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These processes can be characterized by topological changes, such as strengthening and weakening of structural connections between brain regions. Stronger connections are more relevant to reorganization, as reorganization is thought to support speech processing by recruiting additional brain networks as a compensatory mechanism. We investigated connectivity changes associated with ARHL to improve the understanding of the sensory deprivation theory. Similar to the lateralization of speech processing, we hypothesized that structural reorganization associated with ARHL would be most evident in the left hemisphere. We assessed whole-brain structural connectivity using 1.5 Tesla diffusion-weighted MRI and structural T1 images in 2402 participants (median age\u2009=\u200966.1\u00a0years, females\u2009=\u200954.7%) from the population-based Rotterdam Study. Pure-tone audiometry was performed, and pure-tone averages (PTAs), for different frequency ranges including PTA\n                    <jats:sub>low<\/jats:sub>\n                    (250\u20131000\u00a0Hz) and PTA\n                    <jats:sub>all<\/jats:sub>\n                    (250\u20138000\u00a0Hz), were determined for the better-hearing ear to reflect ARHL. ARHL was primarily associated with weaker connections involving frontal and subcortical gray matter regions. Contrary to our hypothesis, no lateralization in the connectivity alterations was observed. PTA\n                    <jats:sub>low<\/jats:sub>\n                    and PTA\n                    <jats:sub>all<\/jats:sub>\n                    yielded the strongest associations, likely driven by low-frequency hearing thresholds. Adjusting for cardiovascular risk factors attenuated associations, especially for PTA\n                    <jats:sub>low<\/jats:sub>\n                    . In conclusion, the findings contradict the hypothesized compensatory structural reorganization expected from the neural effects of sensory deprivation. While the observed weaker connectivity aligns with the sensory deprivation theory, the results also suggest cardiovascular health as a common risk factor.\n                  <\/jats:p>","DOI":"10.1007\/s11357-026-02589-x","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:58:56Z","timestamp":1791842336000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reduced structural connectivity in age-related hearing loss aligns with the sensory deprivation theory"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8710-6427","authenticated-orcid":false,"given":"Jordi H. 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The Rotterdam Study Personal Registration Data collection is filed with the Erasmus MC Data Protection Officer under registration number EMC1712001. The Rotterdam Study has been entered into the Dutch Trial Register (NTR;\n                      \n                      ) and into the WHO International Clinical Trials Registry Platform (ICTRP\n                      \n                      , search portal\n                      \n                      ) under shared catalog number NL6645\/NTR6831. The Rotterdam Study project persistent identifier is\n                      \n                      .","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All participants provided written informed consent to participate in the study and to have their information obtained from treating physicians.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}