Hearing Aid Use Linked to Lower Mortality in Large Multinational Study

Adults with hearing loss who used hearing aids had a lower risk of death than nonusers in a multinational analysis published in The Lancet Healthy Longevity.¹ The findings add to evidence connecting hearing health with healthy aging, but leave an important question unanswered: Does treating hearing loss help people live longer, or do hearing aid users differ in other ways that influence survival?

The study, led by Chuan-Ming Li, MD, PhD, of the National Institute on Deafness and Other Communication Disorders (NIDCD), examined data from 64,128 adults living in Australia, Iceland, the United States, and Norway.

Large population study using pure-tone audiometry

The primary analysis included 13,851 adults aged 20-97 years, with an average age of about 62. Participants came from the Blue Mountains Hearing Study, the Age, Gene/Environment Susceptibility–Reykjavik Study, and the US National Health and Nutrition Examination Survey.

The Norwegian replication study included another 50,277 adults. Across the studies, mortality was tracked for 10-16 years.

Hearing was objectively measured using pure-tone audiometry in all four populations—a notable strength of this analysis of more than 64,000 adults—with hearing loss classified according to average thresholds in the better-hearing ear. Researchers adjusted for age, sex, education, smoking, body mass index, cardiovascular conditions, diabetes, stroke, and noise exposure.

Using individual participant data allowed the team to apply more consistent analyses across populations than a review relying only on previously published summary results.

Greater hearing loss, higher risk for mortality

Compared with normal hearing, mild hearing loss was associated with a 19% higher adjusted hazard of death from any cause in the pooled analysis. The corresponding increases were 55% for moderate hearing loss and 56% for moderately severe or worse hearing loss.

Hearing loss was also associated with increased cardiovascular mortality. The Norwegian analysis supported the overall findings, although the associations between hearing loss and mortality were smaller.

Although the authors classified the hearing aid analyses as exploratory, the findings linked hearing aid use with lower mortality. Among participants with hearing loss, current hearing aid use was associated with a 9% lower adjusted hazard of death from any cause in the pooled analysis (hazard ratio 0.91; 95% confidence interval 0.83–0.99) and a 15% lower adjusted hazard of cardiovascular death.

In Norway, hearing aid use was associated with a 15% lower all-cause mortality hazard and a 16% lower cardiovascular mortality hazard. These are relative differences over follow-up, rather than percentage-point reductions in the likelihood of dying or estimates of additional years of life.

The study supports previous work linking hearing loss with increased mortality. A 2015 study by Genther and colleagues² followed 1,958 US adults aged 70 and older for 8 years and found that audiometrically measured hearing loss was associated with a 20% higher adjusted hazard of death compared with normal hearing. A subsequent 2022 systematic review and meta-analysis by Tan and colleagues,³ encompassing 26 observational studies and more than 1.2 million participants, found that hearing loss was associated with a 13% higher adjusted hazard of all-cause mortality and a 28% higher hazard of cardiovascular mortality. Together, the studies support an association between hearing loss and longevity, while leaving unresolved whether hearing loss contributes directly to earlier death or reflects other underlying health risks.

Why association does not establish cause

In an accompanying commentary,⁴ USC otolaryngologist Janet S. Choi, MD, describes the study’s scale and consistency as notable, but cautions against interpreting the results as proof of a life-extending treatment effect.

She points out that people who obtain and use hearing aids may differ from nonusers in income, access to health care, cognitive and physical functioning, social engagement, and willingness to seek care. Those characteristics can also influence mortality.

Hearing aid use was another limitation. Combining different survey questions into a measure of “current use” could not fully capture daily wearing time, years of use, perceived benefit, or when treatment began.

“Patients should not be advised that hearing aids prolong life on the basis of observational associations alone,” writes Choi.

What this means for hearing care

Several explanations for the findings remain possible. Hearing loss could contribute to poorer health through communication difficulties, social isolation, increased cognitive demands, reduced activity, or injury risk. It could also reflect underlying vascular disease, inflammation, or biological aging that independently affects survival.

Choi emphasizes that uncertainty about longevity should not overshadow the established benefits of hearing care: improved communication, reduced hearing-related disability, and stronger social engagement and connections.

Related findings from the randomized ACHIEVE trial, previously covered by HearingTracker, offer clues about potential pathways connecting hearing care with healthier aging. A 2025 analysis found that hearing aids and audiological support helped older adults preserve social connections and modestly reduced loneliness. More recently, a 2026 analysis of 164 higher-risk participants found a slower rise in a blood biomarker associated with neuroinflammation among those receiving hearing treatment. Although neither finding establishes a survival benefit, both support further investigation of how hearing intervention might influence broader health outcomes.

Future studies will need repeated hearing assessments, more detailed tracking of hearing aid use, and measures of social, cognitive, and physical functioning. Intervention trials and stronger causal analyses could help determine whether treating hearing loss changes the pathways connecting sensory health with longevity—and patient populations who might benefit.

For audiologists, the research strengthens the case for viewing hearing within the broader context of healthy aging; however, it does not establish a mortality benefit that clinicians can promise patients. For consumers, the research offers one more reason to include hearing health in their pursuit of healthy aging, but it does not prove that wearing hearing aids helps you live longer.