Hearing impairment affects around 1.5 billion individuals worldwide (World Health Organization), and there is growing evidence that this could increase the risk of dementia. A major component of hearing impairment is difficulty hearing speech in noisy environments (speech-in-noise hearing impairment). However, until now it was unclear whether difficulty hearing speech-in-noise was associated with developing dementia. Key results:Over 11 years of follow-up, 1,285 participants were identified as developing dementia based on hospital inpatient and death register records. Insufficient and poor speech-in-noise hearing were associated with a 61% and 91% increased risk of developing dementia, compared to normal speech-in-noise hearing, respectively.