Adults with hearing loss who used cochlear implants showed a greater improvement in social quality-of-life than those using hearing aids, based on pooled estimates from a recent review.
In a systematic review and meta-analysis researchers evaluated the association between hearing rehabilitation device use and social outcomes among adults with postlingual hearing loss. The study, led by Kaitlin Hori of Keck School of Medicine, University of Southern California, Los Angeles, and colleagues, aimed to synthesize evidence on whether hearing aids and cochlear implants improve social quality-of-life (QoL), reduce perceived social handicap, and alleviate loneliness. The analysis, included 65 studies (N = 5,911) for systematic review and 35 studies (N = 2,664) for meta-analysis. Eligible studies were identified through comprehensive database searches (Embase, MEDLINE, CINAHL, PsycINFO, and Linguistics and Language Behavior Abstracts) from inception through March 13, 2024. Included studies used validated social outcome measures and reported baseline and follow-up data or control comparisons. The Newcastle-Ottawa Scale was applied to assess bias, with 47 studies rated as low risk and 18 as moderate risk.
Meta-analytic estimates were derived using restricted maximum likelihood-based random-effects models and reported as standardized mean differences(SMDs) The primary outcome, social QoL, was assessed in 26 studies using instruments such as the Nijmegen Cochlear Implant Questionnaire, Short Form 36, and World Health Organization Quality of Life tool. Hearing rehabilitation was associated with a significant improvement in social QoL (SMD, 1.22; 95% CI, 0.88–1.57). Stratified analysis indicated that cochlear implant users experienced a greater benefit (SMD, 1.37; 95% CI, 1.01–1.74) compared with hearing aid users (SMD, 0.62; 95% CI, 0.13–1.10). Additionally, studies measuring perceived social handicap via the Hearing Handicap Inventory for the Elderly reported a pooled SMD of −3.41 (95% CI, −5.16 to −1.65), indicating substantial perceived improvement. Meta-regression suggested that longer intervention duration was associated with greater benefit (β = −0.26; 95% CI, −0.49 to −0.03).
The association between hearing rehabilitation and loneliness was not statistically significant. A pooled analysis of three studies using the UCLA and De Jong scales yielded a standardized mean difference of −0.44 (95% CI, −1.36 to 0.48), indicating no significant reduction in loneliness. There was no between-study heterogeneity (I² = 0%). The limited number of studies and variation in loneliness measurement tools further limited the ability to draw firm conclusions in this domain.
These findings suggested that hearing aids and cochlear implants are associated with improved social outcomes. The researchers concluded that clinicians should consider recommending these devices to mitigate social withdrawal and its related adverse health effects among adults with hearing loss.
Full disclosures can be found in the published review.