Additional interventions for enhancing the quality-of-life of older adults using hearing aids: a systematic review and narrative synthesis

PURPOSE: Hearing loss in older adults substantially affects quality of life. Although hearing aids improve hearing, their effects vary. Combining hearing aids with additional interventions may offer added benefits, yet it remains unclear which quality-of-life domains benefit most. This systematic review examined the effects of hearing aids plus supplementary interventions, compared with hearing aids alone, on quality-of-life outcomes. METHODS: Randomized controlled trials (1996–2024) were identified from seven databases. Eligible studies included adults aged ≥ 65 years and compared hearing aids combined with additional interventions with hearing aids alone. Outcomes were categorized into physical, psychological, and older-adult-specific domains using the WHOQOL-100 and WHOQOL-OLD frameworks. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. A narrative synthesis was conducted. RESULTS: Twelve randomized controlled trials involving 892 participants were included. Additional interventions comprised individual at-home training, group-based auditory rehabilitation, empowerment strategy, and telehealth. Individual at-home training showed partial benefits in sensory abilities, self-efficacy, and autonomy. Group-based auditory rehabilitation enhanced communication strategies and positive emotional outcomes in some studies. Empowerment strategy showed favorable psychological effects, while telephone-based telehealth interventions demonstrated limited impact on quality of life. CONCLUSIONS: Combining hearing aids with additional interventions may improve psychological and autonomy-related aspects of quality of life in older adults. However, heterogeneity in intervention content and outcome measurement limits firm conclusions. Future studies should use adequately powered randomized controlled trials, standardized outcome measures, and longer follow-up, and WHOQOL guided evaluation to support more comprehensive and comparable evidence. REGISTRATION: No. 605082.