Research Summary

Hearing Intervention Reduces Social Isolation and Loneliness in Older Adults with Untreated Hearing Loss

Kate Young

Key Highlights:

  • A best-practice hearing intervention helped older adults with hearing loss retain one additional person in their social network over 3 years.
  • Hearing intervention led to statistically significant improvements in social network diversity and embeddedness.
  • Participants in the intervention group experienced less increase in loneliness over time compared with controls.
  • Results suggest hearing care is a scalable, low-risk strategy to reduce social isolation and loneliness at the population level.

In this secondary analysis of the ACHIEVE randomized clinical trial, hearing intervention demonstrated modest but statistically significant benefits for reducing social isolation and loneliness among older adults with untreated hearing loss. Over a 3-year period, individuals who received hearing aids, audiological counseling, and education retained, on average, one additional person in their social network and experienced improvements in the diversity and embeddedness of their social connections. They also reported smaller increases in loneliness relative to the health education control group.

Given the growing public health concern around loneliness and social isolation in aging populations, this study addressed an important gap. Social isolation and loneliness are linked to serious adverse outcomes, including dementia and mortality. Hearing loss, which affects two-thirds of adults over age 70, impairs communication and could exacerbate social disconnection. Although observational studies have shown associations between hearing loss and diminished social connection, randomized evidence regarding the impact of hearing treatment on these outcomes had previously been limited.

This multicenter, 3-year randomized trial enrolled 977 adults aged 70 to 84 years with untreated bilateral hearing loss and no substantial cognitive impairment. Participants were randomized to receive either a best-practice hearing intervention or a successful aging health education program. The hearing intervention included four sessions with an audiologist for hearing aid fitting, counseling, and follow-up every 6 months. Social isolation and loneliness were assessed at baseline and every 6 to 12 months using two validated instruments: the Cohen Social Network Index and the UCLA Loneliness Scale.

At baseline, both groups had comparable social network sizes and loneliness scores. By year 3, the control group showed a greater decline in network size (from 22.3 to 19.8 people) than the intervention group (from 22.6 to 21.3 people), with an adjusted between-group difference of 1.05 (95% CI, 0.01–2.09). Similar favorable effects of the hearing intervention were observed in network diversity (difference, 0.19; 95% CI, 0.02–0.36) and embeddedness (difference, 0.27; 95% CI, 0.09–0.44). Loneliness increased more in the control group over time, whereas the intervention group remained more stable, with a between-group difference of –0.94 (95% CI, –1.78 to –0.11). Sensitivity analyses confirmed robustness of the findings.

However, the study had several limitations. The trial was not blinded, which could introduce response bias, and the outcomes were exploratory rather than primary endpoints. The trial population was relatively healthy and selective, potentially limiting generalizability. Furthermore, although statistically significant, the observed differences did not meet thresholds for clinical significance on validated scales, raising questions about their real-world impact.

“The results of this prespecified analysis of a randomized clinical trial characterize the potential effects of hearing intervention on reducing social isolation and loneliness in the ACHIEVE study, potentially contributing to the growing body of evidence suggesting that hearing intervention positively affects multiple areas of health, including cognition and communicative function,” the study authors concluded. “Our findings support recent initiatives from the Office of the Surgeon General2 of the US and National Academies1 in identifying interventions to promote social connection for improved health.”

Reference:
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. 2025;185(7):797-806. doi:10.1001/jamainternmed.2025.1140