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A second look at data from the landmark ACHIEVE clinical trial suggests that using hearing aids, paired with professional guidance, can help older adults maintain stronger social networks—potentially curbing the growing crisis of loneliness in America’s aging population.
The new research, published May 12 in JAMA Internal Medicine, revealed that seniors who received hearing treatment maintained more social relationships over a 3-year period than those who did not. Participants fitted with hearing aids and receiving audiologist-led support maintained, on average, one more meaningful connection compared to those who only received general health education. The study also highlighted that the hearing-treated group enjoyed more varied and higher-quality social interactions, encompassing a wider mix of friends, family, and acquaintances.
The CDC reports that over 25% of older Americans experience minimal social contact, and nearly one-third frequently feel lonely. This chronic isolation has been partly attributed to hearing loss, which can hinder everyday communication. In 2023, the U.S. Surgeon General emphasized the need to address "our epidemic of loneliness and isolation" with the same urgency as smoking, obesity, and substance abuse. In the UK, the government even appointed a "Minister of Loneliness” to combat this epidemic.
“Our findings add to evidence that helping aging patients hear better can also enrich their social lives and boost their mental and physical wellbeing,” said study lead author Nicholas S. Reed, AuD, PhD, a member of the NYU Grossman School of Medicine’s Optimal Aging Institute.
Both hearing impairment and loneliness have been associated with serious health issues, including depression, cardiovascular disease, and premature mortality. The researchers note that earlier results from the ACHIEVE trial indicated that hearing interventions may also slow down cognitive decline in adults most at risk for dementia.
“These results support efforts to incorporate hearing aid coverage into Medicare as a means of addressing the nation’s social isolation epidemic, which is especially risky for the elderly,” said ACHIEVE trial co-principal investigator Josef Coresh, MD, PhD. “Making sure Americans can continue engaging with their family and friends as they age is a critical part of maintaining their quality of life,” added Dr. Coresh, also the Terry and Mel Karmazin Professor in the Department of Population Health.
The trial included nearly 1,000 participants between the ages of 70 and 84, recruited from four U.S. regions: Minnesota, Mississippi, North Carolina, and Maryland. All participants had untreated hearing loss at the start of the study.
Researchers employed detailed measures to assess participants’ social lives, including the frequency of their interactions with others, the breadth and diversity of their social networks, and the emotional closeness of their relationships. To assess loneliness, they applied a 20-item scale gauging how frequently individuals felt isolated or emotionally distant.
Initially, loneliness levels were similar in both groups. However, after 3 years, those who received hearing support showed slight improvements in loneliness, while feelings of isolation worsened slightly for the control group.
Dr. Coresh emphasized that the care provided in the trial was unusually comprehensive: damaged devices were replaced swiftly, and participants received a high level of attention, which is not always reflective of typical care. He noted that hearing care currently costs an average of $4,700 and is typically not covered by Medicare.
The team plans to continue monitoring participants for an additional three years and hopes to expand future studies to include a more diverse participant pool, as most current enrollees are White.
The original 2023 ACHIEVE study (Aging and Cognitive Health Evaluation in Elders) is a landmark randomized clinical trial that utilized the same study participants but investigated whether treating hearing loss in older adults could delay or slow cognitive decline. Similarly conducted over 3 years, the study compared a hearing intervention group—who received hearing aids and audiology care—with a control group that received health education. Half of the participants in the intervention group received a comprehensive hearing program that employed audiology best practices, including hearing aids, one-on-one sessions with audiologists, and assistive devices like TV connectors. The comparison group was provided with healthy aging education covering topics such as physical activity, communication with healthcare providers, and aging-related resources.
The 2023 results demonstrated that hearing intervention significantly reduced cognitive decline in older adults who were already at higher risk of dementia, marking a major milestone in understanding the relationship between hearing health and brain aging. However, for the healthier "worried well" population of participants, hearing intervention did not have a significant effect on cognitive status—although it did suggest a potential effect on social engagement and loneliness, prompting further investigation of the data and the resulting study discussed here. (Also see: New Study Supports Hearing Loss as a Major Factor for People Already at Risk for Dementia.)
Funding for the research was provided by several National Institutes of Health (NIH) grants.
Original article citation: Reed NS, Chen J, Huang AR, et al. Hearing intervention, social isolation, and loneliness: A secondary analysis of the ACHIEVE randomized clinical trial. JAMA Intern Med. Published online May 12, 2025. doi:10.1001/jamainternmed.2025.1140
Source: HearingTracker and NYU Langone Health NewsHub
