The short version
- In 64,128 adults followed for 10 to 16 years, even mild hearing loss went with a 19% higher risk of death from any cause, after adjusting for age, smoking, heart disease and more.
- Among people with hearing loss, those who used hearing aids had a 9% lower risk of death in the pooled analysis and 15% lower in a Norwegian replication.
- The study is observational, and the accompanying commentary says patients should not be told hearing aids prolong life on this evidence alone.
Most people who could use a hearing aid do not wear one. In the US national health survey, only about one adult in eight with measurable hearing loss was a regular user. Turning up the TV is the more common fix.
A large study published this week in The Lancet Healthy Longevity asks whether hearing loss, and leaving it untreated, is tied to how long people live. It finds yes on both counts. How it gets there is a lesson in what this kind of evidence can and cannot tell you.
What was measured
The team was led by Chuan-Ming Li, a researcher at the US National Institute on Deafness and Other Communication Disorders. It pooled individual records from three long-running population studies: the Blue Mountains Hearing Study in Australia, the AGES–Reykjavik Study in Iceland, and the US National Health and Nutrition Examination Survey. Together they gave 13,851 adults aged 20 to 97, with an average age of about 62. The team then checked the result in a separate Norwegian group of 50,277 adults. That makes 64,128 people in all.
Two things make this stronger than most studies of its kind. First, hearing was tested, not asked about. Every participant in all four populations sat for pure-tone audiometry, the beeps-in-headphones test an audiologist uses. Second, deaths were tracked for 10 to 16 years.
The analysis adjusted for the obvious rivals: age, sex, education, smoking, body mass index, cardiovascular disease, diabetes, stroke and noise exposure.
What it found
Hearing loss went with a higher risk of death at every level, according to HearingTracker’s report of the paper. Compared with people whose hearing was normal, the adjusted risk of dying from any cause was:
- 19% higher with mild hearing loss
- 55% higher with moderate loss
- 56% higher with moderately severe loss or worse
The 19% for mild loss is the number most readers should notice, because mild loss is the easiest kind to shrug off.
Then the team looked only at people who had hearing loss and compared those who used hearing aids with those who did not. In the pooled three-country analysis, users had a 9% lower risk of death from any cause (hazard ratio 0.91, with a 95% confidence interval of 0.83 to 0.99) and a 15% lower risk of death from cardiovascular disease. In Norway the gaps were a little wider: 15% lower for any cause and 16% lower for cardiovascular death.
That confidence interval matters. Its upper end, 0.99, sits just under 1.0, the line of no difference. The pooled result clears the bar, but not by much. The Norwegian replication, in a group more than three times larger, points the same way, which is the more reassuring part.
It is not the first time
A smaller study in 2024 found much the same thing. Janet Choi, an otolaryngologist at the University of Southern California, and colleagues followed 9,885 adults in the US survey, 1,863 of them with hearing loss, for a median of about 10 years. Hearing loss went with a 40% higher risk of death. Regular hearing-aid users had a 24% lower risk than people who had never used one.
The detail that stuck from that paper was about the people who wore their aids only sometimes. They did no better than people who never wore them at all (hazard ratio 0.93, with a range wide enough to include no effect). If the benefit is real, it seems to need the aids in the ears, not in a drawer.
The new paper could not test that. Its measure of hearing-aid use could not capture how many hours a day people wore them, for how many years, whether the aids helped, or when people started.
The honest read
Choi wrote the commentary that runs alongside the new paper, and she is blunt. “Patients should not be advised that hearing aids prolong life on the basis of observational associations alone.”
The problem is who gets hearing aids. They cost money and take appointments. People who get them may have more income, better access to doctors, sharper thinking, better health and busier social lives. They may also be the sort of people who act on a health problem early. Each of those things predicts a longer life on its own, and adjustment can only soak up the factors a study measured. The authors list these as limits.
The one way to settle it is a randomized trial, and the closest thing to one is ACHIEVE. That US trial randomly assigned 977 adults aged 70 to 84 with untreated hearing loss to hearing aids with audiology support or to a health-education program, and followed them for three years. It was designed to test thinking, not survival.
On its main question, ACHIEVE found nothing. Cognitive decline over three years was the same in both groups, −0.200 against −0.202 standard-deviation units. A sensitivity analysis the team had planned in advance found a different picture inside the trial. The trial drew its volunteers from two sources: an existing research cohort called ARIC, and people recruited fresh. The effect differed between the two, and the authors read that as hearing care helping the group at higher risk of decline and not the other. The authors concluded that hearing care “might reduce cognitive change over 3 years in populations of older adults at increased risk for cognitive decline but not in populations at decreased risk.”
Later ACHIEVE analyses found that hearing aids helped people keep their social connections and modestly reduced loneliness, according to HearingTracker. In 164 higher-risk participants, a blood marker of brain inflammation rose more slowly in the group that got hearing care.
An Australian study published in Neurology in February adds a similar split. Among 2,777 older adults with moderate hearing loss followed for seven years, memory and thinking scores were about the same whether or not people were prescribed hearing aids. Dementia, though, was diagnosed in 5% of those with aids and 8% of those without.
The pattern across these studies is consistent. Untreated hearing loss travels with worse outcomes. Hearing care keeps showing up on the better side of the ledger, most clearly for people at higher risk. And the cleanest experiment so far did not move its main target.
One plausible path runs through connection. Someone who cannot follow a conversation may stop going to dinners and stop calling, and ACHIEVE’s loneliness finding points that way. It remains a hypothesis. None of these papers proves it.
If you are weighing a hearing test. Nothing here says a hearing aid will add years to anyone’s life. What the evidence does support is that hearing loss is common, can be measured with a standard audiometry test, and is linked to worse outcomes when it is left alone. A hearing test is the first step either way, and sudden or one-sided hearing loss is a reason to see a clinician promptly.
What to watch
The cause-and-effect answer has to come from randomized evidence, which means ACHIEVE’s later analyses and any trial built to track survival. The new paper adds 64,128 people, with hearing measured by test rather than by questionnaire, to the evidence that hearing and survival are linked. It does not show that one causes the other.
