Worse hearing loss tracked with higher death rates in 64,000 adults across four countries

People who hear poorly tend to die sooner, or so a long run of single studies has suggested. A new analysis puts firmer numbers on the pattern. It pooled hearing tests from nearly 14,000 adults in Australia, Iceland and the United States, then checked the result in more than 50,000 Norwegians. Compared with normal hearing, mild hearing loss went with a death rate about 19% higher, and moderate loss with one about 55% higher.

The study, led by Chuan-Ming Li and Howard Hoffman of the US National Institute on Deafness and Other Communication Disorders with colleagues in Australia, Norway and Iceland, was published in September in The Lancet Healthy Longevity. Its authors conclude that increasing severity of hearing loss is significantly associated with higher mortality risk, meaning the link clears the usual statistical bar. People with hearing loss who used hearing aids also had slightly lower death rates. That second result is the one likely to be quoted, and it needs the most care.

How much higher death rates ran with each grade of hearing loss

Death rates climbed with the grade of hearing loss and then flattened: beyond the 19% for mild and 55% for moderate loss, moderately severe or worse loss went with a rate only slightly higher again, about 56% above normal hearing. Deaths from heart disease and stroke followed a looser version of the pattern. In the authors’ summary, all three grades of hearing loss were also associated with increased risk of cardiovascular death, by between about 18% and 43%, though the most severe grade was not the highest.

Read those percentages as relative. They describe how much faster deaths built up in each group over the follow-up, not the chance that any one person would die. They also come after the researchers accounted for differences that could explain the pattern. The analysis adjusted for age, sex, education, BMI, smoking, past angina or heart attack, diabetes, high blood pressure, stroke and a history of noise exposure. BMI, or body mass index, measures weight against height.

Norway showed the same hearing loss pattern, with smaller differences. The replication study of 50,277 adults in the Nord-Trondelag region backed the pooled results. HearingTracker, a trade publication that reported on the paper, notes that the associations between hearing loss and mortality were smaller in the Norwegian data.

How four population studies measured hearing in 64,000 adults

Because hearing loss is so common, a link with it is easy to find and hard to interpret. The World Health Organization estimates that among people older than 60 years, over 25% are affected by disabling hearing loss. Many earlier studies relied on people saying whether they had trouble hearing, which mixes hearing up with health, mood and expectations.

This one used tests. All four populations had pure-tone audiometry, the standard hearing test in which a person signals when they hear tones of different pitches at falling volumes. Each person was graded by the average threshold in their better ear, the ear that hears more, using the World Health Organization’s categories of mild, moderate and more severe loss. The three pooled studies were the Blue Mountains Hearing Study in Australia, the Age, Gene/Environment Susceptibility-Reykjavik Study in Iceland, and the US National Health and Nutrition Examination Survey. Together they held 13,851 people with an average age of 62. The Nord-Trondelag Hearing Loss Study, run in Norway in the late 1990s, served as the check. Across the studies, mortality was tracked for between 10 and 16 years.

The method matters as much as the size. This study is an individual participant data meta-analysis: the researchers went back to each person’s record in every study and analyzed them together under the same definitions. Earlier pooled analyses mostly averaged results that each study had already published in its own way, which is a weaker method.

What hearing aid use was linked to

Among people with hearing loss, those who said they currently used hearing aids died at a rate about 9% lower than those who did not, and at a cardiovascular death rate about 15% lower. In the authors’ words, current use of hearing aids was associated with reduced all-cause mortality risk. The Norwegian figures, as reported by the trade publication HearingTracker, were larger, with aid users showing a 15% lower all-cause mortality hazard and a 16% lower cardiovascular one. The same report notes that the authors classified the hearing aid analyses as exploratory, a secondary look rather than the study’s main test.

That label, and the width of the pooled estimates, keep the numbers modest. The ranges around the pooled figures run right up to the line of no difference, so the true effect could be close to zero.

An earlier study produced a bigger number. In 2024, Janet Choi and colleagues at the University of Southern California, using US adults from the same national survey, partly overlapping with the data used here, found the death rate was lower among regular hearing aid users in comparison with never users, by 24%. Choi’s team counted people as regular users when they reported wearing their aids at least once a week or more often over the past year. People who used their aids less than that showed no difference in death rates at all, and only 12.7% of adults with hearing loss were regular users. Measured that way, the gap looked large; with a broader measure of current use across four countries, the new study’s figure is about 9%.

Why hearing aid users might live longer for other reasons

Choi also wrote the commentary that accompanies the new paper, and Choi’s caution is the most useful thing in it. People who get hearing aids and wear them may be wealthier, see doctors more easily, think and move better, have fuller social lives and be readier to seek care, and each of those can lengthen life on its own. HearingTracker’s account of the commentary lists income and access to health care among those differences. Researchers call this a healthy-user effect: the people who take up a treatment are often healthier or better off to begin with. “Patients should not be advised that hearing aids prolong life on the basis of observational associations alone,” Choi writes.

How hearing aid use was measured adds to the doubt. The four studies asked different questions, and, Choi argues, a combined measure of current use could not fully capture daily wearing time, years of use, benefit or when people started. Someone who bought aids years ago and keeps them in a drawer may count the same as someone who wears them all day. The study’s adjustments covered education and medical history; income, cognition and frailty, the differences most likely to separate users from non-users, were not on the list.

How hearing loss could shorten life, if it does

Earlier research supports the link between hearing loss itself and death more firmly than the hearing aid result. A 2014 analysis of 1,958 adults aged 70 and over in the US Health, Aging, and Body Composition Study found hearing loss associated with a 20% increased mortality risk over eight years. A 2022 review led by Benjamin Tan at the National University of Singapore pooled 14 retrospective and 12 prospective observational studies with more than 1.2 million participants. It found hearing loss associated with 13% higher death rates overall and 28% higher cardiovascular death rates. People with both hearing and vision loss fared worse, with death rates about 40% higher, and the hearing loss link looked weaker in studies with longer follow-up duration.

Why the link exists is open. Hearing loss could contribute to poorer health through communication difficulties, social isolation, extra mental effort, less activity or more injuries. Hearing loss could equally be a marker of something else, such as vascular disease, inflammation or faster biological aging, that harms the ear and the heart at the same time. The tie to cardiovascular deaths fits either story.

What trials of hearing care have shown so far

Only a randomized trial can say whether treating hearing loss changes health beyond hearing, and one has been run on a large scale. The US Aging and Cognitive Health Evaluation in Elders trial, known as ACHIEVE, enrolled 977 adults aged 70 to 84 with untreated hearing loss and without substantial cognitive impairment. Half received hearing care, which included counseling from an audiologist and hearing aids, and half received health education sessions. The hearing care did not reduce 3-year cognitive decline in the primary analysis of everyone in the trial, although it may have helped a subgroup at higher risk.

A later look at the same trial found a 27% reduction in the mean number of falls over 3 years with hearing care, an outcome the team had planned to examine but treated as exploratory. Falls are one plausible route between poor hearing and earlier death. No trial has tested death itself. The new study’s authors write that the possible link between hearing aid use, other hearing rehabilitation and “increased life expectancy in adults is an important area for future research investigation.”

What the hearing loss and mortality study means for hearing care

The gradient carries the most weight. Across four countries and more than 64,000 adults, worse measured hearing tracked with higher death rates, which makes hearing loss look like a marker of wider health risk.

The hearing aid result is weaker, smaller than the 2024 estimate and open to exactly the bias Choi describes. Choi stresses the established benefits of hearing care for communication and everyday hearing, and those stand whatever hearing aids do or do not do for life span. Whether a person’s hearing needs testing or treatment is assessed by a hearing professional or doctor.

For now, hearing aid users living slightly longer is an association worth testing in a trial, and not yet evidence that the devices add years.