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Abstract INTRODUCTION This study aimed to determine whether the concomitance of hearing impairment and isolation with lack of conversation, which is considered self‐evident but has not been investigated extensively, is associated with the occurrence of dementia. METHODS A total of 2745 participants were divided into four groups according to the presence/absence of hearing impairment and isolation with lack of conversation. The association of dementia with hearing impairment and isolation with lack of conversation was analyzed using Cox proportional hazards regression. RESULTS The combined hearing impairment and isolation with lack of conversation (hazard ratio: 1.69, 95% confidence interval: 1.09‐2.61) and non‐hearing impairment and isolation with lack of conversation (hazard ratio: 1.60, 95% confidence: 1.07‐2.39) were associated with the development of dementia. DISCUSSION These findings emphasize the importance of promoting high‐quality social relationships throughout life by adopting preventive measures against isolation with lack of conversation from the early stage of awareness of hearing impairment. Highlights Dementia affects 12.9% of those with hearing impairment and isolation. Hearing impairment and isolation are associated with increased risk of dementia. Addressing these risk factors may help reduce the risk of developing dementia. Preventing isolation and promoting quality social relationships is important.