Dizziness and Cognitive Decline Linked to Lower Depression Risk in Hearing Loss Patients

Analyzing electronic health records from more than 43,000 patients across a Midwest United States database, researchers found that the combination of dizziness and cognitive decline was associated with a significantly reduced incidence of both depression and anxiety during a follow-up window of up to 72 months. The study, published in Frontiers in Audiology and Otology, drew on records from January 2018 to June 2024. The researchers included only patients aged 50 years or older who carried diagnosis codes for SNHL and who had no prior diagnosis of depression, anxiety, or bipolar disorder, allowing them to track new-onset psychiatric conditions after the hearing loss diagnosis.

The primary outcome was the cumulative incidence of any of these three disorders within the follow-up period. Statistically, the team used Cox regression models that treated dizziness and cognitive decline as time-dependent exposures, meaning a patient could move from unexposed to exposed status during follow-up and the analysis would account for the timing. After adjusting for confounders, patients with both dizziness and cognitive decline showed a reduced hazard of developing depression compared with controls, with an adjusted hazard ratio of 0.813 (95% confidence interval: 0.676 to 0.979; p = 0.0286).

The reduction was even more pronounced for anxiety, with an adjusted hazard ratio of 0.734 (95% confidence interval: 0.612 to 0.880; p = 0.0008). An adjusted hazard ratio below 1.0 indicates a lower rate of the outcome among the exposed group over time, and in this cohort the combined exposure was linked to roughly a 19 percent lower hazard of depression and a 26 percent lower hazard of anxiety. The authors describe this as an inverse association, and they are careful to frame it as an observed relationship rather than proof of a protective mechanism.

The findings take on a different shape when only one of the two exposures is present. For depression, anxiety, and bipolar disorder alike, having either dizziness or cognitive decline alone was associated with an increased incidence of the psychiatric outcomes. This pattern suggests that the two conditions may interact in ways that single-exposure analyses miss, and it complicates the straightforward assumption that every additional vestibular or cognitive symptom compounds psychiatric risk in hearing-impaired patients.

The findings apply to adults aged 50 and older in a single Midwest health system and should not be generalized to younger populations or other regions without further evidence. Bipolar disorder, the third outcome examined, did not show the same inverse pattern as depression and anxiety. The study reports that single exposures were associated with increased incidence across all three conditions, while the combined exposure was linked to reduced incidence only for depression and anxiety.

The authors call for future research to explore the interactions between dizziness and cognitive decline in order to identify avenues for improved patient-centered psychiatric outcomes in adults with SNHL. Until such mechanistic and longitudinal work is done, the study stands as a large-scale observational signal that the psychiatric landscape following a hearing loss diagnosis is shaped by more than hearing loss alone, and that the co-occurrence of vestibular and cognitive symptoms may reshape risk in unexpected directions.

Subject of Research: Psychiatric risk following new sensorineural hearing loss diagnosis in adults aged 50 and older, focusing on the roles of dizziness and cognitive decline

Article Title: Psychiatric risk with dizziness and cognitive decline in patients with sensorineural hearing loss

Article References: Nagarapu, A. N., Vayyeti, A., Shah, A. K., Sarva, L., Gowda, R., Zhang, Z., Brittain, K., & Harris, D. A. (2026). Psychiatric Risk with Dizziness and Cognitive Decline in Patients with Sensorineural Hearing Loss. Frontiers in Audiology and Otology, 4, 1975143. https://doi.org/10.3389/fauot.2026.1975143

Image Credits: AI Generated

DOI: 10.3389/fauot.2026.1975143

Keywords: sensorineural hearing loss, depression, anxiety, bipolar disorder, dizziness, cognitive decline, retrospective cohort study, Cox regression, electronic health records, older adults, psychiatric risk, audiology