LM108 - Health-Related Quality of Life Benefits of Hearing Aids: What Is the Evidence?

Abstract:
The AAA Writing Group on the Health-Related Quality of Life (HRQoL) Benefits of Hearing Aids conducted a systematic review, building on a previously presented protocol. Comprehensive search strategies across major databases and trial registries identified studies, which were assessed for bias and included in meta-analyses. Preliminary findings suggest hearing aid use enhances overall HRQoL in adults with SNHL, with emerging evidence in specific domains such as balance, mental health, and cognition. This presentation will provide updates on the group’s progress and discussion on areas where further research is needed.

Summary:
By 2050, nearly 2.5 billion people are projected to have some degree of hearing loss, and at least 700 million will require hearing rehabilitation. Untreated sensorineural hearing loss (SNHL) results in loneliness, isolation, depression, anxiety, risk for falls, and reduction of health-related quality of life (HRQoL). Hearing aids are an effective treatment for most SNHL, yet only one in five who need hearing aids pursues amplification. In 2004, the American Academy of Audiology (AAA) assembled a Task Force to assess the HRQoL benefits of hearing aids for adults, whose systematic review was published in 2007. Since then, an accumulation of studies examining the impact of amplification on HRQoL and evolving definitions of HRQoL warrant a reassessment of the recommendation that hearing aid use enhances HRQoL for adults with SNHL.

Purpose:
The purpose of this session is to present the progress of AAA’s Writing Group on the HRQoL Benefits of Hearing Aids for Adults with SNHL, focusing on the following objectives:
Specific aim 1: To derive a graded recommendation for hearing aid use in improving the HRQoL of adults with SNHL
Specific aim 2: To determine the specific effects of hearing aid use on mental health, cognition, and balance for adults with SNHL
Specific aim 3: To perform subgroup analyses, when appropriate, to determine if patient age, degree of loss, sex, type of amplification, time elapsed since fitting, or verification method differentially affect outcomes

Methods and Analysis:
The methods for this systematic review were based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) 2020 guidelines. The type of studies that were included were systematic reviews of randomized control trials (RCTs); single RCTs; systematic reviews of cohort studies; single cohort; “outcomes” research/ecological studies; systematic review of case-control studies; and case-series studies. Included studies will involve adults (> 18 years) with SNHL with the intervention being hearing aids versus no hearing aids or sham/ placebo. Outcome measures focus on HRQoL generally, and within the specific domains of mental health, cognition, and balance. A comprehensive search and retrieval process identified articles and ongoing trials through relevant databases (CINAHL (via EBSCOhost), Cochrane Library, EMBASE (via Ovid SP), MEDLINE (via Ovid SP), PubMed, Scopus, Citations Indexes of Web of Science, ISRCTN Registry, ClinicalTrials.Gov and WHO International Clinical Trials Registry Platform (ICTRP) to identify published and ongoing trials). The retrieved studies were assessed for risk of bias, had data extracted, and meta-analyses were performed.

Conclusion:
Preliminary findings suggest that hearing aid use may enhance certain areas of HRQoL in adults with SNHL. While some evidence suggests a strong recommendation, the scientific evidence in other domains such as balance, mental health, and cognition is still emerging. This presentation will provide updates on the group’s progress in grading recommendations and identifying areas where further research is needed.

Brief Summary of Clinical Takeaways:
The clinical takeaway from this session is that the evidence is strong for hearing aid use enhancing health-related quality of life for adults with sensorineural hearing loss. Findings may also be useful in engaging stakeholders in the development of health policies to support increased HRQoL through improved access to hearing aid treatments for adults with SNHL.