Japan Tackles Dementia Risk with Early Hearing Loss Detection

With Japan’s rapidly aging population putting mounting pressure on medical and nursing care systems, local governments are increasingly turning to an unexpected tool in dementia prevention: early detection of age-related hearing loss. The approach is gaining traction nationwide following overseas research linking hearing loss to an increased risk of dementia. Hearing tests are easy to conduct and could help identify people at risk earlier, potentially reducing future healthcare costs in communities where the elderly population continues to grow. In August last year, a hearing testing event was held at a community center in Noshiro, Akita Prefecture. About 30 residents participated, undergoing hearing tests, simple physical fitness assessments and cognitive function checks using tablet devices. Among them was 79-year-old Toshisada Otani, who joined after his family pointed out that he kept the television volume unusually high. Test results showed declines in both his hearing and cognitive function, and he was advised to consult an ear, nose and throat specialist. “I was disappointed,” Otani said. “But without this opportunity, I would have ended up going to the hospital only after I had completely lost my hearing.” According to the Japanese Society of Otorhinolaryngology Head and Neck Surgery, age-related hearing loss is caused by the gradual decline of hair cells in the ear, which are covered with tiny sound-detecting hairs. About half of people aged 75 and older are estimated to experience hearing loss. The link between hearing loss and dementia risk has been highlighted by international research. In 2024, a committee from the British medical journal The Lancet published a report identifying 14 risk factors for dementia, including smoking and lack of exercise. The report said that eliminating all 14 could potentially prevent or delay up to 45 percent of dementia cases. Hearing loss was identified as the largest risk factor among them, alongside LDL cholesterol, often referred to as “bad” cholesterol. The Akita prefectural government launched a pilot testing program in fiscal 2025, commissioned by Akita University’s Advanced Research Center for Geriatric and Gerontology. To make testing more accessible, community centers and city halls were selected as venues. Akita has the highest aging rate among Japan’s 47 prefectures, with people aged 65 or older accounting for 39.5 percent as of October 2024. Kazunari Miura, head of the prefecture’s longevity and society division, said early detection could help address future shortages in care services. “As the number of caregivers decreases, early detection of dementia signs through screening and implementing countermeasures could lead to reductions in medical and nursing care costs,” Miura said. Support for addressing age-related hearing loss as part of dementia prevention is also expanding in other parts of the country. Hearing aids typically cost between 100,000 yen ($630) and several hundred thousand yen per ear, creating a financial barrier for many elderly people. To ease the burden, local governments including Suzuka in Mie Prefecture and Miyazaki City in the prefecture of the same name are offering subsidies for hearing aid purchases under certain conditions. Other municipalities are focusing on screening and awareness. Okayama has signed a partnership agreement with a hearing aid manufacturer and is working to raise awareness through lectures on hearing ability held as part of preventive care classes. Yamagata conducts hearing checks using a sound-detecting smartphone application developed by a private company. Participants who can hear less than 60 percent of the sound are advised to seek medical attention, as they may have age-related hearing loss. As Japan searches for ways to manage the growing impact of dementia, policymakers and health officials are increasingly viewing hearing health as a practical starting point for prevention.