Hearing · graded by use, two uses
Hearing aids for age-related hearing loss
Self-rated hearing-related quality of life and everyday communication, adults with mild to moderate hearing loss.
At a glance
This is about hearing aids for the gradual hearing loss that comes with age. Across many studies, people with hearing aids rated their hearing, conversations and daily life as much better. That is self-rated, so the letter is B. In one study, everyone got the same hearing aids, but half had them set to barely amplify. People with the real settings understood more words in a noisy room. Only that one study tested hearing by a listening test, so that result is C until a second study repeats it.
- What was measured
- Self-rated hearing-related quality of life and everyday communication in adults with mild to moderate hearing loss who wore hearing aids.
- How big
- Across 8 trials with 1,683 people, self-rated hearing-related quality of life was much better with hearing aids (an effect size How large a difference the treatment made, as distinct from whether the difference could be detected at all. of 1.25, large).Read from the summary of PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 42644645.
- Who it applies to
- Adults with mild to moderate hearing loss, average age 58 to 83; not severe loss or cochlear implants.
- Safety
- Ear discomfort, irritation and dryness are the problems reported; in one trial two people stopped wearing the aids.
- Compared with
- A waiting list, no help, health education, or placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received. hearing aids with almost no amplification.
- Certainty
- Grade B, resting on: Randomized trials of hearing aids against placebo hearing aids, a waiting list, no hearing aid or health education, and their Cochrane meta-analysis A study that pools the numbers from several trials into one combined estimate..
- What would change this grade
- Could rise to A with: A second double-blind Neither the participants nor the people assessing them know who received the real treatment until the trial ends. randomized trial of fitted hearing aids against placebo hearing aids, run by a group independent of the existing trial. Who: Adults aged 55 to 85 with mild to moderate age-related hearing loss. Measured: Speech understanding measured in a standardized listening test (speech in noise), scored blind to allocation. Length: At least 3 months of daily wear.
- Cost
- No price recorded yet.
- Sources
- 5 studies cited on this record, listed under Sources.
The B belongs to one of the two uses graded on this record. The other one carries its own letter.
As studied, and the trials
Humes et al. (Am J Audiol, 2017; PMID 28252160) ran a double-blind trial in which every participant received the same hearing aids and only the settings differed: best-practice amplification or placebo settings. On the Connected Speech Test (sentences at 65 dB SPL against competing babble), the gain in words understood was 21.3 rationalized arcsine units with real settings against 8.7 with placebo settings (Cohen's d 0.62). WHY NOT B: under Rule 06 a single positive trial without independent replication The same finding reproduced by a separate research group. A result seen once can be chance or bias; a replicated one is harder to explain away. is a C. No second independent trial has measured speech understanding by test against placebo or no hearing aid; the listening ability pooled in the 2026 Cochrane review is scored on questionnaires and is graded with the self-rated use.
As studied, and the trials
The 2026 Cochrane review pooled 8 trials and 1,683 participants: a large difference in hearing-specific quality of life favoring hearing aids (standardized mean difference -1.25), moderate certainty, downgraded because participants could not be blinded (Ferguson et al., Cochrane Database Syst Rev, 2026; PMID 42644645). Single trials agree: 194 older veterans at 4 months (Mulrow et al., Ann Intern Med, 1990; PMID 2197909), 977 adults aged 70 to 84 through 3 years in ACHIEVE (Sanchez et al., J Am Geriatr Soc, 2024; PMID 39266468), 385 adults in rural China at 20 months (Ye et al., BMC Med, 2022; PMID 35436911), and the double-blind placebo trial (Humes et al., 2017; PMID 28252160). Self-rated, so the letter stops at B.
Read the grade that matches your goal. How EBL grades by use →
A letter describes the human evidence, not the product, the manufacturer, or the intervention's worth.
See the full evidence record →Hearing aids for age-related hearing loss, graded on self-rated hearing-related quality of life and everyday communication in adults with mild to moderate hearing loss: what the randomized trials measured, in whom, and what they did not show.
Why this letter
Why this gradeThe reasoning, and what the grade does not cover.
Grade B on self-rated hearing-related quality of life and communication: replicated across randomized trials and pooled at moderate certainty in the 2026 Cochrane review (PMIDs 42644645, 2197909, 39266468, 35436911), capped at B because it is self-rated. Grade C on speech understanding measured in a listening test: one double-blind trial against placebo hearing aids (Humes et al., 2017; PMID 28252160), which no second independent trial has repeated, so Rule 06 holds it at C.
WHAT THIS GRADE DOES NOT COVERsevere or profound hearing loss and cochlear implants, which the trials did not test; loneliness, where the review found little to no difference; and memory and thinking, graded on its own record (hearing aids for cognitive decline).
A grade describes the human evidence for a named use. It is not advice, and it is not a judgment on any individual prescription. How the letters are decided →
Evidence notes: randomized trial, meta-analysis, independently replicated
Endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. graded: Self-rated hearing-related quality of life and everyday communication in adults with mild to moderate hearing loss (self_report)
Last reviewed: October 2026
The trial that would change this grade.
Positive trials of this shape from independent research groups would move this entry to A.
Why the current trials fall short
The B rests on self-rated quality of life, which caps it at B, and almost every trial had inadequate or no blinding. Speech understanding in a listening test qualifies for A, but only one double-blind placebo trial has measured it, and no independent group has repeated it.
ClinicalTrials.gov, the public registry run by the U.S. National Library of Medicine, lists studies that are recruiting volunteers. The link below searches it for Hearing Aids among studies recruiting now. EBL has no relationship with any listed study and receives no payment for this link.
Search recruiting studies of Hearing Aids on ClinicalTrials.gov
Dose, form and timing
Measured in the graded trials: word recognition on a speech-in-babble test with and without the hearing aids, and the Hearing Handicap Inventory for the Elderly. A hearing test (audiogram) defines mild to moderate loss.
Safety
Ear discomfort, irritation and dryness are the problems reported; in the 2026 Cochrane review, one of six trials that monitored harms reported two cases, one of which stopped wearing the aids.
Cautions documented in human studies. Each caution on this record, sorted by what it rests on.
- Ear discomfort, irritation and dryness are the reported problems: one of six trials that monitored harms reported two cases, one of whom stopped wearing the aids. (PMID 42644645)
None recorded.
None recorded.
None recorded.
Does not apply: human harm data are listed above.
Grade history
How this letter has changedLatest: No. 381 · October 2026 · First graded.
Hearing aids now have a record for what they are for: hearing. Across randomized trials, people with hearing aids rated their hearing-related quality of life much better, pooled at moderate certainty in the 2026 Cochrane review (Ferguson et al., 2026; PMID 42644645): B, capped because it is self-rated. In a double-blind trial, older adults whose hearing aids had real settings understood more words in background babble than those whose identical aids had placebo settings (Humes et al., 2017; PMID 28252160): C, one trial measuring speech by test, not yet repeated (Rule 06). Applied the written grade definitions under the editor's standing instruction of October 2026 (Arnold Sandlow, D.C.).PMID 28252160 PMID 42644645
Every change to a letter on this site is dated and published. The full evidence log →
Sources
- Citations
- Every paper cited on this page is matched to its PubMed record on every build.
- Retractions
- None of these papers is retracted or under a journal expression of concern. PubMed is checked again on every build.
- Read against the papers
- October 2026. By the EBL editor, Arnold Sandlow, DC.
- Outside review
- Not yet done. No reviewer outside EBL has checked this record.
What each of these checks can and cannot show: evidence integrity.
Primary evidenceFive papers, each linked to its PubMed record.
Ferguson et al. (Cochrane Database Syst Rev, 2026; PMID 42644645): 16 randomized trials, 2,261 adults with mild to moderate hearing loss; hearing-specific quality of life SMD -1.25 (8 trials, 1,683 participants, moderate certainty); listening ability SMD -1.28 (5 trials, 622 participants, moderate certainty); general health-related quality of life SMD -0.27 (low certainty); little to no difference in loneliness (low certainty); working memory very uncertain; pain reported twice in one trial (very low certainty). Humes et al. (Am J Audiol, 2017; PMID 28252160): double-blind trial, same hearing aids with best-practice or placebo settings, 154 adults aged 55 to 79; Connected Speech Test benefit 21.3 versus 8.7 rationalized arcsine units (d 0.62); self-rated benefit d 1.25. Mulrow et al. (Ann Intern Med, 1990; PMID 2197909): 194 older veterans, hearing aid or waiting list, 4 months; social and emotional function and communication function improved. Sanchez et al. (J Am Geriatr Soc, 2024; PMID 39266468): ACHIEVE, 977 adults aged 70 to 84, hearing intervention versus health education; self-rated communicative function 8.9 points better at 6 months and 9.5 at 3 years. Ye et al. (BMC Med, 2022; PMID 35436911): 385 adults aged 45 and over in rural China, free hearing aids versus no intervention, 20 months; hearing handicap scores improved. Funding and conflicts: the Cochrane review had no dedicated funding, and three authors' institutions have received payments from hearing aid makers (WSAudiology, Sonova, Cochlear), stated in the review; ACHIEVE investigators report industry relationships, stated in the paper.
Evidence Based Longevity, Inc. is owner-operated and edited by Arnold Sandlow, D.C., a California-licensed chiropractor. Evidence Based Longevity publishes in English only · Machine translations are not produced or reviewed by EBL for accuracy
How EBL searched for the trials (1 search)
The search that was run, what it returned, and what was left out and why, so the absence of evidence can be checked as well as its presence.
(hearing aid*[tiab]) AND (randomized controlled trial[pt]) AND (hearing loss[tiab] OR presbycusis[tiab]) AND (older[tiab] OR elderly[tiab] OR aged[mh] OR "age-related"[tiab])PubMed watch: does a new study change the grade? (nothing new)
No new paper matching the search behind this grade has been added to PubMed since October 2026.
Last run October 2026. A letter on EBL moves only after a logged review. A new paper never moves a letter by arriving: it is read, the answer is written here, and any change to the letter is published in the evidence log.
Disclosure
Educational use only · Not medical advice · EBL grades published human evidence and does not recommend treatment. Stopping a prescription is a decision for your physician.
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