This study investigated the prevalence and impact of auditory agnosia for environmental sounds in individuals with Alzheimer’s disease (AD), finding that over half exhibited signs of this central auditory dysfunction along with a high rate of unrecognized peripheral hearing loss. Although these factors appeared independent and showed limited direct effect on measured quality of life, possibly due to sheltered living environments and lack of patient awareness, they jointly contribute to daily functional decline, highlighting the importance of early hearing assessment and intervention in AD management.