Key messages
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Hearing aids probably cause a large improvement in the ability of adults with mild to moderate hearing loss to take part in everyday life and to listen to other people. They may slightly improve everyday health-related well-being but may make little to no difference to loneliness.
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It is unclear whether hearing aids result in a difference in working memory (the ability to hold information in your mind for a short time and act on it) or cause unwanted effects, such as pain or over-exposure to noise, as there was very limited evidence to help us answer this question.
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We need better and longer studies that report the effects of hearing aids separately for different age groups, sexes, levels of hearing loss, types of hearing aids, social and financial situations, and races and ethnicities.
What is mild to moderate hearing loss?
Hearing loss is very common, with most people affected having mild to moderate hearing loss.
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Mild hearing loss means soft sounds are harder to hear and may result in difficulties listening in noisy backgrounds.
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Moderate hearing loss means speech may not be clear and conversations can be difficult to hear, in quiet as well as noisy backgrounds.
The most common causes of hearing loss are ageing and noise exposure.
How is hearing loss managed?
Hearing aids are the most common technology used to help people with mild to moderate hearing loss and are in widespread use. Hearing aids make sounds louder and aim to make them clearer, so they are easier to hear. This is particularly important for hearing speech. The overall goal of hearing aids is to reduce the impact of hearing loss and improve a person's ability to take part in everyday life.
What did we want to find out?
We wanted to find out if hearing aids were better than other options, such as no hearing aids, placebo (dummy) hearing aids, or education programmes, to improve:
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a person's ability to take part in everyday situations;
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unwanted effects such as pain or those caused by over-exposure to noise;
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well-being related to general health, such as physical and social well-being;
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the ability to listen to other people;
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mental health – we were most interested in loneliness; and
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the ability to think, remember, and learn (cognition) – we were most interested in working memory (holding information in the mind for a short time and acting on it).
What did we do?
We searched for studies that looked at hearing aids for adults with mild to moderate hearing loss compared to other options. We compared and summarised the studies, and then rated our confidence in the evidence based on factors such as study methods, size and duration.
What did we find?
We found 16 studies involving 2261 adults with mild to moderate hearing loss. Their average age was between 58 and 83 years. The studies lasted between four weeks and three years and took place in the USA, Europe, Brazil, Hong Kong, and Australia.
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Hearing aids probably cause a large improvement in the ability of adults with mild to moderate hearing loss to take part in everyday situations (8 studies, 1683 people).
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It is unclear if hearing aids cause unwanted effects. Only one study reported two cases of people feeling pain or discomfort with hearing aids; no studies reported unwanted effects from over-exposure to noise.
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Hearing aids may slightly improve general well-being related to health (4 studies, 1558 people), and probably cause a large improvement in the ability to listen to other people (5 studies, 622 people).
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Hearing aids may result in little or no difference in loneliness (2 studies, 907 people).
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Their effects on working memory are unclear (3 studies, 910 people).
The evidence from this review supports the usual practice of offering hearing aids to adults with mild to moderate hearing loss who seek help for their hearing difficulties.
What are the limitations of the evidence?
There were several limitations. It is often difficult to hide whether someone is wearing hearing aids in a study as they are usually visible. This may affect the accuracy of the results. Studies of three months or less may not be long enough to measure the full range of effects from hearing aids. Some effects may only become evident over a longer period. Studies measured the effects of hearing aids differently, which made them difficult to compare.
How up to date is this review?
This is an update of a review first published in 2017. We last searched for evidence in August 2024. We also included published evidence from existing and ongoing studies up to 18 May 2026.
Read the full abstract
The main clinical intervention for mild to moderate hearing loss is the provision of hearing aids. These are routinely offered and fitted to those who seek help for hearing difficulties. By amplifying and improving access to sounds, and speech sounds in particular, the aim of hearing aid use is to reduce the negative consequences of hearing loss and improve participation in everyday life.
Objectives
To evaluate the benefits and harms of hearing aids in adults with mild to moderate hearing loss.
Search strategy
Cochrane Information Specialists searched CENTRAL, Cochrane ENT registry, MEDLINE, Embase, Web of Science, ClinicalTrials.gov, ICTRP and additional sources for published and unpublished trials. The date of the final search was 2 August 2024. We have also included published existing and ongoing studies up to 18 May 2026.
Selection criteria
Randomised controlled trials (RCTs) of hearing aids compared to a passive or active control in adults with mild to moderate hearing loss.
Data collection and analysis
We used the standard methodological procedures expected by Cochrane. The primary outcomes in this review were hearing-specific health-related quality of life and the adverse effect pain. Secondary outcomes were health-related quality of life, listening ability and the adverse effect noise-induced hearing loss. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics.
Main results
We included five RCTs involving 825 participants. The studies were carried out in the USA and Europe, and were published between 1987 and 2017. Risk of bias across the studies varied. Most had low risk for selection, reporting and attrition bias, and a high risk for performance and detection bias because blinding was inadequate or absent.
All participants had mild to moderate hearing loss. The average age across all five studies was between 69 and 83 years. The duration of the studies ranged between six weeks and six months.
There was a large beneficial effect of hearing aids on hearing-specific health-related quality of life associated with participation in daily life as measured using the Hearing Handicap Inventory for the Elderly (HHIE, scale range 1 to 100) compared to the unaided/placebo condition (mean difference (MD) -26.47, 95% confidence interval (CI) -42.16 to -10.77; 722 participants; three studies) (moderate-quality evidence).
There was a small beneficial effect of hearing aids on general health-related quality of life (standardised mean difference (SMD) -0.38, 95% CI -0.55 to -0.21; 568 participants; two studies) (moderate-quality evidence). There was a large beneficial effect of hearing aids on listening ability (SMD -1.88, 95% CI -3.24 to -0.52; 534 participants; two studies) (moderate-quality evidence).
Adverse effects were measured in only one study (48 participants) and none were reported (very low-quality evidence).
Authors' conclusions
The available evidence suggests that hearing aids likely improve hearing-specific health-related quality of life and listening ability in adults with mild to moderate hearing loss, with a large beneficial effect. Hearing aids may also improve general health-related quality of life. This evidence is compatible with the widespread provision of hearing aids as first-line clinical management in those who seek help for hearing difficulties. The review did not provide evidence that hearing aids were effective at improving loneliness or working memory, nor that hearing aids resulted in adverse effects. To improve the certainty of evidence and ascertain whether the effects of hearing aids vary according to demographics (e.g. age, sex, degree of hearing loss, socioeconomic environment, race and ethnicity), greater consistency is needed in outcome measures used. Longer-term, placebo-controlled studies may be more sensitive to potential effects on mental health and cognition, but it may not be ethically justifiable to withhold hearing aids long term.
Funding
The review had no dedicated funding.
Registration
Registration (2015) PROSPERO: CRD42016043834
Protocol (2015) DOI: 10.1002/14651858.CD012023
Original review (2017) DOI: 10.1002/14651858.CD012023.pub2
