Understanding hearing loss may be the first step in making the choice to do something about it. Severe hearing loss: Conversations must be louder, and group discussions require significant effort. Profound hearing loss: Without hearing aids or other assistance, communication is extremely difficult. Common medical conditions such as infections, smoking, hypertension, diabetes, vascular disease and other health issues may contribute to hearing loss. More recent research has also found an association between untreated hearing loss and an increased risk of cognitive decline.