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 ( OR s) 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