> ## Content Index
> Fetch the complete content index at: https://the-longevity-brief.ghost.io/llms.txt
> Use this file to discover other available public pages before exploring further.

# Get a baseline hearing test before you think you need one
- URL: https://the-longevity-brief.ghost.io/get-a-baseline-hearing-test-before-you-think-you-need-one/
- Published: 2026-10-22T10:00:00.000Z
- Updated: 2026-10-22T10:00:06.000Z
- Description: Hearing loss tied for the largest modifiable dementia risk factor in the 2024 Lancet Commission. The ask, the number, and the honest caveats.
- Author: The Longevity Brief

At your next checkup, ask about a full hearing test with an audiologist. The results come back as a chart called an audiogram, and testing while your hearing still seems fine gives you a baseline for later.

The 2024 Lancet Commission on dementia named fourteen modifiable risk factors. Hearing loss in midlife tied with high LDL cholesterol as the largest, each linked to an estimated 7 percent of dementia cases worldwide.

The Commission estimates that 45 percent of dementia could potentially be prevented or delayed if all fourteen were addressed. That is a population estimate, not a promise for any one person.

Does treating hearing loss change the outcome? The largest trial so far, ACHIEVE, published in The Lancet in 2023, gave 977 adults aged seventy to eighty-four with untreated hearing loss either hearing aids with audiologist support or health education.

Overall, after three years, cognitive decline was about the same in both groups. In a smaller group at higher risk of decline, the hearing intervention was linked to 48 percent slower decline.

So the honest summary is promising, not settled. The trial did not include women in their fifties or people with the mildest loss, and the benefit appeared in a subgroup.

No US guideline tells symptom-free women in their fifties to get tested. The US Preventive Services Task Force found the evidence insufficient to recommend for or against routine screening, so this is your choice, not a requirement.

The case for choosing it: age-related hearing loss tends to creep in, and you cannot catch a slow change you never measured.

Here is the move. Say: “I’d like a baseline hearing test with an audiologist, and a repeat in a few years if anything looks off.”

If you already struggle to follow conversation in noisy rooms, say so. Check your insurance first, since a test without symptoms may not be covered.

When the result comes back, ask for the average hearing level in your better ear. In the World Health Organization’s grading, under 20 decibels is normal and 20 to under 35 is mild, though US reports often use a different scale.

If loss shows up, talk through options early. Over-the-counter hearing aids have been sold in the US without a prescription since October 2022 for adults with perceived mild to moderate loss.

Your hearing keeps your brain in the conversation. Get the number on file this year.