Hearing Aids and Cochlear Implants Boost Social Connections and Quality of Life, Systematic Review Finds

Strong evidence supports the idea that hearing aids and cochlear implants enhance social engagement and quality of life outcomes for adults with hearing loss, according to a systematic review and meta-analysis published today in JAMA Otolaryngology–Head & Neck Surgery.

The new study, “Social Outcomes Among Adults With Hearing Aids and Cochlear Implants,” examines data from 65 prior studies (out of 5,847 screened and 310 that underwent full-text review) and is the largest meta-analysis yet to focus on the social effects of hearing devices.

Hearing Loss and Social Isolation: A Known but Understudied Link

Previous studies have demonstrated strong connections between hearing loss and poorer social outcomes, such as social isolation and loneliness, depression, anxiety, and even cognitive decline. Research dating back to the 1980s and early 90s has shown that hearing loss can negatively impact the ability to participate in social activities, and the use of hearing aids and implants can enhance social connectedness and quality of life.

However, existing data are typically gathered from various questionnaires and often involve different methodologies and small sample sizes. Until now, high-quality pooled evidence on this topic has been limited. The authors note that social withdrawal is one of the most significant downstream effects of untreated hearing loss; however, the extent to which hearing aids and cochlear implants enhance social outcomes has not been systematically assessed. This new meta-analysis fills an important gap.

Study coauthor Janet Choi, MD, MPH, an otolaryngologist with Keck Medicine of USC, told HearingTracker: “While it has been recognized that hearing loss can contribute to social isolation and loneliness, our study provides the strongest evidence to date that hearing devices (both hearing aids and cochlear implants) are associated with measurable improvements in social outcomes.

“What’s new here is the ability to quantify these benefits across a large number of studies using validated tools,” continues Choi. “For consumers, it affirms that hearing devices do more than improve hearing—they enhance social life. For clinicians, it reinforces the importance of proactively recommending hearing devices, not just for auditory health but for broader psychosocial well-being. And for policymakers, it supports expanding access to hearing devices as part of strategies to promote healthy aging and reduce downstream risks like depression, cognitive decline, and even dementia.”

Key Findings: Better Social Quality of Life and Reduced Social Handicap

The meta-analysis focused on three key social outcomes:

• Social quality of life (QoL)
• Perceived social handicap
• Loneliness

Across the board, the findings were positive—especially for social quality of life.

Social Quality of Life and Perceived Social Handicap

For adults with hearing loss, use of hearing aids or cochlear implants was associated with a large and statistically significant improvement in social QoL (standardized mean difference [SMD], 1.22). People using hearing aids showed a moderate benefit (SMD, 0.62), while cochlear implant users experienced a larger effect (SMD, 1.37).

The authors noted that cochlear implants had a bigger impact, likely because recipients typically have more severe hearing loss and more room for improvement.

Additionally, the use of hearing devices was associated with a significant reduction in perceived social handicap, as measured by the Hearing Handicap Inventory for the Elderly (HHIE) and similar tools. The effect size for this outcome was also large (SMD, -3.41).

Loneliness Findings: Promising but Inconclusive

The data on loneliness were more limited and less conclusive. Only three studies were eligible for meta-analysis on this outcome, and while hearing device use was associated with a moderate reduction in loneliness (SMD, -0.44), the confidence interval crossed zero, suggesting the finding wasn’t statistically significant.

However, the broader systematic review—which included additional studies not suitable for meta-analysis—generally pointed toward reductions in loneliness among hearing aid and cochlear implant users.

Duration Matters: Longer Use Linked to Bigger Gains

The analysis also determined that longer use of hearing devices correlates with greater improvements in both social QoL and perceived social handicap. This supports previous research indicating that the benefits of hearing rehabilitation often grow over time as users adapt to their devices and rebuild confidence in social situations.

Why Social Outcomes Matter

The authors highlight that improving social outcomes isn’t just about making people feel more connected; it may also have downstream benefits for mental and cognitive health.

Dr. Choi told HearingTracker, "What stood out was the size of the effect, particularly for cochlear implant users. We found that people who received cochlear implants—often after struggling with severe to profound hearing loss—experienced large improvements in social quality of life. This was especially striking given the low utilization rate of cochlear implants, which is as low as 2% among those who might benefit.

“Another interesting finding was that the longer people used their devices, the greater the benefit they reported,” she added. “This suggests that sustained engagement with the device really matters. It was also somewhat surprising that the data on loneliness were more limited, highlighting an area where more research is needed.”

The 2024 Lancet Commission on Dementia Prevention recently identified hearing loss as one of the leading modifiable risk factors for dementia. Social isolation and loneliness, which can worsen with untreated hearing loss, are themselves linked to cognitive decline, depression, and even increased mortality. Similarly, the ACHIEVE study suggested that dementia risk may be reduced by half for some at-risk populations, and a more recent follow-up analysis showed that hearing aids in tandem with audiology assistance led to more varied and meaningful social interactions, encompassing a wider range of friends, family, and acquaintances.

In addition to these, hearing loss is also linked to a wide range of chronic illnesses. By helping people stay socially engaged, hearing aids and cochlear implants play a crucial role in promoting long-term health.

Dr. Choi was also the lead author of a January 2024 paper in The Lancet, which shows that adults with hearing loss who use hearing aids have almost a 25% lower risk of mortality. “I think the message is simple: hearing loss may be invisible, but its impact isn’t,” she says. “Hearing aids and cochlear implants can make a meaningful difference—reconnecting you with the people and activities that matter most. That kind of social engagement isn’t just nice to have; it has been linked to better mood, stronger relationships, and even lower risk of brain inflammation and cognitive decline.

“If you’re noticing signs of hearing loss, I always recommend getting your hearing tested. And if hearing devices are indicated, give them a try. Many people are surprised by the world they’ve been missing and the difference it can make in their daily lives.”

More information about this study at: Keck Medicine of USC.