The WHAM Study: Socio-Emotional Well-being Effects of Hearing Aid Use and Mediation Through Improved Hearing Ability

Objectives: Hearing impairment can negatively impact socio-emotional well-being. While hearing aids (HA) may improve hearing ability, communication, social participation, and emotional well-being, longitudinal studies are scarce and evidence quality is low. This longitudinal study examines the associations between (research question [RQ] 1) HA uptake and socio-emotional well-being, mediation by self-perceived hearing disability, and differences between subgroups, (RQ2) frequency of HA use (daily number of hours) and socio-emotional well-being, and (RQ3) duration of HA use (years of use) and socio-emotional well-being. Design: Data from October 2006 to January 2024 from the Netherlands Longitudinal Study on Hearing were used for this study. Every 5 yrs, participants were invited to complete an online digits-in-noise hearing test and survey, which included variables on HA use, psychosocial health, tinnitus, hyperacusis, and self-perceived hearing disability. For RQs 1 and 2, cumulative data from three 5-yr intervals (baseline [T0] to 5-yr follow-up [T1], T1-T2, and T2-T3) was compiled, based on eligibility for a HA at the beginning of the studied time interval but not using it at that time and either reporting HA use (HA uptake) or no HA use (no HA uptake) at follow-up and frequency of use at follow-up. Differences between those who adopted a HA versus those who did not were examined while controlling for pre-(non)uptake socio-emotional outcomes. After applying exclusion criteria, the final samples included n = 281 unique participants for RQ1 and n = 280 for RQ2. For RQ3, participants with 5, 10, or 15 yrs of HA use were identified and analyzed to assess the impact of long-term use, with n = 180 unique participants in the final dataset. Outcomes assessed for each RQ were depression, anxiety, distress, somatization, social loneliness, emotional loneliness, and total loneliness. Gamma regression models with generalized estimating equations were performed to analyze all RQs. Results: Approximately 87% of participants were ≤65 yrs of age at T0. Among individuals without tinnitus, HA uptake was significantly associated with lower depression scores (p < 0.05). Among those aged >65 yrs, HA uptake was significantly associated with lower total loneliness scores. No significant associations were found between HA uptake and anxiety, somatization, distress, and emotional loneliness. Self-perceived hearing disability did not mediate the relationship between HA uptake and socio-emotional well-being outcomes. No significant associations between the duration of HA use and socio-emotional well-being outcomes were found. Frequency of HA use was not significantly associated with any outcome except somatization, where using a HA for 1 to 4 hrs per day was significantly associated with lower somatization scores. Conclusions: This longitudinal study contributes valuable evidence to the growing body of research on the psychosocial benefits of HAs, highlighting both the potential and the limitations of device use in improving well-being. Results suggest that audiologists might consider integrating psychosocial support as part of a comprehensive treatment approach beyond simply recommending HA adoption or increased usage.