Vascular Pathology in Age-Related Hearing Loss

Age-related hearing loss (ARHL) is a growing global healthcare challenge. An increasing body of research suggests an association between ARHL and conditions such as dementia, hypertension, diabetes, and obesity. However, the causal relationships between these pathologies and ARHL remain poorly understood. We propose that vascular pathology may be a key pathogenetic link connecting these conditions, particularly given the inherent vulnerability of the cochlear blood supply and microvasculature. One promising approach for studying vascular pathology in the ageing cochlea involves combining optical tissue clearing, light-sheet microscopy, and advanced 3D network analysis. This enables a comprehensive assessment of vascular pathology and its spatial mapping onto the pathology of other cochlear structures. To fully disentangle the factors contributing to ARHL, this approach should be integrated into extensive, systematic animal studies, incorporating models of ageing, noise exposure, and ARHL-related comorbidities in combination and in isolation.