The key point here is that tinnitus-related cognitive impairment can improve with proper treatment, ie. it's reversible. Dementia, on the other hand, is progressive and irreversible.

Shared Co-Factors in Tinnitus and Dementia

Tinnitus often overlaps with several co-factors, making it difficult to isolate as an independent risk factor. Loud, fluctuating tinnitus is a form of atypical migraine, which brings a cluster of comorbidities—sleep disorders, mood disorders (anxiety and depression), and brain inflammation.

Rather than tinnitus alone driving dementia risk, it’s overall brain health that matters most. Addressing these interconnected factors is the key to reducing cognitive decline and reducing the risk of dementia.

Sleep, Tinnitus and Dementia

Poor sleep is a common struggle for individuals with tinnitus and can worsen cognitive difficulties. While many people attribute their insomnia to tinnitus, tinnitus itself does not typically wake people up. Instead, another issue—such as a sleep disorder—disrupts sleep, and upon waking, the person notices their tinnitus, mistakenly believing it was the cause.

People with tinnitus frequently have pre-existing sleep disorders like insomnia or sleep apnea, both of which are associated with a higher risk of cognitive decline—regardless of tinnitus. Poor sleep quality impairs memory, executive function, and overall brain health, increasing the long-term risk of dementia.

Sleep plays a crucial role in brain health, particularly through the glymphatic system, which clears away waste products. Around 90% of this “brain cleaning” occurs during sleep. When sleep is disrupted, brain fluids accumulate pro-inflammatory molecules, including amyloid-beta, a toxic protein linked to Alzheimer’s disease.

The Importance of Sleep in Brain Health

Improving sleep is essential for reducing cognitive strain and supporting brain function. Quality sleep restores the brain’s natural detoxification processes, helping to clear harmful waste products and maintain cognitive resilience.

At NeuroMed, addressing insomnia is a core part of tinnitus treatment. By optimizing sleep, we support proper glymphatic function, reducing the buildup of amyloid proteins and lowering the risk of dementia associated with poor sleep quality. This approach not only enhances cognitive function but also improves overall well-being.

Could Tinnitus Cognitive Impairment Actually Be ADHD?

Many people with tinnitus report experiencing cognitive issues, often described as “brain fog.” This includes difficulty focusing, forgetfulness, and mental fatigue. While some may worry that these cognitive problems are signs of dementia, recent research suggests that they resemble inattentive-type ADHD rather than dementia [7].

The mental fog seen in tinnitus is related to the underlying atypical migraine process that causes tinnitus to become louder. When the atypical migraine process affects the centers of the brain that keep us alert, the you feel a sense of fogginess mentally.

Both tinnitus and inattentive ADHD share key characteristics:

• Trouble Concentrating: Both tinnitus and ADHD lead to distractibility, making it difficult to focus on tasks.
• Memory Lapses: Cognitive challenges in both conditions include forgetfulness and trouble organizing information.
• Sensory Overload: Both conditions involve sensory processing issues where individuals are overly sensitive to stimuli.

This suggests that cognitive difficulties in tinnitus patients might not be early signs of dementia, but rather symptoms akin to ADHD, driven by sensory processing disruptions and increased cognitive load.

Tinnitus treatments that address the underlying atypical migraine process (such as those at NeuroMed) can help improve focus and alleviate “tinnitus brain fog” by reallocating mental resources back to attention and memory functions.

Can Treating Tinnitus Help Prevent Dementia?

Tinnitus does not cause dementia, but both conditions share underlying brain health factors such as neuroinflammation, poor sleep, and stress. Fortunately, the best strategies for managing tinnitus-related cognitive issues also support dementia prevention. By reducing inflammation, optimizing sleep, and supporting brain detoxification, it’s possible to improve focus, reverse mild cognitive impairment, and protect long-term brain function.

The Importance of Brain Inflammation

Addressing brain inflammation is the most important thing to consider in treating tinnitus and dementia. Neuroinflammation is a significant driver of many neurodegenerative diseases, dementia included. Over time, this inflammation disrupts synaptic connections, accelerates neuronal loss, and impairs cognitive function, all of which contribute to the onset and progression of dementia.

Research also links tinnitus to neuroinflammation, particularly through its identification as a form of atypical migraine. Migraines and tinnitus both share underlying neuroinflammatory mechanisms, where heightened neural excitation and imbalances in the nervous system lead to persistent symptoms.

By addressing the sources of neuroinflammation that contribute to the atypical migraine (brain sensitivity), it is possible to promote overall brain health and potentially reduce the risk of dementia. At NeuroMed, neuroinflammation is addressed through the following methods:

• Sleep optimization: We delve deeply into your sleep issues and try to identify the causes of your sleep problems. Tailored treatment is given to address the specific cause either by our team or with another professional to treat sleep apnea or insomnia.
• Nutraceutical Therapy: Specific supplements recommend as part of the NeuroMed plan (such as vitamin D, coenzyme q10, and melatonin) help to reduce oxidative stress and neuroinflammation.
• Anti-Inflammatory Diet: The anti-inflammatory diet used at NeuroMed helps reduce systemic inflammation, which can have protective effects on brain health. As part of your treatment, you will have several visits with our health coach/nutritionist who will guide you every step of the way.
• Stress Reduction Methods: Stress is a significant trigger for neuroinflammation. Techniques such as mindfulness and meditation are employed at NeuroMed to lower stress levels, which serves to reduce neuroinflammation.

By implementing these strategies, the therapies at NeuroMed not only reduce tinnitus symptoms but can also support long-term brain health, decreasing the risk of dementia for patients.

Is Cognitive Impairment from Tinnitus Reversible?

The cognitive impairment experienced by patients with migraine-related tinnitus is generally reversible and doesn't follow the same progression as dementia. Unlike the irreversible decline seen in dementia, the cognitive issues associated with tinnitus can be improved with the right treatment approach.

At NeuroMed, multimodal therapy addresses both neurological and lifestyle factors to target the root causes of mild cognitive impairment (MCI) linked to tinnitus. This comprehensive strategy includes pharmacotherapy, nutraceuticals, lifestyle changes, sound therapy, and cognitive-behavioral therapy (CBT) to reduce tinnitus symptoms and improve cognitive function [8].

Key components of the NeuroMed approach include:

• Reducing brain excitation: Medications helps calm overactive neural pathways that contribute to tinnitus symptoms and cognitive strain, reducing the excessive brain activity linked to tinnitus.
• Reducing neuroinflammation: Anti-inflammatory diets and nutraceuticals are used to target the chronic inflammation that worsens tinnitus and contributes to cognitive decline.
• Sleep optimization: Improving sleep quality is crucial for brain detoxification. Addressing sleep apnea and insomnia supports the brain’s cleaning system, clearing toxins associated with diseases like Alzheimer's.
• Reducing cognitive load and emotional stress: Sound therapy and CBT help reorganize brain networks, alleviating the emotional and cognitive strain caused by tinnitus, and improving focus, attention, and overall cognitive function.

By targeting these underlying issues, the treatments not only alleviate tinnitus but also reverse cognitive decline, promoting long-term brain health and preventing the progression of MCI toward more serious conditions.

Conclusion: Is Tinnitus A Precursor To Dementia?

While the atypical migraine process which causes tinnitus to be loud can lead to cognitive impairment, there is no evidence that tinnitus directly causes dementia. The cognitive issues linked to tinnitus are often temporary and reversible, especially when treated early.

By managing tinnitus through multimodal treatments like those at NeuroMed, patients can protect their cognitive health and prevent further decline. With the right interventions, it is possible to reduce the mental toll of tinnitus and improve overall brain function, helping patients regain clarity and focus.

To learn more about how NeuroMed’s protocols can lower your tinnitus, improve your brain health, and reduce the risk of dementia, please schedule a free consultation today.

Tinnitus and Dementia: Frequently Asked Questions

References for Tinnitus and Dementia

[1]           M. Iraniparast et al., “Cognitive Reserve and Mild Cognitive Impairment: Predictors and Rates of Reversion to Intact Cognition vs Progression to Dementia,” Neurology, vol. 98, no. 11, pp. e1114–e1123, Mar. 2022, doi: 10.1212/WNL.0000000000200051.

[2]           D. Yang, D. Zhang, X. Zhang, and X. Li, “Tinnitus-associated cognitive and psychological impairments: a comprehensive review meta-analysis,” Front. Neurosci., vol. 18, p. 1275560, Feb. 2024, doi: 10.3389/fnins.2024.1275560.

[3]           R. Malesci et al., “Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links,” J. Clin. Med., vol. 10, no. 9, p. 1881, Apr. 2021, doi: 10.3390/jcm10091881.

[4]           Y. Hamza and F.-G. Zeng, “Tinnitus Is Associated With Improved Cognitive Performance in Non-hispanic Elderly With Hearing Loss,” Front. Neurosci., vol. 15, p. 735950, 2021, doi: 10.3389/fnins.2021.735950.

[5]           Q. Ruan, B. Chen, and F. Panza, “Which Came First, Age-Related Hearing Loss with Tinnitus or Cognitive Impairment? What are the Potential Pathways?,” J. Integr. Neurosci., vol. 22, no. 5, p. 109, Aug. 2023, doi: 10.31083/j.jin2205109.

[6]           G. Livingston et al., “Dementia prevention, intervention, and care: 2020 report of the Lancet Commission,” Lancet Lond. Engl., vol. 396, no. 10248, pp. 413–446, 2020, doi: 10.1016/S0140-6736(20)30367-6.

[7]           “Mild Cognitive Impairment or Attention-Deficit/Hyperactivity Disorder in Older Adults? A Cross Sectional Study – PMC.” Accessed: Sep. 09, 2024. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488111/

[8]           E. W. Beukes, D. M. Baguley, P. M. Allen, V. Manchaiah, and G. Andersson, “Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial,” Ear Hear., vol. 39, no. 3, pp. 423–433, 2018, doi: 10.1097/AUD.0000000000000505.