Association Between Hearing Loss and Social Integration Among Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis.

Purpose: This meta-analysis aimed to examine the association between hearing loss and social integration as well as the effectiveness of audiologic rehabilitation interventions.

Method: Academic databases were comprehensively searched up to December 2023 to identify relevant cross-sectional cohort studies and randomized controlled trials (RCTs) with participants aged 45 years and older. Outcome effects were reported as odds ratios (ORs) for observational studies and standardized mean differences (SMDs) for intervention studies, and pooled analyses were conducted using the random-effects model.

Results: A total of 36 articles published in either Chinese or English were included in this meta-analysis: 11 cohort studies involving 52,037 participants, 23 cross-sectional studies involving 142,067 participants, and two RCTs involving 141 participants. Overall, hearing loss was associated with significantly greater odds of social isolation (OR = 1.19, 95% confidence interval [CI] [1.09, 1.31]) and social inactivity (low level of social participation: OR = 1.32, 95% CI [1.13, 1.54]; high level of social participation: OR = 0.85, 95% CI [0.79, 0.91]) among middle-aged and older adults. No significant effects of audiologic rehabilitation interventions on social integration were found (SMD = 0.22, 95% CI [-0.46, 0.89]).

Conclusions: This systematic review and meta-analysis provides evidence that hearing loss increases the risk of social isolation and reduces social participation among middle-aged and older adults. These findings highlight the importance of providing hearing-related services to enhance social integration in the aging population.

Supplemental material: https://doi.org/10.23641/asha.29941460.