Effectiveness of interventions for social isolation, loneliness, and social participation in older adults with hearing loss: results from a systematic review

BACKGROUND: Hearing loss is increasingly prevalent among older adults and significantly impacts their ability and motivation to communicate. This often results in reduced social participation, increased feelings of loneliness, and a higher risk of social isolation. This review aims to evaluate the effectiveness of interventions designed to improve social participation, reduce loneliness, and mitigate social isolation in older adults with hearing loss. METHODS: This review followed PRISMA guidelines. Keyword and subject heading searches were conducted within MEDLINE, EMBASE, PsycINFO, AgeLine, CINAHL, and ProQuest Sociology. Articles were selected based on pre-defined inclusion and exclusion criteria. Quality assessment was conducted with the Cochrane Risk of Bias and the Risk of Bias in Non-randomized Studies of Interventions tools. RESULTS: The search identified 746 records, of which 11 met inclusion criteria. Two studies employed pilot randomized controlled trial designs, while the remaining studies used prospective pre-post observational designs. Interventions included hearing aids, cochlear implants, assistive listening technologies, and Group Auditory Rehabilitation (GAR). Across study designs, interventions targeting hearing loss were consistently showed improvements in loneliness and social participation, with the strongest and most consistent evidence observed for GAR combined with hearing device uptake. In contrast, social isolation was less frequently measured, limiting conclusions for this outcome relative to loneliness and social participation. CONCLUSIONS: The best available evidence across diverse study designs suggests that hearing interventions, including hearing devices and Group Auditory Rehabilitation, can support improvements in loneliness and social participation in older adults with hearing loss. Although fewer studies have directly examined social isolation, available findings indicate potential benefit. Future research should further evaluate social isolation outcomes, long-term sustainability, and mechanisms of change. SYSTEMATIC REVIEW REGISTRATION: PROSPERO database (reference number CRD42024529695).